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Group treatment of problem‐solving deficits in outpatients with traumatic brain injury: A randomised outcome study

Sixty higher‐level outpatients with traumatic brain injury (TBI), all at least 1 year post‐injury, were randomly assigned to either conventional group neuropsychological rehabilitation or an innovative group treatment focused on the treatment of problem‐solving deficits. Incorporating strategies for addressing underlying emotional self‐regulation and logical thinking/reasoning deficits, the innovative treatment is unique in its attention to both motivational, attitudinal, and affective processes and problem‐solving skills in persons with TBI. Participants in the innovative group improved in problem solving as assessed using a variety of measures, including (1) executive function, (2) problem‐solving self‐appraisal, (3) self‐appraised emotional self‐regulation and clear thinking, and (4) objective observer ratings of roleplayed scenarios. These improvements were maintained at follow‐up. Baseline performance on timed attention tasks was related to improvement; individuals who processed the most slowly benefited the most. These participants did not show improvements on timed attention tasks, but did improve on problem‐solving measures. Such findings are consistent with successful compensatory strategy use—the person may still have deficits and symptoms, but now has effective strategies for reducing their impact on daily functioning.