Concerned couple embracing

What is the study about?

This study aims to examine the effectiveness of the Therapeutic Couples Intervention (TCI) on caregiver needs and burden after brain injury. TCI is an individually-administered couples intervention (a therapist works with one partner at a time) that focuses on improvement in adjustment and communication. Traumatic brain injury (TBI) can have a negative impact on family relationships including relationship quality. This can be especially true for partners who serve as caregivers who can suffer from depression, anxiety and burden in this new caregiver role.

What did the study find?

This study found that there is evidence supporting that a structured couple’s intervention can reduce unmet needs and burden in caregivers, following brain injury. These findings include improvement in emotional support needs, professional support needs, and community support needs. Post-treatment improvements were still present at the 3-month follow-up. Additionally, caregiver burden continued to decrease after post-treatment to follow-up.

Who participated in the study?

Individuals with brain injuries and their caregiver partners (n=75). Participants were recruited through rehabilitation and community organization referrals and self-referrals through conference presentations, support groups, and newsletters.

How was the study conducted?

This study was a 2-arm, parallel, randomized trial with a waitlist control.

How can people use the results?

Individuals with TBI and their families can use the results of this study to better understand the effects of caregiver burden and how TCI can help improve caregiver wellbeing and partner relationship quality. Practitioners can use these findings to support new approaches to providing support to TBI survivors and their caregiver partners.


Graham, K. M., Kreutzer, J. S., Marwitz, J. H., Sima, A. P., & Hsu, N. H. (2019). Can a couples’ intervention reduce unmet needs and caregiver burden after brain injury? Rehabilitation Psychology. doi:10.1037/rep0000300


The contents of this quick review were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DPKT0009). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this quick review do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.