Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T23:49:19.611Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychoeducational Interventions for Problematic Anger in Chronic Moderate to Severe Traumatic Brain Injury: A Study of Treatment Enactment

Published online by Cambridge University Press:  27 January 2020

Tessa Hart Open the ORCID record for Tessa Hart [Opens in a new window] ,
Monica J. Vaccaro ,
Jesse R. Fann ,
Roland D. Maiuro ,
Shira Neuberger  and
Steven Sinfield
Tessa Hart*
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
Monica J. Vaccaro
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
Jesse R. Fann
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
Roland D. Maiuro
Affiliation:
Private Practice, Seattle, WA, USA
Shira Neuberger
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
Steven Sinfield
Affiliation:
Drexel University College of Medicine, Philadelphia, PA 19129, USA
*
Correspondence and reprint requests to: Tessa Hart, Moss Rehabilitation Research Institute, 50 Township Line Road, Elkins Park, PA 19027, USA. E-mail: thart@einstein.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Treatment enactment, a final stage of treatment implementation, refers to patients’ application of skills and concepts from treatment sessions into everyday life situations. We examined treatment enactment in a two-arm, multicenter trial comparing two psychoeducational treatments for persons with chronic moderate to severe traumatic brain injury and problematic anger.

Methods:

Seventy-one of 90 participants from the parent trial underwent a telephone enactment interview at least 2 months (median 97 days, range 64–586 days) after cessation of treatment. Enactment, quantified as average frequency of use across seven core treatment components, was compared across treatment arms: anger self-management training (ASMT) and personal readjustment and education (PRE), a structurally equivalent control. Components were also rated for helpfulness when used. Predictors of, and barriers to, enactment were explored.

Results:

More than 80% of participants reported remembering all seven treatment components when queried using a recognition format. Enactment was equivalent across treatments. Most used/most helpful components concerned normalizing anger and general anger management strategies (ASMT), and normalizing traumatic brain injury-related changes while providing hope for improvement (PRE). Higher baseline executive function and IQ were predictive of better enactment, as well as better episodic memory (trend). Poor memory was cited by many participants as a barrier to enactment, as was the reaction of other people to attempted use of strategies.

Conclusions:

Treatment enactment is a neglected component of implementation in neuropsychological clinical trials, but is important both to measure and to help participants achieve sustained carryover of core treatment ingredients and learned material to everyday life.

