Treatment Efficacy of Social Communication Skills Training After Traumatic Brain Injury: A Randomized Treatment and Deferred Treatment Controlled Trial

Call for an Integrative and Multi-Disciplinary Approach to Traumatic Brain Injury (TBI)

“…More recently, Dahlberg and colleagues (2007) have developed a program that targets social skills broadly and uses a group process approach, emphasizing self-assessment and individual goal setting, and encouraging generalization through homework and family or friend involvement. The social skills TBI group showed significant improvement in their participation in reciprocal conversation, social style, quantity and clarity of expression, and speech aesthetics, compared to their baseline scores that were not achieved by the control group and these treatment effects were maintained and at 3, 6, and 9 months follow-up (Dahlberg et al, 2007).…”

“…Such a research design can be applied to the acute care setting, as the study that demonstrated that increasing rehabilitation intensity reduces length of hospital stay (Shiel et al, 2001) or in the chronic care setting, where structured, multidisciplinary rehabilitation in a community setting can improve social functioning (Powell et al, 2002). Using a RCT design, investigators have demonstrated that: direct patient involvement in neurorehabilitation goal setting resulted in a significant improvement in obtaining the goals from pre-test to post-test (Webb & Glueckauf, 1994), that donepezil improved attention and short-term memory (Zhang et al, 2004), and social communication skill training improved communication skills (Dahlberg et al, 2007). While findings from a well-designed RCT are statistically the most the convincing, they have limitations that include the financial and resource requirements of conducting such trials, the ethical implications of including a placebo or control group, and the masking of individual treatment responses due to data aggregation and group reporting.…”

A Need for Improved Training Interventions for the Remediation of Impairments in Social Functioning following Brain Injury

“…Briefly, ''Class I'' consisted of prospective randomized controlled trials (RCTs); ''Class II'' consisted of prospective cohort studies, retrospective case-control studies, or controlled clinical series; and ''Class III'' included uncontrolled clinical series or single-subject studies. Based on these criteria, six studies were rated as Class I McDonald, 2008b, 2008c;Dahlberg et al, 2007;Helffenstein and Wechsler, 1982;McDonald et al, 2008;Radice-Neumann et al, 2009), one as Class II ( Johnson and Newton, 1987), and five as Class III (Braunling-McMorrow et al, 1986;Brotherton et al, 1988;Gajar et al, 1984;Guercio et al, 2004;O'Reilly et al, 2000). In most of the studies reviewed here, participants were reported to be medically stable, and classification of injury severity was based on Glasgow Coma Scale scores or duration of post-traumatic amnesia.…”

“…In addition, several studies to date have evaluated the effects of social training interventions in individuals with ABI McDonald, 2008b, 2008c;Braunling-McMorrow et al, 1986;Brotherton et al, 1988;Dahlberg et al, 2007;Gajar et al, 1984;Helffenstein and Wechsler, 1982;Johnson and Newton, 1987;McDonald et al, 2008;O'Reilly et al, 2000;Radice-Neumann et al, 2009). The training studies discussed in this review primarily focused on two functional domains: social communication skills and emotion perception.…”

Personality and Behavior Changes Subsequent to Traumatic Brain Injury: A Review of the Literature

“…Alternative therapies such as music therapy can be useful for patients who experience, loss of language or speech as a result of their injuries (Murrey, 2006). Along with individual psychotherapy, several authors suggest that group therapy may be helpful for those who need additional social skill building or peer support (Crowe, 2008;Dahlberg et al, 2007;Joseph & Linley, 2008).…”