Hélène Audrit1, Miriam H Beauchamp2, Simon Tinawi3, Maude Laguë-Beauvais3, Elaine de Guise4. 1. Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada. 2. Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada. 3. McGill University Health Centre, Traumatic Brain Injury program, Montreal, Quebec, Canada. 4. Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada; Research Institute of McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: elaine.de.guise@umontreal.ca.
Abstract
BACKGROUND: Mild traumatic brain injury (mTBI) is associated with persistent post-concussive symptoms (PCSs) in approximately 15% of cases. These symptoms can be somatic (e.g., headache), cognitive (e.g., forgetfulness, poor attention and concentration capacities), emotional (e.g., anxiety, depression, irritability) and/or sleep-arousal complaints (e.g., fatigue, sleep problems). Although practice guidelines recommend early intervention to prevent and treat PCS, we still lack an effective, standardized, integrative, post-acute intervention based on a sound and validated theoretical model. OBJECTIVES: The purpose of this article is to present the development and theoretical background underpinning a novel intervention for patients with PCSs in the post-acute phase after mTBI (1-3 months post-injury). PROCEDURE: With a biopsychosocial approach (Hou et al., 2012) and best practice recommendations, we developed a novel multidimensional intervention targeting factors that perpetuate PCSs and that can be changed with the intervention. This individual-session intervention provides practical tools for managing PCSs and is designed to provide psycho-education and reassurance, reinforce individual objectives and promote a return to activities. Each session targets one category of PCSs: Sleep/fatigue, Attention, Anxiety/depressed mood, Memory/Organization (SAAM intervention). The rationale underlying the choices of format and content for the intervention is discussed, as are the associated strengths, limitations, opportunities and challenges. CONCLUSION: This article could support researchers and clinicians to develop, replicate and/or implement interventions addressing current best practices in mTBI management.
BACKGROUND: Mild traumatic brain injury (mTBI) is associated with persistent post-concussive symptoms (PCSs) in approximately 15% of cases. These symptoms can be somatic (e.g., headache), cognitive (e.g., forgetfulness, poor attention and concentration capacities), emotional (e.g., anxiety, depression, irritability) and/or sleep-arousal complaints (e.g., fatigue, sleep problems). Although practice guidelines recommend early intervention to prevent and treat PCS, we still lack an effective, standardized, integrative, post-acute intervention based on a sound and validated theoretical model. OBJECTIVES: The purpose of this article is to present the development and theoretical background underpinning a novel intervention for patients with PCSs in the post-acute phase after mTBI (1-3 months post-injury). PROCEDURE: With a biopsychosocial approach (Hou et al., 2012) and best practice recommendations, we developed a novel multidimensional intervention targeting factors that perpetuate PCSs and that can be changed with the intervention. This individual-session intervention provides practical tools for managing PCSs and is designed to provide psycho-education and reassurance, reinforce individual objectives and promote a return to activities. Each session targets one category of PCSs: Sleep/fatigue, Attention, Anxiety/depressed mood, Memory/Organization (SAAM intervention). The rationale underlying the choices of format and content for the intervention is discussed, as are the associated strengths, limitations, opportunities and challenges. CONCLUSION: This article could support researchers and clinicians to develop, replicate and/or implement interventions addressing current best practices in mTBI management.
Authors: Daniel H Daneshvar; Christine M Baugh; Roberto D Lama; Maya Yutsis; Roy D Pea; Shelley Goldman; Gerald A Grant; Robert C Cantu; Lee M Sanders; Ross D Zafonte; Brian Hainline; Piya Sorcar Journal: Neurotrauma Rep Date: 2021-12-08