Improving natural social interaction: Group rehabilitation after Traumatic Brain Injury

Abstract

ABSTRACT This pilot study investigates the outcomes of a group treatment approach for communication difficulties after Traumatic Brain Injury (TBI). This programme, entitled INSIGHT, focuses on group interactions and is designed to manage the various behaviours and impulses that may manifest with this injury. Additionally, INSIGHT promotes natural and authentic communication, encourages flexibility in interaction, and is client-centred. While group treatment services were provided through an outpatient University clinic, treatment occurred in authentic, contextualized everyday community environments. Participants in the treatment programme included six individuals who experienced chronic communication difficulties as a result of moderate to severe TBI. Three trained student clinicians provided the treatment, under the supervision of the principal investigator. Outcomes were examined at four intervals over one year. Goal Attainment Scaling (GAS) scores served as the primary quantitative outcome measure and a discourse analysis procedure, called Exchange Structure Analysis, served as a secondary qualitative outcome measure. Significant improvements in GAS scores and qualitative evidence of enhanced social communication skills indicated that the clients demonstrated improvements over this one-year period. This research indicates that the INSIGHT programme, a client-centred contextualized approach that promotes positive identity construction, shows promise as an effective model for treating chronic communication difficulties in individuals with TBI.