• Joanne Azulay, Colette M Smart, Tasha Mott, and Keith D Cicerone.
• JFK Johnson Rehabilitation Institute, University of Victoria, British Columbia, Canada.
• J Head Trauma Rehabil. 2013 Jul 1;28(4):323-31.

ObjectiveTo evaluate the effectiveness of the mindfulness-based stress reduction (MBSR) program tailored to individuals with mild traumatic brain injury (mTBI).DesignA convenience sample recruited from clinical referrals over a 2-year period completed outcome measures pre- and posttreatment intervention.SettingPost-acute brain injury rehabilitation center within a suburban medical facility.ParticipantsTwenty-two individuals with mTBI and a time postinjury more than 7 months. Eleven participants were men and 11 were women, ranging in age from 18 to 62 years.InterventionA 10-week group (with weekly 2-hour sessions) modeled after the MBSR program of Kabat-Zinn, but with modifications designed to facilitate implementation in a population of individuals with brain injury. (The treatment involved enhancement of attentional skills, in addition to increased awareness of internal and external experiences associated with the perspective change of acceptance and nonjudgmental attitude regarding those experiences).Main Outcome MeasuresPerceived Quality of Life Scale, Perceived Self-Efficacy Scale, and the Neurobehavioral Symptom Inventory. Secondary measures included neuropsychological tests, a self-report problem-solving inventory, and a self-report measure of mindfulness.ResultsClinically meaningful improvements were noted on measures of quality of life (Cohen d = 0.43) and perceived self-efficacy (Cohen d = 0.50) with smaller but still significant effects on measures of central executive aspects of working memory and regulation of attention.ConclusionThe MBSR program can be adapted for participants with mTBI. Improved performance on measures associated with improved quality of life and self-efficacy may be related to treatment directed at improving awareness and acceptance, thereby minimizing the catastrophic assessment of symptoms associated with mTBI and chronic disability. Additional research on the comparative effectiveness of the MBSR program for people with mTBI is warranted.

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