patients diagnosed with TBI cope better with counseling and outreach programs when dealing with new or abnormal behaviors?
Traumatic brain injury (TBI) may result in social and emotional defects (such as delayed word recall) that result in frustrating and embarrassing moments for the victim. Of all counseling and intervention programs, rehabilitation therapy (CRT) is the one that is commonly used and, therefore, this literature review will conduct a meta-analytic search (focusing on quantitative studies within the last five years) in order to assess the efficacy of CRT in helping TBI individuals with their social and emotional skills and perceptions.
The essay identified and reviewed seven randomized trials of language, emotional and social communication cognitive rehabilitation. Inclusion terms were that participants had to possess sufficient cognitive capacity to be included in a group and impairment in emotional and social skills was evidenced either by a questionnaire or by the clinician's reference. All of the studies were on chronic and moderately severe TBI.
Description of studies
Bornhofen and McDonald (2008a; 2008b) reported two trials that dealt with emotion deficits. Their program used group activities as well as home assignment and journal notation to teach skills for emotion perception. Sessions were 25 hours held over 8 weeks. The 12 participants were randomly recruited either to treatment or to a waitlist group. Researchers used facial expression (naming and matching), The Awareness of Social Inference Test (TASIT), and psycho-social reintegration as studies of outcome. TASIT showed significant results when individuals were tested immediately post treatment, with minimal results between intervention group and control on others. More significant results on all measures of intervention were however seen when follow up tests were taken a month later.
Bornhofen and McDonald (2008b) repeated their trial in order to identify the effective components of the program and see which of the counseling / treatment aspects were most responsible for improvement. They used three groups: self-instruction training, errorless strategy, and a waitlist. There were 25 hours across 10 weeks and a therapist worked with each group. The 18 participants were randomized across the three groups, and outcome measures included facial expression recognition, facial expression naming and matching, psycho-social reintegration, and depression and anxiety, as well as relative ratings of adjustment, social performance, and psycho-social reintegration. Few differences showed between the different elements used in the programs for treatment.
McDonald et al. (2008) conducted a randomized trial of social emotion perception training and social behavior compared to a control group. Each was 48 hours. Group sessions focused on social behavior (2 hours) and emotion training (1 hour) and a third intervention was CBT (1 hour). Social behavior was measured by the Partner Directed Behavior Scale and the Personal Conversational Style Scale as well as the TASIT for anxiety and Katz Adjustment Scale. Apparently, the social behavior treatment program (using skills other than CBT) was more effective than the CBT prong.
Schwandt et al. (2012) investigated the efficacy of aerobic exercise intervention in reducing depression of TBI individuals and helping them cope with their emotion. The design was a 12-week aerobic exercise program that was composed of a single group; participants were tested both before and after the program. Participants were randomly selected from a group of patients who were recruited form an outpatient clinic and had some physical impairment. The 12 participants were at least 11 months post injury. Measures used were the Hamilton Rating Scale for Depression; aerobic capacity (cycle ergometer, heart rate at reference resistance, perceived exertion); Rosenberg Self-Esteem Scale and program perception (survey). The participant's observation of effect of program was noted and summarized. Descriptive statistics also collated and described comparison between pre- and post -- results. Outcome showed significant increase in self-esteem, as well as enhanced skill in physical movements and reduction of depression. There were no adverse effects. Researchers concluded that an aerobic program is extremely helpful for TBI patients. Further research needs to be conducted on intensity, frequency, and duration of such a program.
Chard et al. (2011) used a far larger group -- 42 participants from a Veterans Administration residential program to test for the efficacy of psychoeducational activities and CBT on comorbid posttraumatic stress disorder (PTSD) and TBI. The participants were randomly selected between the two control groups. Each program…