Telephone Delivery of Cognitively Augmented Behavioral Activation (Tele-CABA) for Traumatic Brain Injury
Abstract
Rationale and Objectives: Traumatic Brain Injury (TBI) is a significant cause of disability among Veterans and Service members, with long-term physical, cognitive, and mental health consequences. Veterans and Service members with a history of TBI are at increased risk for mental illness and long-term health problems, have greater difficulty reintegrating into society and returning to work, and report more strain on their relationships and reduced life satisfaction. They are also at greater risk for cognitive problems, including long-term cognitive decline related to dementia. The proposed study, Telephone Delivery of Cognitively Augmented Behavioral Activation (Tele-CABA) for TBI, seeks to investigate a 10-week, manualized, cognitive rehabilitation treatment that will be delivered by telephone to Veterans and Service members with a history of TBI. Tele-CABA involves identifying personally meaningful goals and activities while simultaneously learning cognitive strategies to aid in working toward those goals. The long-term objective of this study is to develop an accessible intervention to address the complex needs of patients with TBI. The overall objective of Tele-CABA is to reduce cognitive and psychiatric health distress and promote personal resilience so that Veterans and Service members may feel more productive and satisfied in life. Clinical Impact and Application: It is estimated that 15-23% of Veterans and Service members who served in Iraq and Afghanistan have experienced at least one TBI. Due to the demands of combat, many of these individuals often have little time to recover from their injuries and are at increased risk for persistent cognitive, psychological, and psychosocial difficulties. Post-traumatic stress disorder is one of the most common mental health disorders among Veterans of wartime Service, affecting approximately 15% of Veterans across eras. Also implicated are the impacts of additional common problems, including chronic pain, depression, and functional impairment due to physical injuries. Core symptoms of psychiatric distress frequently observed in those with TBI history include problems with attention and memory, social withdrawal and relationship distress, sleep disturbance, and irritability. When left untreated, these symptoms interfere with daily functioning and diminish quality of life. The Tele-CABA intervention aims to address these challenges in Veterans and Service members by giving them tools to reduce cognitive complaints, encouraging identification of personal values and goals, and promoting life satisfaction. Information gained from this study will be shared with the Federal Interagency Traumatic Brain Injury Research (FITBIR) network to support ongoing research and improve upon treatments for TBI in both the military and civilian communities. Treatments to address the complex needs of Veterans and Service members with a history of TBI are necessary to improve recovery and community reintegration. Currently, few interventions exist, and even fewer provide access for Veterans and Service members who are unwilling or unable to obtain services in Department of Veterans Affairs (VA) or Department of Defense (DoD) clinic settings. Tele-CABA builds upon our prior research and could set the precedent for providing cognitive rehabilitation by telephone. This would have a significant clinical impact in addressing the gap in accessible treatments for Veterans and Service members with a history of TBI. Furthermore, it could reach patients who have limited access to or are uncomfortable with traditional therapeutic settings. There are no known health risks to participating in this treatment. Study participants who receive the Tele-CABA intervention will engage in weekly, 60-minute intervention sessions for a total of 10 consecutive weeks. It is expected that they will experience improvement in their cognitive and mental health, daily function, and personal life satisf
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910747
Entities
People
- Megan Callahan
Organizations
- United States Army
- Veterans Affairs Medical Center (Oregon)