A Randomized Controlled Trial of the Group-Based Modified Story Memory Technique in TBI
Abstract
Background: Difficulties with new learning and memory are among the most common deficits in individuals with traumatic brain injury (TBI) and have been shown to have a negative impact on multiple aspects of everyday life, including employment and social functioning. There is thus a tremendous need for the development of effective interventions for learning and memory dysfunction in TBI. Research to date has shown a one-on-one intervention protocol for memory deficits to be highly effective in persons with TBI and multiple sclerosis (MS), the modified Story Memory Technique (mSMT); however, clinicians highlight a need for group-based protocols due to insurance reimbursement issues. That is, insurance companies are not willing to reimburse for individual cognitive rehabilitation sessions, but they do reimburse for group-based cognitive rehabilitation. There thus exists a critical need to document the efficacy of group-based interventions for memory deficits in persons with MS. The proposed study tests the ability of a group administration of the mSMT to improve memory in persons with moderate to severe TBI. Over a decade of research and development conducted at our center has demonstrated the mSMT to be effective for improving memory in individuals with TBI across three realms of functioning, memory abilities on standardized tests, brain functioning during neuroimaging and everyday life. Given the strong efficacy data on the mSMT, coupled with the current trends in insurance reimbursement, clinicians worldwide have highlighted the need to provide the mSMT via an effective group format. We have thus modified the treatment protocol for group administration. Objective: This pilot RCT will test the efficacy of a group administration of the mSMT for persons with moderate to severe TBI. To date, the research we have conducted on the mSMT has had a profound impact on the lives of persons with TBI and is expected to continue to do so as the treatment is used globally. Results of this study will help all patients with TBI with memory problems. This includes all severities of TBI, as memory deficits are observed across all TBI severities. Importantly, this study is designed to identify an effective intervention format that has the greatest likelihood of being widely available to the greatest number of patients with TBI. The potential clinical applications are therefore immense in that the protocol is simple to administer with a laptop computer and a manual. It is also available in multiple languages. This study will increase the clinical application of the mSMT by offering the treatment in a format more readily reimbursed by insurance companies. Participants receive multiple benefits from participation, with virtually no risks. First, they will be monetarily compensated for their time. Second, they have a 50/50 chance of being assigned to the treatment group and receiving free treatment for their memory deficits. Fourth, if they participate in the neuroimaging portion of the study, they will get a free state-of-the-art MRI (magnetic resonance imaging) scan and can bring the digital images to their physician. Finally, participants will benefit psychologically through the knowledge that they are aiding in the development of new treatment for persons with TBI struggling with memory deficits. Finally, the currently proposed study is highly likely to contribute to advancing TBI treatment, patient care, and/or quality of life. Clinics nationally and internationally seek evidenced-based approaches to treat cognitive dysfunction. The mSMT has demonstrated efficacy when individually administered, but clinicians cite the need for group administration. This study will test the efficacy of just such a program and is thus poised to have a profound impact on persons with TBI through the availability of an effective, group-administered program for treating learning and memory deficits. Effectively treating learning an
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610726
Entities
People
- Nancy Chiaravalloti
Organizations
- Kessler Institute for Rehabilitation
- United States Army