Journal:Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):14, 1, 95, 43109
Study evaluated the efficacy of the Short-Term Executive Plus (STEP) cognitive rehabilitation program for improving executive dysfunction, attention, and emotional regulation after traumatic brain injury (TBI). The goal of STEP is to teach a core set of metacognitive skills that can be applied across a wide range of real-life activities. The treatments included in STEP are problem solving training, emotional regulation training, attention training, and use of cognitive supports. Ninety-eight participants with TBI and executive dysfunction were randomly to immediately start the STEP program (12 weeks of group training in problem solving and emotional regulation and individual sessions of attention and compensatory strategies training) or to the waitlist. Factor analysis was used to create a composite executive function measure using the Problem Solving Inventory (PSI), Frontal Systems Behavior Scale (FSBS), Behavioral Assessment of the Dysexecutive Syndrome, and Self-Awareness of Deficits Interview. Emotional regulation was assessed with the Difficulties in Emotion Regulation Scale. The primary attention measure was the Attention Rating and Monitoring Scale. Secondary measures included neuropsychological measures of executive function, attention, and memory and measures of affective distress, self-efficacy, social participation, and quality of life (QOL). Intention-to-treat mixed-effects analyses revealed significant treatment effects for the composite executive function measure and the FSBS and PSI. No between-group differences were found on the neuropsychological measures or on measures of attention, emotional regulation, self-awareness, affective distress, self-efficacy, participation, or QOL. Results suggest that the STEP program is efficacious in improving self-reported post-TBI executive function and problem solving.