Self-Regulation Skills Interview Research Articles

Cognitive and self-regulation skills for employment among people with brain injury: A comparison of employed and non-employed people using mixed analysis.

Employment for people with brain injuries is challenging, and identifying the factors that can be improved by rehabilitation and establishing appropriate intervention methods are imperative. To examine whether differences in cognitive functions and self-regulation skills exist between employed and non-employed people with brain injuries. In addition, we explored the self-regulation skills characteristic of employed people by qualitatively comparing them to those of non-employed people. Using a mixed research method, demographic data, neuropsychological tests, self-efficacy, and self-regulation skills were compared between 38 people with brain injuries (16 employed and 22 unemployed) in the community. Subsequently, self-regulation skills were assessed by the Self-Regulation Skills Interview (SRSI), and participants' responses were qualitatively compared. No significant differences were observed in demographic data and neuropsychological tests, but employed people showed significantly better SRSI scores than unemployed people (p < 0.01). The qualitative analysis of the SRSI showed that employed people recognised themselves as having more specific symptoms than unemployed people. For example, they recognised the behaviour 'when having more than one errand, forgetting it', whereas non-employed people only recognised the category 'failure of prospective memory'. Furthermore, employed people reviewed their behaviour and developed ingenious coping strategies, such as 'looking back on appointments that have been made', 'writing down as soon as having a schedule', whereas unemployed people only exhibited categories such as 'writing schedules on the cell phone'. Self-regulation skills, such as recognising specific symptoms and developing relevant coping strategies, are effective for gaining employment.

Development of the Japanese version of the awareness questionnaire for assessment of self-awareness after acquired brain injury: reliability and validity

ABSTRACT Background The evaluation of impaired self-awareness (ISA) after brain injury is not widespread in Japan, and there is a lack of Japanese assessments of self-awareness. Objectives To translate the original version of the Awareness Questionnaire (AQ), an instrument for assessing ISA, into Japanese using a validated method and examine its reliability and validity in inpatients with stroke. Methods This cross-sectional, prospective study enrolled 130 participants. The double-translation process was used to develop the Japanese version of the AQ. Results Data were collected from 120 patients. High intra-rater reliability was observed for the patient (Cronbach’s α = 0.824) and clinician samples (Cronbach’s α = 0.933). High intra- and inter-rater reliability were found for all AQ items [interclass coefficient (ICC) (1, 1) = 0.828, ICC (2, 1) = 0.852, ICC (3, 1) = 0.848]; however, the sub-item analysis revealed only moderate reliability. Validity assessment revealed a low but significant positive correlation (r = 0.209; p < 0.05) between the Japanese version of the AQ and the Japanese version of the Self-Regulation Skills Interview and a low but significant negative correlation (r = 0.197; p < 0.05) between the Japanese version of the AQ and the Mini-Mental State Examination. Conclusions The Japanese version of the AQ was developed and applied to stroke patients, but the concept of post-stroke ISA may differ from ISA after traumatic brain injury, highlighting the need for a stroke-specific version of the AQ.

Pilot Study of the Cognitive-Functional Intervention for Adults (Cog-Fun A): A Metacognitive-Functional Tool for Adults With Attention Deficit Hyperactivity Disorder.

Adults with attention deficit hyperactivity disorder (ADHD) often experience chronic challenges in their life roles. There is a need for evidence-based occupational therapy interventions to help enhance their functioning. To determine the preliminary effectiveness of the Cognitive-Functional Intervention for Adults (Cog-Fun A), a metacognitive-functional occupational therapy tool for the improvement of occupational performance (OP) and quality of life (QoL) in adults with ADHD. One-group pretest-posttest design with a 3-mo follow-up. Community setting in Jerusalem, Israel. Fourteen adults, ages 18-60 yr, with a valid diagnosis of ADHD and an indication of executive function (EF) impairment. Participants received 15 1-hr weekly sessions that addressed self-awareness of strengths and challenges through education and guided discovery as well as strategy acquisition and implementation within a context of occupational goal attainment. The Behavioral Rating Inventory of Executive Function-Adult version, an adult ADHD QoL measure, the Canadian Occupational Performance Measure, and the Self-Regulation Skills Interview were administered. Twelve participants completed the intervention. Posttreatment scores revealed statistically significant improvements in EF, awareness, OP, and QoL. Gains in QoL showed a modest reduction at the 3-mo follow-up. The Cog-Fun A is a promising intervention for improving OP and QoL among adults with ADHD and should be investigated further. What This Article Adds: The Cog-Fun A offers an effective nonpharmacological, metacognitive-functional, occupation-centered treatment option for adults with ADHD.

Practical utilization of the Japanese edition of the “Self-Regulation Skills Interview” in measuring the self-awareness of patients with higher brain dysfunction

Practical utilization of the Japanese edition of the “Self-Regulation Skills Interview” in measuring the self-awareness of patients with higher brain dysfunction

Effect of Strategy Training on Self-Awareness of Deficits After Stroke.

