Executive functioning in TBI from rehabilitation to social reintegration: COMPASS goal, a randomized controlled trial (grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013-2016)

Alexander V. Libin*, Joel Scholten, Manon Maitland Schladen, Ellen Danford, Nawar Shara, Walter Penk, Jordan Grafman, Linda Resnik, Dwan Bruner, Samantha Cichon, Miriam Philmon, Brenda Tsai, Marc Blackman, Alexander Dromerick

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Traumatic brain injury is a major health problem that frequently leads to deficits in executive function. Self-regulation processes, such as goal-setting, may become disordered after traumatic brain injury, particularly when the frontal regions of the brain and their connections are involved. Such impairments reduce injured veterans' ability to return to work or school and to regain satisfactory personal lives. Understanding the neurologically disabling effects of brain injury on executive function is necessary for both the accurate diagnosis of impairment and the individual tailoring of rehabilitation processes to help returning service members recover independent function. Methods/design: The COMPASSgoal (Community Participation through Self-Efficacy Skills Development) program develops and tests a novel patient-centered intervention framework for community re-integration psychosocial research in veterans with mild traumatic brain injury. COMPASSgoal integrates the principles and best practices of goal self-management. Goal setting is a core skill in self-management training by which persons with chronic health conditions learn to improve their status and decrease symptom effects. Over a three-year period, COMPASSgoal will recruit 110 participants with residual executive dysfunction three months or more post-injury. Inclusion criteria combine both clinical diagnosis and standardized scores that are >1 SD from the normative score on the Frontal Systems Rating Scale. Participants are randomized into two groups: goal-management (intervention) and supported discharge (control). The intervention is administered in eight consecutive, weekly sessions. Assessments occur at enrollment, post-intervention/supported discharge, and three months post-treatment follow-up. Discussion: Goal management is part of the "natural language" of rehabilitation. However, collaborative goal-setting between clinicians/case managers and clients can be hindered by the cognitive deficits that follow brain injury. Re-training returning veterans with brain injury in goal management, with appropriate help and support, would essentially treat deficits in executive function. A structured approach to goal self-management may foster greater independence and self-efficacy, help veterans gain insight into goals that are realistic for them at a given time, and help clinicians and veterans to work more effectively as true collaborators.

Original languageEnglish (US)
Article number32
JournalMilitary Medical Research
Volume2
Issue number1
DOIs
StatePublished - Nov 30 2015

Fingerprint

Organized Financing
Rehabilitation
Randomized Controlled Trials
Veterans
Executive Function
Self Care
Brain Injuries
Self Efficacy
Community Integration
Brain Concussion
Aptitude
Return to Work
Health
Practice Guidelines
Language
Wounds and Injuries
Brain

Keywords

  • Community re-integration
  • Executive function
  • Goal-setting
  • Manualized psychosocial intervention
  • Randomized controlled trial
  • Traumatic brain injury
  • Veterans

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Libin, Alexander V. ; Scholten, Joel ; Schladen, Manon Maitland ; Danford, Ellen ; Shara, Nawar ; Penk, Walter ; Grafman, Jordan ; Resnik, Linda ; Bruner, Dwan ; Cichon, Samantha ; Philmon, Miriam ; Tsai, Brenda ; Blackman, Marc ; Dromerick, Alexander. / Executive functioning in TBI from rehabilitation to social reintegration : COMPASS goal, a randomized controlled trial (grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013-2016). In: Military Medical Research. 2015 ; Vol. 2, No. 1.
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title = "Executive functioning in TBI from rehabilitation to social reintegration: COMPASS goal, a randomized controlled trial (grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013-2016)",
abstract = "Background: Traumatic brain injury is a major health problem that frequently leads to deficits in executive function. Self-regulation processes, such as goal-setting, may become disordered after traumatic brain injury, particularly when the frontal regions of the brain and their connections are involved. Such impairments reduce injured veterans' ability to return to work or school and to regain satisfactory personal lives. Understanding the neurologically disabling effects of brain injury on executive function is necessary for both the accurate diagnosis of impairment and the individual tailoring of rehabilitation processes to help returning service members recover independent function. Methods/design: The COMPASSgoal (Community Participation through Self-Efficacy Skills Development) program develops and tests a novel patient-centered intervention framework for community re-integration psychosocial research in veterans with mild traumatic brain injury. COMPASSgoal integrates the principles and best practices of goal self-management. Goal setting is a core skill in self-management training by which persons with chronic health conditions learn to improve their status and decrease symptom effects. Over a three-year period, COMPASSgoal will recruit 110 participants with residual executive dysfunction three months or more post-injury. Inclusion criteria combine both clinical diagnosis and standardized scores that are >1 SD from the normative score on the Frontal Systems Rating Scale. Participants are randomized into two groups: goal-management (intervention) and supported discharge (control). The intervention is administered in eight consecutive, weekly sessions. Assessments occur at enrollment, post-intervention/supported discharge, and three months post-treatment follow-up. Discussion: Goal management is part of the {"}natural language{"} of rehabilitation. However, collaborative goal-setting between clinicians/case managers and clients can be hindered by the cognitive deficits that follow brain injury. Re-training returning veterans with brain injury in goal management, with appropriate help and support, would essentially treat deficits in executive function. A structured approach to goal self-management may foster greater independence and self-efficacy, help veterans gain insight into goals that are realistic for them at a given time, and help clinicians and veterans to work more effectively as true collaborators.",
keywords = "Community re-integration, Executive function, Goal-setting, Manualized psychosocial intervention, Randomized controlled trial, Traumatic brain injury, Veterans",
author = "Libin, {Alexander V.} and Joel Scholten and Schladen, {Manon Maitland} and Ellen Danford and Nawar Shara and Walter Penk and Jordan Grafman and Linda Resnik and Dwan Bruner and Samantha Cichon and Miriam Philmon and Brenda Tsai and Marc Blackman and Alexander Dromerick",
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day = "30",
doi = "10.1186/s40779-015-0061-2",
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Libin, AV, Scholten, J, Schladen, MM, Danford, E, Shara, N, Penk, W, Grafman, J, Resnik, L, Bruner, D, Cichon, S, Philmon, M, Tsai, B, Blackman, M & Dromerick, A 2015, 'Executive functioning in TBI from rehabilitation to social reintegration: COMPASS goal, a randomized controlled trial (grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013-2016)', Military Medical Research, vol. 2, no. 1, 32. https://doi.org/10.1186/s40779-015-0061-2

