This article and any supplementary material should be cited as follows: Twamley EW, Jak AJ, Delis DC, Bondi MW, Lohr JB. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial. J Rehabil Res Dev. 2014;51(1):XX–XX. http://dx.doi.org/10.1682/JRRD.2013.01.0020

Slideshow ProjectDOI:10.1682/JRRD.2013.01.0020JSP

Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for

Veterans with traumatic brain injury: Pilot randomized controlled trial

Elizabeth W. Twamley, PhD; Amy J. Jak, PhD; Dean C. Delis, PhD; Mark W. Bondi, PhD; James B. Lohr, MD

This article and any supplementary material should be cited as follows: Twamley EW, Jak AJ, Delis DC, Bondi MW, Lohr JB. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial. J Rehabil Res Dev. 2014;51(1):XX–XX. http://dx.doi.org/10.1682/JRRD.2013.01.0020

Slideshow ProjectDOI:10.1682/JRRD.2013.01.0020JSP

• Aim– Evaluate 12-wk compensatory cognitive training

intervention (Cognitive Symptom Management and Rehabilitation Therapy [CogSMART]) in context of supported employment for Veterans with mild to moderate traumatic brain injury (TBI).

• Relevance– TBI can result in cognitive impairments and persistent

postconcussive symptoms that limit functional recovery, including return to work.

This article and any supplementary material should be cited as follows: Twamley EW, Jak AJ, Delis DC, Bondi MW, Lohr JB. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial. J Rehabil Res Dev. 2014;51(1):XX–XX. http://dx.doi.org/10.1682/JRRD.2013.01.0020

Slideshow ProjectDOI:10.1682/JRRD.2013.01.0020JSP

Method• Participants randomly assigned to 12 wk of:– Supported employment plus CogSMART. – Enhanced supported employment that controlled for

therapist attention (control).

• Employment specialist delivered CogSMART sessions, which included psychoeducation on:– TBI.– Improving sleep, fatigue, headaches, and tension.– Compensatory cognitive strategies in prospective memory,

attention, learning and memory, and executive functioning.

This article and any supplementary material should be cited as follows: Twamley EW, Jak AJ, Delis DC, Bondi MW, Lohr JB. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial. J Rehabil Res Dev. 2014;51(1):XX–XX. http://dx.doi.org/10.1682/JRRD.2013.01.0020

Slideshow ProjectDOI:10.1682/JRRD.2013.01.0020JSP

Results

• Supported employment + CogSMART demonstrated:– Significantly reduced postconcussive symptoms.– Improved prospective memory functioning.

• Small to medium effect sizes favoring CogSMART for:– Posttraumatic stress disorder symptom severity,

depressive symptom severity, and attainment of competitive work within 14 wk.

• CogSMART participants rated intervention highly.

This article and any supplementary material should be cited as follows: Twamley EW, Jak AJ, Delis DC, Bondi MW, Lohr JB. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic brain injury: Pilot randomized controlled trial. J Rehabil Res Dev. 2014;51(1):XX–XX. http://dx.doi.org/10.1682/JRRD.2013.01.0020

Slideshow ProjectDOI:10.1682/JRRD.2013.01.0020JSP

Conclusion

• Adding CogSMART to supported employment may improve postconcussive symptoms and prospective memory.

• These effects (plus smaller effects on psychiatric symptoms and ability to return to work) warrant replication in larger trial.