Feasibility of a skills-based substance abuse prevention program following traumatic brain injury

OBJECTIVE: To demonstrate the feasibility of a skills-based substance abuse prevention counseling program in a community setting for adults who sustained traumatic brain injury. PARTICIPANTS: Convenience sample of 117 participants (mean age = 35 years) with preinjury history of alcohol or other drug use. Intervention group participants (n = 36) from 3 vocational rehabilitation programs; a no-intervention comparison group (n = 81) from an outpatient rehabilitation service. INTERVENTION: 12 individual counseling sessions featuring skills-based intervention. MAIN OUTCOME MEASURES: Changes in self-reported alcohol and other drug use, coping skillfulness, affect, and employment status from baseline to 9 months postintervention. RESULTS: Significant differences were noted at baseline for the intervention and comparison groups on ethnicity, time postinjury, marital status, and employment (P < .05). At the 9-month follow-up, the intervention group participants achieved a statistically significant decrease in alcohol and drug use (P < .05), increase in coping skillfulness (P < .01), and increased likelihood of maintaining employment (P < .01) relative to the comparison group. Controlling for baseline-adjusted means for the intervention and comparison groups, a statistically significant group difference in adjusted change was noted; the intervention group participants reported lower negative affect at the 9-month follow-up assessment (P < .05). CONCLUSIONS: A skills-based intervention provides a promising approach to promoting abstinence from all substances and increasing readiness for employment for adults with traumatic brain injuries in outpatient settings.