Evaluation of an Intervention for Apathy After Traumatic Brain Injury: A Multiple-Baseline, Single-Case Experimental Design

Background: Apathy is diminished initiation, sustained activity, and concern about goal-directed behaviors. It occurs in between 46% and 71% of adults with traumatic brain injury and has widespread effects. Despite this, evidence for treatment of apathy is sparse, with no evidence for treatments aimed at sustaining activity toward goal-directed behavior. Method: A multiple-baseline, single-case experimental design evaluated a novel treatment for apathy in a 32-year-old man with traumatic brain injury. This treatment incorporated motivational interviewing and external compensation to increase sustained activity toward cumulative goals. Results: A specific treatment effect was demonstrated. Reliable Change Indices indicated a significant decrease in apathy that was maintained at 1-month follow-up. Conclusion: Treatment had a strong and specific effect on treated goal-directed activity and decreased apathy. The success of treatment was dependent on initiation as well as sustaining goal-directed activity.