Abstract:
Persisting affective, somatic, cognitive and sensory symptoms are often reported by a significant subset of people who sustain mild or moderate TBI. Objective neuropsychological impairments have been documented in survivors of mild and moderate traumatic brain injuries. These difficulties result in substantial handicap, as people are unable to sustain employment or meet demands of daily living.
Integrated neuropsychological rehabilitation programs that address subjective symptoms, objective neuropsychological deficits, and general functional disability following brain injury have been developed across the nation over the last 15 years. Many of these programs integrate cognitive remediation techniques with psychotherapeutic treatment to help people better adapt to post-injury life. However, the treatment practices and length of treatment vary across programs and the effectiveness of these interventions has not been clearly and scientifically established.
Past research on the topic has suffered from a lack of rigorous control, clouding the answer to the question of whether neuropsychological rehabilitation is efficacious. Studies have been limited by use of incompletely defined intervention procedures, lack of adequate experimental controls, or a primary focus on individuals with severe brain trauma rather than mild and moderate brain injury. By including a fairly homogeneous client population, utilizing an appropriate control group, and using a clearly defined treatment protocol, many of the methodological limitations of previous studies are being addressed.
The present investigation evaluates the effectiveness of a comprehensive rehabilitation program comprised of cognitive-behavioral psychotherapy and cognitive remediation to reduce persisting symptomatology among people with mild and moderate TBI. The overall goal of the program is to improve neuropsychological functioning, emotional well being, and functional status through integration of the remedial and psychotherapeutic interventions.