Background and aims: Impaired communication is a well-documented and enduring consequence of traumatic brain injury (TBI). As a result of this impairment, people with TBI frequently experience communication breakdown and associated stress. Typically, we use communication-specific coping strategies in situations characterised by communication breakdown. Productive strategies enhance message transfer; non-productive strategies do little to resolve problems and frequently result in negative social interaction. This research aimed to evaluate the effectiveness of a new treatment, Communication-specific Coping Intervention (CommCope-I), which specifically targets coping in the context of communication breakdown.Method: Single-case experimental design (A–B–A with follow-up using multiple probes) across two participants was used. Participants were Samantha, a 30-year-old woman who had sustained severe TBI 8 years previously, and Thomas, a 34-year-old man who had sustained severe TBI when he was 29 years old. CommCope-I is a 6-week programme which targets personally relevant productive coping strategies identified collaboratively with the client. Productive coping scripts are developed and practised through a series of graded scenarios that are evaluated with the aid of video recording.Results: Percentage of non-overlapping corrected data (PNCD) was used to analyse the results. PNCD involves a data-correction procedure to remove baseline trend from the data series prior to calculating the change produced as a result of intervention. A large treatment effect was demonstrated in both participants (PNCD: end of treatment Samantha = 100%, Thomas = 100%, 3-month follow-up Samantha = 100%, Thomas = 100%). These results are consistent with highly effective treatment.Conclusions: This study provides sound phase-1 evidence for the effectiveness of CommCope-I.

People with traumatic brain injury (TBI) describe everyday interactions as a long-term challenge frequently associated with ongoing stress. Communication-specific Coping Intervention (CommCope-I) is a new treatment developed to target coping in the context of communication breakdown. The intervention incorporates principles of cognitive behavioural therapy, self-coaching and context-sensitive social communication therapy. The purpose of this study was to examine the effectiveness of CommCope-I in a group of adults with severe TBI and ongoing functional communication difficulties. Participants were 13 adults with severe TBI (GCS = 3-8; mean age = 35.2 years; mean time post-injury = 7.6 years). The project involved three phases: (1) Control/pre-intervention wait phase (multiple assessments), (2) Treatment (6 weeks), and (3) Follow-up (12 weeks). Repeated measures ANOVA with planned pairwise comparisons were used to test the significance of change. Intervention elicited statistically significant improvements in communication-specific coping, functional communication and stress that were maintained for three months. Improved use of communication-specific coping strategies was evident in clinician blind ratings. Clients reported significant reduction in stress at the end of treatment and one and three months later. This intervention provides a promising means of improving communication-specific coping and reducing communication dysfunction and its negative consequences for people with TBI.

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