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Neuropsychol Rehabil. 2017 Sep;27(6):959-982. doi: 10.1080/09602011.2015.1090459. Epub 2015 Sep 29.

Interventions to increase engagement with rehabilitation in adults with acquired brain injury: A systematic review.

Author information

a Department of Psychology , University of Edinburgh , Edinburgh , UK.
b Department of Psychology , City University London , London , UK.
c Private Practice, St Paul's Practice , London , UK.
d South London and the Maudsley NHS Trust, Liaison Psychiatry for Guy's and St Thomas's Hospital , London , UK.


Rehabilitation in adults with acquired brain injury is often hampered by a lack of client engagement with the rehabilitation process, leading to frustration, withdrawal of services and poorer recovery. Motivation, apathy and awareness are potential mechanisms underlying engagement, but few studies have suggested potential intervention techniques. A systematic review of the literature was carried out to identify and evaluate interventions designed to increase rehabilitation engagement in adults with acquired brain injury. Database searches used the following terms: rehabilitation, brain injury, and compliance/engagement/adherence in PsychInfo, Medline, Cinahl, Embase, AMED, Web of Knowledge, PsycBite, Cochrane clinical trials, and Hand searches were conducted of reference lists and relevant journals. Fifteen studies were included in the review. Intervention techniques fell into two broad categories: behavioural modification techniques and cognitive/meta-cognitive skills. Contingent reward techniques were most effective at increasing adherence and compliance, while interventions enabling clients' active participation in rehabilitation appeared to increase engagement and motivation. The review highlighted methodological and measurement inconsistencies in the field and suggested that interventions should be tailored to clients' abilities and circumstances.


Acquired brain injury; Engagement; Motivation; Rehabilitation

[Indexed for MEDLINE]

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