Effects of interactive strategy modelling training on problem‐solving by persons with traumatic brain injury

Abstract

Background: Problem‐solving skills may be affected by traumatic brain injury (TBI). Because the ability to solve problems is integral to the social, educational, and vocational reintegration of persons who have sustained a TBI, interventions to improve this executive function have become an important part of rehabilitation.Aims: This Phase I study examined the effects of a behavioural intervention, interactive strategy modelling training (ISMT), on problem solving by individuals who had incurred a TBI.Methods & Procedures: Study participants were 20 individuals recruited from TBI support groups. All lived at home and were several months post‐injury. Participants received a period of ISMT intended to train them to use meta‐cognitive strategies to solve 20‐questions problems. RAPS (Rapid Assessment of Problem Solving), a clinical test of problem solving was used to assess the effects of ISMT (Marshall, Karow, Morelli, Iden, & Dixon, 2003a). RAPS was administered before (Pre‐training), after (Post‐training), and 1‐month after training (Follow‐up).Outcomes & Results: Participants improved in problem solving significantly on RAPS from the Pre‐ to the Post‐training tests. Specifically, they (a) solved problems with fewer questions, (b) asked more constraint‐seeking questions, and (c) increased their question‐asking efficiency scores. These improvements were maintained on the Follow‐up test.Conclusions: Improved problem solving on RAPS was associated with better planning and strategy use, less impulsivity, and strategy shifting. Results suggest that IMST had a therapeutic effect and indicate a need to develop further hypotheses for testing ISMT in functional contexts.