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Aim

Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial. Elizabeth W. Twamley, PhD; Amy J. Jak, PhD; Dean C. Delis, PhD; Mark W. Bondi, PhD; James B. Lohr, MD. Aim

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Aim

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  1. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial Elizabeth W. Twamley, PhD; Amy J. Jak, PhD; Dean C. Delis, PhD; Mark W. Bondi, PhD; James B. Lohr, MD

  2. Aim • Evaluate 12-wk compensatory cognitive training intervention (Cognitive Symptom Management and Rehabilitation Therapy [CogSMART]) in context of supported employment for Veterans with mild to moderate traumatic brain injury (TBI). • Relevance • TBI can result in cognitive impairments and persistent postconcussive symptoms that limit functional recovery, including return to work.

  3. Method • Participants randomly assigned to 12 wk of: • Supported employment plus CogSMART. • Enhanced supported employment that controlled for therapist attention (control). • Employment specialist delivered CogSMART sessions, which included psychoeducation on: • TBI. • Improving sleep, fatigue, headaches, and tension. • Compensatory cognitive strategies in prospective memory, attention, learning and memory, and executive functioning.

  4. Results • Supported employment + CogSMART demonstrated: • Significantly reduced postconcussive symptoms. • Improved prospective memory functioning. • Small to medium effect sizes favoring CogSMART for: • Posttraumatic stress disorder symptom severity, depressive symptom severity, and attainment of competitive work within 14 wk. • CogSMART participants rated intervention highly.

  5. Conclusion • Adding CogSMART to supported employment may improve postconcussive symptoms and prospective memory. • These effects (plus smaller effects on psychiatric symptoms and ability to return to work) warrant replication in larger trial.

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