Self-awareness of deficits, or the ability to understand the effects of impairments on daily life, is often diminished after a stroke. Diminished self-awareness influences participation in rehabilitation and functional outcomes. To examine whether self-awareness of deficits changed over time after a stroke (N = 43) and whether metacognitive strategy training (n = 21) resulted in improved self-awareness compared with direct skill training (n = 22). Secondary analysis of data collected from a randomized controlled trial. Inpatient stroke rehabilitation. Adults with cognitive impairments after an acute stroke. Metacognitive strategy training is an approach in which clients are guided through a process of self-assessment and develop solutions for barriers to task performance. This approach was compared with direct skill training, in which the therapist provides specific instructions for task completion, removing the client-initiated assessment and problem-solving components. Self-awareness measures included the Self-Regulation Skills Interview and Self-Awareness of Deficits Interview at baseline and 3 mo and 6 mo after the intervention. We used a one-way analysis of variance (ANOVA) to analyze change in self-awareness and a two-way ANOVA to examine differences between groups over time. There was a statistically significant and potentially meaningful difference over time in the self-awareness domain of strategy behavior, F(2) = 3.35, p = .039, but there were no differences in improvements between the metacognitive strategy and direct skill training groups. Self-awareness warrants further investigation to determine whether it improves naturally over time or through both interventions after stroke. Self-awareness of deficits, and the use of strategies in particular, may improve in the early stages of stroke recovery, but the optimal approach for intervention remains unclear.

The development and initial validation of a new tool to measure self-awareness of driving ability after brain injury.

The aim of this study was to develop and provide initial validation data for a self-awareness of on-road driving ability measure for individuals with brain injury. Thirty-nine individuals with Traumatic Brain Injury completed an on-road driving assessment, the Self-Regulation Skills Interview (SRSI) and the newly developed Brain Injury Driving Self-Awareness Measure (BIDSAM). BIDSAM self, clinician and discrepancy scales demonstrated high levels of internal consistency (α=0.83-0.92). Criterion-related validity was established by demonstrating significantly higher correlations between clinician ratings and on-road performances, rs =0.82, P<0.01, compared to self-ratings, rs =0.45, P<0.05. Discrepancy scores were significantly correlated with the SRSI emergent, rs =0.52, P<0.01, and anticipatory awareness scores, rs =0.37, P<0.05, indicative of convergent validity. These results provide initial support for the BIDSAM as a reliable and valid measure of self-awareness of on-road driving ability following TBI.

Improved self-awareness and coping strategies for patients with acquired brain injury—A group therapy programme

Primary objective: This study evaluates the effects of a group therapy programme for anticipatory self-awareness and coping strategies.Design: The study includes methodological triangulation using three methods to gather data: an overall self-report questionnaire, Self Regulation Skills Interview (SRSI) and focus group interview.Subjects: Twenty-one individuals with acquired brain injury participated in a group therapy programme.Methods: A self-report questionnaire developed and used especially for evaluation of the described intervention was used at the end of the last session of the group therapy programme. The Self Regulation Skills Interview–SRSI, was used within 2 weeks before and after the subjects participated in one group program. Three Focus groups were used as a third method for data collection. The Focus group interviews were accomplished 1 month after each group programme.Results: The individuals increased their self-awareness and strategy behaviour significantly. Participating in the group therapy programme had had an effect on their life and work situation and on their self-confidence.Conclusions: A structured group therapy programme helps patients with acquired brain injury understand the consequences of their neuropsychological deficits, helps them improve awareness of their impairments and helps them develop coping strategies.

A multicontext approach to promoting transfer of strategy use and self regulation after brain injury: An exploratory study

Background/aim: Persons with brain injury frequently demonstrate decreased ability to monitor and apply strategies learned in treatment to everyday situations. The aim of this study is to refine, explore and provide preliminary testing of the multicontext approach in promoting strategy use across situations and increasing self-regulation, awareness and functional performance.Methods: This study used a single-subject design with repeated measures pre- and post-intervention, with data analysed descriptively and graphically. Four persons with difficulty following multi-step directions, 3–5 years post-TBI, received a nine session intervention programme. Outcome measures included the Awareness Questionnaire, Self-Regulation Skills Interview, Behavior Rating Inventory of Executive Function, Multiple Errands Test and an Executive Function Performance Test sub-task. The process of change within each treatment session was examined with strategy and awareness ratings.Results: All participants demonstrated positive changes in self-regulatory skills and strategy use that was observed across tasks. As expected, general awareness of deficits remained unchanged. Examination of individual participants revealed important, varying patterns of change in strategy use, learning transfer and self-awareness across intervention.Conclusions: Results provide preliminary support for the feasibility and efficacy of the multicontext approach in promoting transfer of strategy use to enhance functional performance and selective aspects of awareness. Further investigation, including a larger controlled study, is needed to confirm or limit these observations.

The associations among self-awareness, emotional well-being, and employment outcome following acquired brain injury: A 12-month longitudinal study.

