Abstract
Objective
To evaluate the effectiveness of a replicable group treatment program for improving
social competence after traumatic brain injury (TBI).
Design
Multicenter randomized controlled trial comparing 2 methods of conducting a social
competency skills program, an interactive group format versus a classroom lecture.
Setting
Community and veteran rehabilitation centers.
Participants
Civilian, military, and veteran adults with TBI and social competence difficulties
(N=179), at least 6 months postinjury.
Interventions
The experimental intervention consisted of 13 weekly group interactive sessions (1.5h)
with structured and facilitated group interactions to improve social competence, and
the control consisted of 13 traditional classroom sessions using the same curriculum
with brief supplemental individual sessions but without structured group interaction.
Main Outcome Measures
Profile of Pragmatic Impairment in Communication (PPIC), an objective behavioral rating
of social communication impairments after TBI. LaTrobe Communication Questionnaire
(LCQ), Goal Attainment Scale (GAS), Satisfaction with Life Scale, Posttraumatic Stress
Disorder Checklist-C (PCL) civilian version, Brief Symptom Inventory 18 (BSI-18),
Scale of Perceived Social Self-Efficacy (PSSE).
Results
Social competence goals (GAS) were achieved and maintained for most participants regardless
of treatment method. Significant improvements in the primary outcome (PPIC) and 2
of the secondary outcomes (LCQ and BSI) were seen immediately posttreatment and at
3 months posttreatment in the alternative treatment arm only; however, these improvements
were not significantly different between the group interactive structured treatment
and alternative treatment arms. Similar trends were observed for PSSE and PCL-C.
Conclusions
Social competence skills improved for persons with TBI in both treatment conditions.
The group interactive format was not found to be a superior method of treatment delivery
in this study.
Keywords
List of abbreviations:
AT (Alternative Treatment), BSI (Brief Symptom Inventory), GAS (Goal Attainment Scale), GIST (group interactive structured treatment), LCQ (LaTrobe Communication Questionnaire), MTBI (mild traumatic brain injury), OSU-TBI-ID (Ohio State University Traumatic Brain Injury Identification), PCL-C (Posttraumatic Stress Disorder Checklist-Civilian Version), PPIC (Profile of Pragmatic Impairment in Communication), PSSE (Scale of Perceived Social Self-Efficacy), PTSD (posttraumatic stress disorder), RAVLT (Rey Auditory Verbal Learning Test), SWLS (Satisfaction with Life Scale), TBI (traumatic brain injury), TMT (Trail Making Test), VA (Department of Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 02, 2018
Footnotes
Current affiliation for Bell, Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX.
Supported by the US Department of Defense award number W81XWH-11-1-0635 (grant no. PT100068).
Clinical Trial Registration No.: NCT01465269.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
