Window to Hope: A Randomized Controlled Trial of a Psychological Intervention for the Treatment of Hopelessness Among Veterans With Moderate to Severe Traumatic Brain Injury

J Head Trauma Rehabil. 2018 Mar/Apr;33(2):E64-E73. doi: 10.1097/HTR.0000000000000351.


Objective: To evaluate the efficacy of a psychological intervention to reduce moderate to severe hopelessness among Veterans with moderate to severe traumatic brain injury (TBI).

Design: Two-arm parallel group, controlled, randomized crossover trial, with 3-month follow-up for those initially allocated to treatment. Participants were randomly allocated in blocks of 4 on a 1:1 ratio to treatment (n = 15) or waitlist (n = 20) groups.

Setting: A Veterans Affairs Medical Center.

Participants: Veterans between the ages of 26 and 65 years, with a history of moderate to severe TBI, and moderate to severe hopelessness.

Interventions: A 20-hour manualized small group cognitive-behavioral intervention.

Main outcome measures: Beck Hopelessness Scale (primary), Beck Depression Inventory, and Beck Scale for Suicide Ideation.

Results: A significant difference between groups was found for postintervention scores on the Beck Hopelessness Scale (P = .03). Significant decreases were maintained at follow-up. For those initially allocated to the waitlist group who completed the intervention, treatment gains were noted in decreased hopelessness (P = .01) and depression (P = .003).

Conclusions: Findings from this trial provide additional support for the efficacy of this method of psychological treatment of hopelessness among individuals with moderate to severe TBI.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Brain Injuries, Traumatic / psychology*
  • Brain Injuries, Traumatic / therapy*
  • Cognitive Behavioral Therapy*
  • Cross-Over Studies
  • Depressive Disorder / prevention & control
  • Female
  • Hope*
  • Humans
  • Male
  • Middle Aged
  • Suicidal Ideation
  • Treatment Outcome
  • Veterans / psychology*