Development of a Brief Version of Compensatory Cognitive Training for Veterans with Mild Traumatic Brain Injury
Abstract
Objective and Rationale of Proposed Study: More than 300,000 Veterans and Active Duty Service Members (ADSM) have sustained a mild traumatic injury (mTBI) since the start of the conflicts in Iraq and Afghanistan. Many of these individuals report cognitive difficulties symptoms (such as memory, attention, and organization problems) that persist even years after the injury. Additional treatment options that are both accessible and effective are needed for these cognitive difficulties. This study aims to develop a brief cognitive rehabilitation (CR) intervention and then evaluate the effectiveness of that treatment in Veterans with a history of mTBI. During the development phase, we will identify the components of the brief CR intervention through a multi-step process. In particular, we will evaluate the results of a recently completed study that showed that a 10-week CR intervention called Compensatory Cognitive Training (CCT) was effective for Veterans with a history of mTBI in terms of improving their day-to-day cognitive functioning and use of strategies to compensate for day-to-day cognitive difficulties. This intervention will be the foundation for the brief CR intervention we are developing. We will also ask clinicians and Veterans for their opinions about CR and current barriers to care for ongoing cognitive difficulties. All of that information will be combined to develop a brief CR intervention, called CCT-Brief, which we anticipate will involve five 90-minute sessions. After this treatment manual is finalized, we aim to conduct a study comparing the effectiveness of CCT-Brief compared to receiving education about mTBI and cognitive functioning. We expect that Veterans who receive the CCT-Brief intervention will report improvement in thinking skills (memory, attention, organization) and increased use of compensatory strategies, compared to those who only receive the education. We also want to understand who benefited from this treatment and who didn’t so we know who to recommend the treatment for in the future. Applicability and Impact of Proposed Future Clinical Trial: This intervention will be designed specifically for Veterans with a history of mTBI who report ongoing cognitive difficulties. We anticipate that this brief intervention will increase access to care by reducing the time and financial burdens associated with lengthy treatments, and lead to improved cognitive functioning, and overall day to day functioning. If this treatment is found to be helpful for Veterans and ADSM who experience persisting cognitive difficulties, this will fill a significant gap in our current treatment options. This intervention could be easily disseminated to Veterans Affairs (VA) and Department of Defense (DoD) facilities across the country, and we will make this information and the treatment materials widely available to the scientific community and to leadership in the VA and DoD. Project Timeline: It will take 1 year to complete all of the activities necessary to identify the components of the CCT-Brief intervention, finalize the treatment manual, and prepare to conduct the study comparing CCT-Brief to the education control condition. If we are able to quickly secure funding for the clinical trial once the development period is finished, we anticipate that results of this study would be available as soon as 2023/24. At that time, if this intervention is found to be effective, the results and recommendations from this study could be quickly disseminated to the Veterans Health Administration (VHA), DoD, academic, and other interested individuals. Importantly, at the end of that study, we hope to know how effective this intervention is, for whom it is most effective, and for what specific outcomes it is most effective. We will also have a treatment manual that can be rapidly made available to other providers for use in their clinical practice.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910531
Entities
People
- Kathleen Pagulayan
Organizations
- Seattle Institute for Biomedical and Clinical Research
- United States Army