Training Programs

Other Training Activities

The RRTC is engaging in three additional types of capacity building/training activities. First, training modules will be developed for dissemination to universities that train psychology interns and medical students; the aim of each module is to expand the TBI knowledge base at an early stage in the careers of these key providers of health care services. Second, a variety of presentations and workshops will be used to educate practicing physicians, psychologists, and other practitioners about important elements in providing health services in the community to people with TBI. Third, opportunities for student training — from high school through graduate studies — are provided to encourage young people to engage in rehabilitation research on TBI and/or to improve their research skills.

Development of Training Modules

• Modular Training for Predoctoral Psychology Interns
  A training module on TBI screening, identification, assessment, and treatment/accommodations will be developed for psychologists-in-training. The module will highlight the negative effects of underidentification, in the voices of individuals with TBI who experienced a failure in timely identification of their brain injury. To expedite dissemination, video conferencing is planned in 2006-2009.
• Modular Training in TBI for Medical Students
  A training module aimed at increasing awareness of TBI amongst "beginning" medical students will be developed. The long-term objective is to have this TBI module become embedded within standard medical school curricula. The module will be created by two physicians with acquired brain injuries, who will provide both professional and personal perspectives. An overview of TBI, screening, differential diagnosis, acute and rehabilitation management, and needed accommodations in medical management of TBI will be highlighted. The module will first be implemented at MSSM. Several strategies will be used for outreach to additional medical schools, e.g., personal contacts with former graduates of MSSM who now hold leadership positions in other PM&R departments. Targeted outreach to other established PM&R departments within large medical schools across the United States and elsewhere will be implemented, with feedback of host institutions solicited to revise the module. A final version will be placed on the RRTC Web site in Year 5.

Training Activities/Workshops for Professionals in Practice

For the following training activities, as dates are set for workshops and presentations, this information will be provided in the Calendar of Events.

