Goal Management Training Combined With External Cuing as a Means to Improve Emotional Regulation, Psychological Functioning, and Quality of Life in Patients With Acquired Brain Injury: A Randomized Controlled Trial

Sveinung Tornås; Marianne Løvstad; Anne-Kristin Solbakk; Anne-Kristine Schanke; Jan Stubberud

doi:10.1016/j.apmr.2016.06.014

Goal Management Training Combined With External Cuing as a Means to Improve Emotional Regulation, Psychological Functioning, and Quality of Life in Patients With Acquired Brain Injury: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2016 Nov;97(11):1841-1852.e3. doi: 10.1016/j.apmr.2016.06.014. Epub 2016 Jul 15.

Authors

Sveinung Tornås¹, Marianne Løvstad², Anne-Kristin Solbakk³, Anne-Kristine Schanke², Jan Stubberud⁴

Affiliations

¹ Sunnaas Rehabilitation Hospital, Nesodden, Norway. Electronic address: Sveinung.tornaas@sunnaas.no.
² Sunnaas Rehabilitation Hospital, Nesodden, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
³ Department of Psychology, University of Oslo, Oslo, Norway; Division of Surgery and Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway.
⁴ Sunnaas Rehabilitation Hospital, Nesodden, Norway.

PMID: 27424292
DOI: 10.1016/j.apmr.2016.06.014

Abstract

Objective: To investigate whether goal management training (GMT) expanded to include external cuing and an emotional regulation module is associated with improved emotional regulation, psychological functioning, and quality of life (QOL) after chronic acquired brain injury (ABI).

Design: Randomized controlled trial with blinded outcome assessment at baseline, posttraining, and 6-month follow-up.

Setting: Outpatient.

Participants: Persons with ABI and executive dysfunction (N=70; 64% traumatic brain injury; 52% men; mean age ± SD, 43±13y; mean time since injury ± SD, 8.1±9.4y).

Intervention: Eight sessions of GMT in groups, including a new module addressing emotional regulation, and external cuing. A psychoeducative control condition (Brain Health Workshop) was matched on amount of training, therapist contact, and homework.

Main outcome measures: Emotional regulation was assessed with the Brain Injury Rehabilitation Trust Regulation of Emotions Questionnaire, the Emotional Control subscale and the Emotion Regulation factor (Behavior Rating Inventory of Executive Function-Adult Version), and the Positive and Negative Affect subscales from the Dysexecutive Questionnaire. Secondary outcome measures included psychological distress (Hopkins Symptom Checklist-25) and QOL (Quality of Life After Brain Injury Scale).

Results: Findings indicated beneficial effects of GMT on emotional regulation skills in everyday life and in QOL 6 months posttreatment. No intervention effects on measures of psychological distress were registered.

Conclusions: GMT is a promising intervention for improving emotional regulation after ABI, even in the chronic phase. More research using objective measures of emotional regulation is needed to investigate the efficacy of this type of training.

Trial registration: ClinicalTrials.gov NCT02692352.

Keywords: Brain injuries; Clinical trial; Cognition; Emotions; Executive function; Rehabilitation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Brain Injuries / psychology*
Brain Injuries / rehabilitation*
Cues
Emotions*
Executive Function
Female
Goals*
Health Status
Humans
Male
Middle Aged
Mindfulness
Patient Education as Topic / methods
Physical Therapy Modalities
Quality of Life
Stress, Psychological / psychology

Associated data

ClinicalTrials.gov/NCT02692352