Improving Work Outcomes for Veterans with Traumatic Brain Injury
Annual rept. 1 Sep 2010-31 Aug 2011
VETERANS MEDICAL RESEARCH FOUNDATION (VETERANS AFFAIRS) SAN DIEGO CA
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The study is a 12-month randomized controlled trial comparing supported employment SE plus Cognitive Symptom Management and Rehabilitation Therapy CogSMART, or SE-Cog, to enhanced supported employment ESE for OEFOIF veterans with mild to moderate traumatic brain injury TBI who are unemployed and want to return to work. CogSMART is a manualized, 12-week compensatory cognitive training intervention designed to provide the following 1 psychoeducation 2 strategies to address sleep problems, fatigue, headaches, and stress and 3 strategies to improve prospective memory, attention, learningmemory, and executive functioning. Assessments of cognition, postconcussive symptoms, psychiatric symptoms, functional skills, and quality of life will be administered at baseline, and at 3, 6, and 12 months following study enrollment. Work outcomes i.e., weeks and hours worked, wages earned will be measured weekly during the 12-month study. Results thus far indicate that CogSMART has robust effects on postconcussive symptoms as well as some aspects of neuropsychological performance. In addition, there are CogSMARTassociated trends toward improvement in depressive symptom severity and quality of life. These results suggest that CogSMART, in the context of supported employment, may improve postconcussive symptoms and cognitive performance as well as more distal outcomes such as depressive symptoms, quality of life, and potential work outcomes.
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