• Introductory Training in Evidence-based Practice (EBP) in TBI Rehabilitation
  EBP is a relatively new methodology with which few psychologists or physiatrists are familiar. With the long-term goal of increasing rehabilitation professionals' comfort in use of EBP to select appropriate treatments for individuals with TBI, basic concepts will be presented, in a variety of professional contexts, e.g., APA-Division 22, ACRM, and APMR. Didactics will include an overview of EBP, an introduction to principles underlying EBP and an understanding of how EBP reviews can assist in selection of TBI interventions.
• Advanced Training in EBP in TBI Rehabilitation
  An advanced 12-hour course focused on hands-on processes involved in EBP will be implemented. Training will be divided into four three-hour segments over two months. This pacing will allow for assigned homework between sessions, to maximize EBP skill acquisition. To maximize cross training of rehabilitation professionals, the course will be open to psychologists, postdoctoral fellows, physiatrists, and physiatry residents who have completed the introductory course on EBP or have prior experience in use of EBP. The course will provide direct experience with computerized literature searches, screening and grading of research evidence, coding/abstracting of reported interventions and outcomes, systematic reviews, and completion of meta-analyses related to a specific TBI intervention.
• Post-TBI Depression: Diagnosis and Treatment Implications in Clinical Practice
  Our research has documented patterns of the emergence and resolution of depression, a frequent comorbid psychiatric pathology after TBI and the negative impact of depression on psychosocial functioning. To disseminate this information to psychologists in nonrehabilitation settings, an introductory lecture on issues of post-TBI depression and treatment accommodations will be presented at conferences attended by psychologists in private practice and in mental health settings (e.g., APA, NYSPA).
• Use of Cognitive Behavioral Therapy to Address Post-TBI Depression
  In 2007-2009, preliminary findings emerging from R1 regarding the efficacy of CBT will be incorporated into the training module described above, to become an advanced training workshop in appropriate settings (e.g., APA Division 22, ACRM). Modifications of post-TBI depression treatment, specifically the use of CBT will be discussed. Cross training strategies will be utilized, with targeted outreach directed at both rehabilitation psychologists and psychologists specializing in CBT.
• Psychological Interventions with Older Adults with TBI
  Our longitudinal and cross-sectional research suggests needed shifts in approaches to screening, assessing and treating the elderly with potentially unidentified TBI. Training activities will be targeted to psychologists working in geriatric rehabilitation, private practice, and mental health settings with elderly populations. Didactics will cover approaches to TBI screening, modification of assessment, and needed accommodations in treatment of the elderly with TBI. To maximize outreach to targeted users, abstracts for presentations will be submitted for conferences attended primarily by psychologists in private practice (e.g., APA, NYSPA), in rehabilitation psychology (Division 22 of APA) and those employed in geriatric settings.
• Medical Diagnosis and Treatment in Older Adults with TBI
  This activity will consist of a one-day conference held at MSSM in 2006 and 2008. This effort will bring together physicians from MSSM's Departments of Rehabilitation Medicine and Geriatrics and Adult Development, as well as senior RRTC staff, and will focus on medical diagnostic and treatment issues related to care of the elderly with TBI. Topics to be covered include the prevalence of TBI, screening, differential diagnosis, neuroradiological findings, acute and rehabilitation interventions, pharmacological treatment considerations, psychosocial impact of TBI on the elderly, referral issues, and accommodations within treatment. Targeted audiences will include physiatrists, gero-psychiatrists, and geriatric physicians caring for the elderly.
• Understanding and Implementing Participatory Action Research (PAR)
  The staff of this RRTC has experienced firsthand the benefits of involving individuals with TBI in all aspects of research, training, and dissemination. Creating a PAR environment requires shifts in the traditional research paradigm. Training activities to increase use of PAR in rehabilitation research settings will be targeted to rehabilitation researchers through workshops presented at the annual meetings of ACRM and APPMR.
• Identifying and Accommodating Individuals with TBI in Community Settings
  This activity will focus on educating community service providers about screening their clients for TBI and accommodating TBI-related issues within traditional service delivery systems. The Brain Injury Screening Questionnaire and its companion manual will be introduced as a screening tool with which needed accommodations can be determined. Targeted outreach will be directed to independent living centers and other community service providers.
• Person-Centered Planning for Individuals with TBI
  In recent work, we adapted Personal Futures Planning (PFP) for use with individuals with TBI. A PFP workbook (Moving On), a manual to help facilitators implement PFP, an introductory videotape and a set of slides providing an overview of PFP were developed in collaboration with Dr. Beth Mount, the originator of PFP. In 2003, the State of Minnesota provided funding to update the materials. Also, a TBI Consumer Report Issue No. 8, Person-Centered Planning was developed. In this training activity, these materials will provide the basis for a three-hour workshop aimed at assisting community-based settings in implementing PFP. The workshop will be offered to appropriate organizations expressing interest (contact mary.hibbard@mssm.edu).
• Implementing Peer Mentoring Programs for Individuals and their Families after TBI. In collaboration with the Brain Injury Association of New York State, in 1998-2004 RRTC staff implemented and evaluated a peer-mentoring program for individuals with TBI and their family members. The Brain Injury Association of New Jersey duplicated this model. Most recently, a "Train the Trainer" workshop on the how-to's of funding, implementing, maintaining and evaluating mentoring programs was developed, piloted at a meeting of BIA administrators in Massachusetts and was implemented at a national meeting of HRSA-funded programs. The workshop will be offered to additional appropriate groups expressing interest (contact mary.hibbard@mssm.edu).

Research Training for Graduate Level Students

• Extern Training in Rehabilitation Research
  One year research externships are provided to graduate students enrolled in doctoral or master's level psychology programs. Graduate student externs receive training in different aspects of TBI rehabilitation research, which may include rehabilitation interventions, neuropsychological test administration and scoring, clinical interviewing, data management, research administrative activities, and protection of human subjects/HIPAA regulations. Externs can participate in all didactics open to postdoctoral fellows and psychology interns. Graduate students are recruited through doctoral psychology programs and via e-mail inquiries (contact teresa.ashman@mssm.edu or joshua.cantor@mssm.edu).
• Physiatry Resident Training: Review of Rehabilitation Research
  The goal of this activity is to increase research evaluation skills of physiatry residents. This seminar at MSSM is held twice monthly. In each seminar, current rehabilitation journal articles are reviewed. To enhance critical evaluation skills, residents are taught to critique methodological strengths and weaknesses and critically evaluate study outcomes. Related issues of research protocol development, quantitative research approaches, basic statistics, and study design are discussed.

Research Training for Undergraduate Students

• Undergraduate Psychology Extern Training in Rehabilitation Research.
  Two- to 12-month externships are provided to undergraduates enrolled in either psychology or pre-medicine studies who express interest in gaining preliminary experience in clinical research within the area of rehabilitation. Externships are typically completed in collaboration with a student's college, with academic credit provided for volunteer efforts. Externs receive training in research skills, research recruitment, basic research design, library research, data analysis, data entry, and protection of human subjects/HIPAA regulations. Undergraduate externships will be made available to suitable requestors who contact the RRTC via letter, e-mail teresa.ashman@mssm.edu, or phone.