Keywords

Traumatic brain injuriesTreatment enactmentClinical trialsAnger managementTreatment fidelityTreatment implementation
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Special Issue 1: Rehabilitation , January 2020 , pp. 119 - 129
Copyright
Copyright © INS. Published by Cambridge University Press, 2020. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bellg, A.J., Borrelli, B., Resnick, B., Hecht, J., Minicucci, D.S., Ory, M., Ogedegbe, G., Orwig, D., Ernst, D., & Czajkowski, S. (2004). Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH Behavior Change Consortium. Health Psychology, 23(5), 443–451.CrossRefGoogle Scholar
Corrigan, J.D. & Hammond, F.M. (2013). Traumatic brain injury as a chronic health condition. Archives of Physical Medicine and Rehabilitation, 94(6), 1199–1201.CrossRefGoogle Scholar
Derogatis, L.R. (1993). Brief Symptom Inventory (BSI): Administration, Scoring and Procedures Manual (4th ed.). Minneapolis, MN: NCS Pearson, Inc.Google Scholar
DiGuiseppe, R. & Tafrate, R.C. (2003). Anger treatment for adults: A meta-analytic review. Clinical Psychology: Science and Practice, 10(1), 70–84.Google Scholar
Dobkin, B.H. (2016). Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care. Current Opinion in Neurology, 29(6), 693–699.CrossRefGoogle Scholar
Duffy, S.A., Cummins, S.E., Fellows, J.L., Harrington, K.F., Kirby, C., Rogers, E., Scheuermann, T.S., Tindle, H.A., &Waltje, A.H. (2015). Fidelity monitoring across the seven studies in the Consortium of Hospitals Advancing Research on Tobacco (CHART). Tobacco Induced Diseases, 13(1), 29.CrossRefGoogle Scholar
Faulkner, M.S. (2012). Intervention fidelity: Ensuring application to practice for youth and families. Journal for Specialists in Pediatric Nursing, 17(1), 33–40.CrossRefGoogle Scholar
Grace, J. & Malloy, P.F. (2001). Frontal Systems Behavior Scale (FrSBe): Professional manual. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Grow, J.C. Collins, S.E. Harrop, E.N., & Marlatt, G.A. (2015). Enactment of home practice following mindfulness-based relapse prevention and its association with substance-use outcomes. Addictive Behaviors, 40, 16–20.CrossRefGoogle Scholar
Hart, T. (2009). Treatment definition in complex rehabilitation interventions. Neuropsychological Rehabilitation, 19(6), 824–840.CrossRefGoogle Scholar
Hart, T., Benn, E.K., Bagiella, E., Arenth, P., Dikmen, S., Hesdorffer, D.C., Novack, T.A., Ricker, J.H., &Zafonte, R. (2014). Early trajectory of psychiatric symptoms after traumatic brain injury: Relationship to patient and injury characteristics. Journal of Neurotrauma, 31(7), 610–617.CrossRefGoogle Scholar
Hart, T., Brockway, J.A., Fann, J.R., Maiuro, R.D., & Vaccaro, M.J. (2015). Anger self-management in chronic traumatic brain injury: Protocol for a psycho-educational treatment with a structurally equivalent control and an evaluation of treatment enactment. Contemporary Clinical Trials, 40, 180–192.CrossRefGoogle Scholar
Hart, T., Brockway, J.A., Maiuro, R.D., Vaccaro, M., Fann, J.R., Mellick, D., Harrison-Felix, C., Barber, J., &Temkin, N. (2017). Anger self-management training for chronic moderate to severe traumatic brain injury: Results of a randomized controlled trial. The Journal of Head Trauma Rehabilitation, 32(5), 319–331.CrossRefGoogle Scholar
Hart, T., Dijkers, M., Whyte, J., Braden, C., Trott, C., & Fraser, R. (2010). Vocational interventions and supports following job placement for persons with traumatic brain injury. Journal of Vocational Rehabilitation, 32(3), 135–150.CrossRefGoogle Scholar
Hart, T., Fann, J., & Novack, T. (2008). The dilemma of the control condition in experience-based cognitive and behavioral treatment research. Neuropsychological Rehabilitation, 18(1), 1–21.CrossRefGoogle Scholar
Lichstein, K.L., Riedel, B.W., & Grieve, R. (1994). Fair test of clinical trials: A treatment implementation model. Advances in Behavior Research and Therapy, 16, 1–29.CrossRefGoogle Scholar
Maiuro, R., Vitaliano, P., & Cahn, T. (1987). A brief measure for the assessment of anger and aggression. Journal of Interpersonal Violence, 2(2), 166–178.CrossRefGoogle Scholar
Olatunji, B.O. & Lohr, J.M. (2004). Nonspecific factors and the efficacy of psychosocial treatments for anger. The Scientific Review of Mental Health Practice, 3(2), 3–18.Google Scholar
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tuscon, AZ: Neuropsychology Press.Google Scholar
Rixon, L., Baron, J., McGale, N., Lorencatto, F., Francis, J., & Davies, A. (2016). Methods used to address fidelity of receipt in health intervention research: A citation analysis and systematic review. BMC Health Services Research, 16(1), 663.CrossRefGoogle Scholar
Schmidt, M. (1996). Rey Auditory Verbal Learning Test. Torrance, CA: Western Psychological Services.Google Scholar
Spielberger, C. (2000). State-Trait Anger Expression Inventory – Revised. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Spillane, V., Byrne, M.C., Byrne, M., Leathem, C.S., O’Malley, M., & Cupples, M.E. (2007). Monitoring treatment fidelity in a randomized controlled trial of a complex intervention. Journal of Advanced Nursing, 60(3), 343–352.CrossRefGoogle Scholar
Taub, E., Uswatte, G., Mark, V.W., Morris, D.M., Barman, J., Bowman, M.H., Bryson, C., Delgado, A., &Bishop-McKay, S. (2013). Method for enhancing real-world use of a more affected arm in chronic stroke: Transfer package of constraint-induced movement therapy. Stroke, 44(5), 1383–1388.CrossRefGoogle Scholar
Veenstra, L., Bushman, B.J., & Koole, S.L. (2018). The facts on the furious: A brief review of the psychology of trait anger. Current Opinion in Psychology, 19, 98–103.CrossRefGoogle Scholar
Wechsler, D. (1999). Wechsler Abbreviated Scale of Intelligence (WASI). San Antonio, TX: Harcourt Assessment, Inc.Google Scholar
Whyte, J., Dijkers, M.P., Hart, T., Van Stan, J.H., Packel, A., Turkstra, L.S., Zanca, J., Chen, C., Ferraro, M. (2018). The importance of voluntary behavior in rehabilitation treatment and outcomes. Archives of Physical Medicine and Rehabilitation, 100(1), 156–163.CrossRefGoogle Scholar
Zauszniewski, J.A., Lekhak, N., Burant, C.J., Underwood, P.W., & Morris, D.L. (2016). Resourcefulness training for dementia caregivers: Establishing fidelity. Western Journal of Nursing Research, 38(12), 1554–1573.CrossRefGoogle Scholar