The proposed study will examine the feasibility, credibility, satisfaction and proof of concept of the ?Recovering Together? dyadic resiliency skills program in improving emotional distress in dyads of patients (pts) with acute neurological illness (ANI) and their family caregivers (cgs) who screen in as at risk for chronic heightened emotional distress (e.g., symptoms of PTS, depression or anxiety) at hospitalization in the Neuroscience Intensive Care Unit (NICU). ?Recovering Together? teaches resiliency skills and interpersonal communication to dyads early in the recovery process, when they embark on their journey for recovery and renewal. We will also explore program related changes in resiliency (e.g., coping, mindfulness, self-efficacy, social support) and interpersonal communication (eg., interpersonal bond). To achieve our aims we will conduct a pilot RCT of the Recovering Together program (2 in person session at hospitalization and 4 via secure live video after discharge,) versus an attention placebo educational control (2 in person sessions and 4 live video after discharge). Both members of the dyad will participate in all sessions. Recovering Together targets and strategies align with the theoretical response-shift framework to adaptation, the family strength vulnerability model, the dyadic longitudinal model, the actor partner interdependence model, and the resiliency framework. Our team is well positioned to conduct this study with specific experience in intervention development with medical populations; established infrastructure in the NICU including ability to recruit and retain participants; and strong preliminary data. Results from this R21 study will be used to apply for funding to conduct a fully powered multi-sited efficacy RCT, if set benchmarks for this feasibility trial are met, through an R01. The goal is dissemination and implementation of the Recovering Together program aimed at optimizing recovery and improving quality of life/wellbeing for both pts and cgs.
The proposed work has the potential to enhance the care of all patients admitted to the NICU and their caregivers who are at risk for chronic heightened emotional distress. The ?Recovering Together? dyadic resiliency program we developed starts in the hospital with 2 in person visits and continue with secure live video after discharge. By improving resiliency and emotional functioning, this program has the potential to improve long-term quality of life and wellbeing, and decrease risk for future illness and mortality in both patients and their caregivers.