Objective: To investigate self-awareness and emotional well-being according to change in employment outcome in people with acquired brain injury (ABI). Design: A 12-month longitudinal study. Participants and Setting: Fifty adults with ABI attending outpatient rehabilitation (n = 17) or vocational rehabilitation services (n = 33). Time since injury ranged from 6 months to 12 years (M = 4.3 years, SD = 4.1). Main Outcome Measures: Self Awareness of Deficits Interview, Self-Regulation Skills Interview, Hospital Anxiety Depression Scale, and employment outcome (stable employment, improved employment, and stable unemployment). Results: At the initial assessment, level of awareness for the improved employment group was significantly lower than that for the stable employment group (P .017). Demographic and injury-related variables were generally not related to employment outcome. Conclusions: The findings empirically support the theoretical view that an increase in self-awareness is associated with improved employment status, although the direction of this relation is unclear.

The Relative Importance of Metacognitive Skills, Emotional Status, and Executive Function in Psychosocial Adjustment Following Acquired Brain Injury

To examine the interrelationships between metacognitive skills and measures of emotional status and executive function following acquired brain injury (ABI), and examine their relative importance to psychosocial outcomes. A cross-sectional multicentre study employing correlational and multiple regression analyses. Sixty-seven adults with ABI living in the community, on average 4.4 years (SD = 4.7) postinjury. Sydney Psychosocial Reintegration Scale, Self-Awareness of Deficits Interview, Self-Regulation Skills Interview, Hospital Anxiety Depression Scale, Beck Hopelessness Scale, and standardized measures of executive function. Metacognitive skills correlated with level of hopelessness and executive measures of idea generation and error self-regulation. The best predictor of psychosocial outcome was depressive symptoms, with specific outcomes additionally related to error self-regulation and intellectual awareness. The findings highlight the need to evaluate interventions targeting depression and metacognitive skills to improve psychosocial outcomes.

Investigation of psychological and neuropsychological factors associated with clinical outcome following a group rehabilitation programme

The present study investigated neuropsychological and psychological factors associated with successful treatment outcome following a group intervention for individuals with acquired brain injury (ABI). Participants were classified into two groups (“Clinically Improved” and “Not Improved”) based upon the findings of a previous study (Ownsworth, McFarland, & Young, 2000a). A discriminant analysis was used to predict group membership on three outcome measures (Awareness and Strategy Behaviour indices of the Self-Regulation Skills Interview and the Psychosocial Dimension of the Sickness Impact Profile) between pre-assessment and post-assessment, and between pre-assessment and 6 months follow-up. Neuropsychological factors involved measures of executive functioning and psychological factors were assessed using measures of personality-related denial and coping-related denial. Overall, the results indicated that individuals with impaired executive functioning were most likely to be classified as Clinically Improved on measures of awareness, strategy behaviour and psychosocial functioning. Individuals who deny or minimise their ABI symptoms were less likely to improve their psychosocial functioning following the group intervention. Future research needs to evaluate interventions for enhancing self-regulation skills and improving psychosocial functioning for individuals who employ denial as a main strategy for coping following ABI.

Self-awareness and psychosocial functioning following acquired brain injury: An evaluation of a group support programme

This study investigated a group support programme designed to improve selfawareness deficits and psychosocial functioning in a group of chronic patients (N = 21) with acquired brain injury (ABI). The participants were on average 8.6 years (range: 1-36 years) post-injury and were seen at the Brain Injury Association of Queensland, Australia. The assessment of participants involved two standardised measures of intellectual self-awareness with collateral reports from relatives. The present study introduced a new measure called the Self-Regulation Skills Interview (SRSI) which assessed higher levels of self awareness and self-regulation skills. Psychosocial functioning was assessed using a standardised self-report measure. At baseline the group had a relatively high level of intellectual self-awareness regarding their deficits, a low to moderate level of self-regulation skills, and significant psychosocial impairment. The participants were involved in a 16-week group programme which involved components of cognitive rehabilitation, cognitive-behavioural therapy, and social skills training. A post-intervention assessment indicated that participants had significantly improved levels of self-regulation skills and psychosocial functioning. A 6-month follow-up assessment indicated that overall, participants had maintained the gains made during the programme. The important role of self-regulation skills is emphasised as the principle factor contributing to the maintenance of the gains observed.

Development and Standardization of the Self-Regulation Skills Interview (SRSI): A New Clinical Assessment Tool for Acquired Brain Injury

The Self-regulation Skills Interview (SRSI) is a clinical tool designed to measure a range of metacognitive skills essential for rehabilitation planning, monitoring an individual's progress, and evaluating the outcome of treatment interventions. The results of the present study indicated that the SRSI has sound interrater reliability and test–retest reliability. A principle components analysis revealed three SRSI factors: Awareness, Readiness to Change, and Strategy Behavior. A comparison between a group of 61 participants with acquired brain injury (ABI) and a group of 43 non-brain-injured participants indicated that the participants with ABI had significantly lower levels of Awareness and Strategy Behavior, but that level of Readiness to Change was not significantly different between the two groups. The significant relationship observed between the SRSI factors and measures of neuropsychological functioning confirmed the concurrent validity of the scale and supports the value of the SRSI for post-acute assessment.