Enhancing Goal Management Training with Attention Drill Training

Abstract

<h3>Research Objectives</h3> To investigate whether Goal Management Training (GMT) combined with attention drill training improves executive function over GMT alone. <h3>Design</h3> Quasi-experimental two group comparison, before and after. <h3>Setting</h3> Veterans' Administration Outpatient Rehabilitation. <h3>Participants</h3> Veterans with blast-related mild Traumatic Brain Injury (mTBI) previously enrolled to GMT only treatment (n=7) were compared to Veterans with blast-related mTBI treated with GMT plus attention drill training (n=8). <h3>Interventions</h3> GMT is a metacognitive group intervention, presented in 10-weekly, 2-hour PowerPoint interactive sessions. GMT combined with attention drill training included GMT with 10 additional, 2-hour sessions employing three different types of additional attention training: (1) Attention Process Training version-III; (2) use of a Smartphone application called the Veterans' Task Manager to set functional attention goals in a naturalistic setting; and (3) Brain HQ attention tasks 2-3 hours per week. <h3>Main Outcome Measures</h3> Executive Composite Score of the National Institutes of Health Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (NIH EXAMINER). <h3>Results</h3> GMT alone did not result in a significant pre-/post treatment improvement (p=0.44: effect size 0.12) according to the NIH EXAMINER Executive Composite Score. However, GMT plus attention drill training resulted in a significant improvement with a large Cohen's d effect size (p=.006; effect size = 2.23) and had a significantly greater improvement than GMT alone (p=.01). <h3>Conclusions</h3> The addition of attention drill training to GMT significantly improved overall executive function over GMT alone. In a meta-analysis of GMT, effect size was related to the number of sessions (Strenova, 2019), supporting our large effect size findings with the addition of attention training sessions to GMT. A randomized control study is needed to determine whether GMT plus attention drill training improves functioning over GMT alone. <h3>Author(s) Disclosures</h3> The authors have no conflicts to declare.