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 language | English (US) |
|---|---|
| Article number | 32 |
| Journal | Military Medical Research |
| Volume | 2 |
| Issue number | 1 |
| DOIs | |
| State | Published - Nov 30 2015 |
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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
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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 journal › Article
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
UR - http://www.scopus.com/inward/record.url?scp=84966430682&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84966430682&partnerID=8YFLogxK
U2 - 10.1186/s40779-015-0061-2
DO - 10.1186/s40779-015-0061-2
M3 - Article
C2 - 26664736
AN - SCOPUS:84966430682
VL - 2
JO - Military Medical Research
JF - Military Medical Research
SN - 2095-7467
IS - 1
M1 - 32
ER -