The Carers Way Ahead: a randomized controlled trial of an online psychoeducational programme for families managing challenging behaviours following traumatic brain injury

Challenging behaviours following acquired brain injury can lead to social isolation, reduced quality of life, and carer distress. The online “Carers Way Ahead” (CWA) support programme advises families how to manage behaviours and promotes self-care. An RCT determined if CWA reduces challenging behaviours and improves carer mood, family function and general health. 44 carers of individuals with ABI were randomly allocated to Active Treatment (n = 23; 10-week intervention) or Waitlist control (n = 21). A clinical psychologist provided input as needed. Primary and secondary outcomes were measured pre and post intervention and, where possible, at 6- and 12-month follow-up. Following intervention, the Active group reported reduced depression, anxiety, and stress (d:.84–1.22). No other outcomes were significant. Post hoc, pre–post analyses of everyone who received the intervention (N = 35) indicated improved behaviour, carer mood, family functioning, and strategy use, with many gains sustained at 6 months post-intervention. On average, clinicians provided two hours of support per carer. To conclude, CWA is effective for improving carer mood. The RCT was underpowered, so changes in other outcomes remain ambiguous, but future studies may address this. CWA is now available in seven languages https://cwa.psy.unsw.edu.au/.