Executive functioning in TBI from rehabilitation to social reintegration : COMPASS goal, a randomized controlled trial (grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013-2016). / Libin, Alexander V.; Scholten, Joel; Schladen, Manon Maitland; Danford, Ellen; Shara, Nawar; Penk, Walter; Grafman, Jordan; Resnik, Linda; Bruner, Dwan; Cichon, Samantha; Philmon, Miriam; Tsai, Brenda; Blackman, Marc; Dromerick, Alexander.

In: Military Medical Research, Vol. 2, No. 1, 32, 30.11.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Executive functioning in TBI from rehabilitation to social reintegration

T2 - COMPASS goal, a randomized controlled trial (grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013-2016)

AU - Libin, Alexander V.

AU - Scholten, Joel

AU - Schladen, Manon Maitland

AU - Danford, Ellen

AU - Shara, Nawar

AU - Penk, Walter

AU - Grafman, Jordan

AU - Resnik, Linda

AU - Bruner, Dwan

AU - Cichon, Samantha

AU - Philmon, Miriam

AU - Tsai, Brenda

AU - Blackman, Marc

AU - Dromerick, Alexander

PY - 2015/11/30

Y1 - 2015/11/30

N2 - Background: Traumatic brain injury is a major health problem that frequently leads to deficits in executive function. Self-regulation processes, such as goal-setting, may become disordered after traumatic brain injury, particularly when the frontal regions of the brain and their connections are involved. Such impairments reduce injured veterans' ability to return to work or school and to regain satisfactory personal lives. Understanding the neurologically disabling effects of brain injury on executive function is necessary for both the accurate diagnosis of impairment and the individual tailoring of rehabilitation processes to help returning service members recover independent function. Methods/design: The COMPASSgoal (Community Participation through Self-Efficacy Skills Development) program develops and tests a novel patient-centered intervention framework for community re-integration psychosocial research in veterans with mild traumatic brain injury. COMPASSgoal integrates the principles and best practices of goal self-management. Goal setting is a core skill in self-management training by which persons with chronic health conditions learn to improve their status and decrease symptom effects. Over a three-year period, COMPASSgoal will recruit 110 participants with residual executive dysfunction three months or more post-injury. Inclusion criteria combine both clinical diagnosis and standardized scores that are >1 SD from the normative score on the Frontal Systems Rating Scale. Participants are randomized into two groups: goal-management (intervention) and supported discharge (control). The intervention is administered in eight consecutive, weekly sessions. Assessments occur at enrollment, post-intervention/supported discharge, and three months post-treatment follow-up. Discussion: Goal management is part of the "natural language" of rehabilitation. However, collaborative goal-setting between clinicians/case managers and clients can be hindered by the cognitive deficits that follow brain injury. Re-training returning veterans with brain injury in goal management, with appropriate help and support, would essentially treat deficits in executive function. A structured approach to goal self-management may foster greater independence and self-efficacy, help veterans gain insight into goals that are realistic for them at a given time, and help clinicians and veterans to work more effectively as true collaborators.

AB - Background: Traumatic brain injury is a major health problem that frequently leads to deficits in executive function. Self-regulation processes, such as goal-setting, may become disordered after traumatic brain injury, particularly when the frontal regions of the brain and their connections are involved. Such impairments reduce injured veterans' ability to return to work or school and to regain satisfactory personal lives. Understanding the neurologically disabling effects of brain injury on executive function is necessary for both the accurate diagnosis of impairment and the individual tailoring of rehabilitation processes to help returning service members recover independent function. Methods/design: The COMPASSgoal (Community Participation through Self-Efficacy Skills Development) program develops and tests a novel patient-centered intervention framework for community re-integration psychosocial research in veterans with mild traumatic brain injury. COMPASSgoal integrates the principles and best practices of goal self-management. Goal setting is a core skill in self-management training by which persons with chronic health conditions learn to improve their status and decrease symptom effects. Over a three-year period, COMPASSgoal will recruit 110 participants with residual executive dysfunction three months or more post-injury. Inclusion criteria combine both clinical diagnosis and standardized scores that are >1 SD from the normative score on the Frontal Systems Rating Scale. Participants are randomized into two groups: goal-management (intervention) and supported discharge (control). The intervention is administered in eight consecutive, weekly sessions. Assessments occur at enrollment, post-intervention/supported discharge, and three months post-treatment follow-up. Discussion: Goal management is part of the "natural language" of rehabilitation. However, collaborative goal-setting between clinicians/case managers and clients can be hindered by the cognitive deficits that follow brain injury. Re-training returning veterans with brain injury in goal management, with appropriate help and support, would essentially treat deficits in executive function. A structured approach to goal self-management may foster greater independence and self-efficacy, help veterans gain insight into goals that are realistic for them at a given time, and help clinicians and veterans to work more effectively as true collaborators.

KW - Community re-integration

KW - Executive function

KW - Goal-setting

KW - Manualized psychosocial intervention

KW - Randomized controlled trial

KW - Traumatic brain injury

KW - Veterans

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