Use of SMS Messaging to Promote Emotional Health for People With Traumatic Brain Injury: A Randomized Controlled Trial

Emotional distress is a significant problem for people with TBI, but few empirically validated treatments are available. Behavioral Activation (BA) is a promising model for TBI because it is conceptually simple, involving translation of important life values into the planning of activities that, by the theory underpinning BA, should improve mood through greater exposure to environmental reward. In this randomized controlled trial, we will develop a brief (2 hour) manualized BA treatment for participants with TBI who report at least mild depression and/ or anxiety. Treatment will include the development of implementation intentions, which are grounded in theories of action phases and consist of if-then statements that serve as reminders to seize on opportunities to carry out plans, and to overcome the obstacles involved. Participants will receive their own implementation intentions via SMS (text) messages daily for 8 weeks. A comparison group will receive a brief motivational session followed by 8 weeks of self-selected SMS messages expressing general encouragement to work on goals. Outcome measures will assess perceived degree of environmental reward, degree of behavioral activation, emotional status, societal participation, and satisfaction with life. Significant others will also provide ratings of community participation.