Research Program

Research Project 1: Treatment of Post-TBI Depression — A Randomized Clinical Trial

Overview

This project compares the effects of cognitive behavioral therapy (CBT) and a standard treatment for depression. Short- and long-term outcomes will be evaluated in terms of changes in mood (primarily depression and anxiety), participation in activities and life satisfaction.

Goals

• Demonstrate the efficacy of cognitive behavioral therapy (CBT), both immediately after treatment and in the long term, in alleviating post-TBI depression.
• Examine the relationship between improved mood, participation, and life satisfaction.
• Implement exploratory analyses of the relationships between person and injury characteristics and outcomes of treatment.
• Maximize potential application to clinical practice by:
  • Implementing the treatment in a clinical context so that its utility is demonstrated in a setting that maximizes ecological validity, and
  • Creating and disseminating a manual detailing CBT treatment modified for use with people who have experienced a TBI.

R1 is a randomized clinical trial that compares two treatment conditions: CBT and supportive psychotherapy (SPT). CBT has been shown to be effective in diverse studies. In R1, CBT has been shaped to be used specifically with people with typical post-TBI cognitive challenges. All participants are given an opportunity to immediately receive a randomly assigned psychotherapy intervention to potentially enhance coping. Both CBT and SPT involve 16 sessions of individual treatment. The initial session is 90 minutes, with remaining sessions 50 minutes. In both treatments, participants are seen for three months, with sessions twice weekly for the first month and once a week subsequently. The research assistants who administer pre- and post-intervention evaluation instruments are blind to each participant's randomly assigned treatment condition. Evaluation instruments are administered at baseline and at three points of follow-up: one week, six months, and one year after treatment. A detailed manual describing treatment methods will be developed based on the intervention; it will be disseminated widely through workshops for professionals and on the RRTC Web site.