CogSMART: Cognitive Training for Veterans with Traumatic Brain Injury
This pilot trial evaluated CogSMART for Veterans with TBI, showing reduced symptoms and improved memory. Integrating CogSMART into supported employment may enhance cognitive function and work outcomes.
CogSMART: Cognitive Training for Veterans with Traumatic Brain Injury
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Presentation Transcript
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 • 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.
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.
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.
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.