Goal-oriented attentional self-regulation training in individuals with acquired brain injury in a subacute phase: a pilot feasibility study

Abstract

The primary aim of this prospective pilot study was to assess feasibility of implementing goal-oriented attentional self-regulation (GOALS) training in Slovenia with patients with multiple cognitive deficits after acquired brain injury in acute phase of recovery. Seven patients with acquired brain injury (i.e. stroke, traumatic brain injury, and subarachnoid hemorrhage) with a mean postinjury time of 4.3 months (SD = 1.25) and mean age of 34.5 years (SD = 18.6) were recruited for the study. The group program consisted of 10 sessions twice a week and included cognitive strategy training, social skills training, and psychoeducation. Structured interviews and neuropsychological tests were used before and after the training to determine the influence of the interventions on daily life tasks and attentional networks performance involving cognitive and behavioral domains. GOALS influenced self-reports of positive effect on the individual goals set by the patients. Training had a positive influence on executive control and memory. The results from the present study suggest that it is feasible to implement GOALS manualized executive function training in Slovenia, with the patients in a somewhat more acute stage than in previous studies, and that GOALS training may be a promising nonpharmacological treatment for cognitive and behavioral difficulties after acquired brain injury. Further research is needed to extend these findings in a larger sample.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part III: Executive Functions

“…As well, a small, single-arm pilot study assessed feasibility in 7 individuals with ABI of the goal-oriented attentional self-regulation (GOALS) program following ABI. They found significant pre- to postimprovements on neuropsychological measures of executive control and self-report of goal attainment 24. Lastly and as described earlier, Cantor et al18 found significant treatment effects, predominantly for self-reported executive function deficits.…”

“…They found significant pre-to postimprovements on neuropsychological measures of executive control and self-report of goal attainment. 24 Lastly and as described earlier, Cantor et al 18 found significant treatment effects, predominantly for self-reported executive function deficits.…”

“…The evidence base for treating individuals with metacognitive strategies in our prior guidelines included 21 studies, 8 of which were RCTs. Since then, 4 new studies have been included 18,24–26. Overall, the weight of the evidence continues to support the use of meta-cognitive strategies to enhance executive functioning.…”

“…Since then, 4 new studies have been included. 18,[24][25][26] Overall, the weight of the evidence continues to support the use of metacognitive strategies to enhance executive functioning.…”

Efficacy of Intervention of Participation and Executive Functions (I-PEX) for Adults Following Traumatic Brain Injury: A Preliminary Pilot Randomized Controlled Trial

“…Jeffay et al 11 recommend conducting it at least 6 months post-TBI, likely due to the limited research examining EF interventions in the subacute phase. [13][14][15][16] Both recommend strategies that focus on functional outcomes personally relevant to patients.…”