Improved Conversation Outcomes After Social Communication Skills Training for People With Traumatic Brain Injury and Their Communication Partners: A Clinical Trial Investigating In-Person and Telehealth Delivery

Abstract

Purpose The aim of the study was to investigate the effectiveness of social communication skills training (TBIconneCT) for people with traumatic brain injury (TBI) and their communication partners, delivered in-person or via telehealth, on quality of conversations. Method This study is a clinical trial, including an in-person intervention group ( n = 17), a telehealth intervention group ( n = 19), and a historical control group ( n = 15). Participants were adults at least 6 months post moderate-to-severe TBI with social communication skills deficits and their usual communication partners. Participants completed a casual and purposeful conversation task at pre-intervention, postintervention, and a follow-up assessment. A blinded assessor evaluated conversations using the Adapted Measure of Participation in Conversation and the Adapted Measure of Support in Conversation. Treatment effects were examined by comparing groups on change in ratings between pre- and posttraining. Maintenance of effects was examined using change between posttraining and follow-up assessment. The trial protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001024538). Results Trained participants with TBI had significant improvements in participation in casual conversation compared to controls. Trained communication partners also had significant improvements compared to controls on ratings of support in casual conversations. However, treatment effects were not maintained at follow-up for two of eight measures. Comparisons between outcomes of in-person and telehealth groups found negligible to small effect sizes for six of eight measures. Conclusions The findings reinforce previous studies demonstrating the efficacy of communication partner training after TBI. Telehealth delivery produced similar outcomes to in-person delivery.

A survey of cognitive–communication difficulties following TBI: are families receiving the training and support they need?

“…Family members demonstrated an improved ability to facilitate conversations with the person following TBI (Sim et al 2013, Mann et al 2015 and reported increased confidence when supporting the person following TBI at social events following this training (Togher et al 2012). Similar communication outcomes were obtained when the person following TBI and their family member received CPT as a dyad rather than a group and the use of telehealth to enable participants to access the training remotely did not affect the outcome (Rietdijk et al 2020).…”

“…Time to create family specific information has been identified by SALT's as a key barrier to service delivery for CCD following TBI and changes to the format and content of this information is required (Short et al 2014). Recent CPT studies are beginning to address the evidence-practice gap by creating shorter, more accessible versions of established programmes (Rietdijk et al 2020).…”

Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers

“…The present study investigated acceptability of telehealth-based delivery of a social communication skills programme for people with TBI and their communication partners in the context of a clinical trial. A separate report on this clinical trial 15 describes the efficacy of this programme, with findings that trained communication partners improved their skill in supporting conversation, as evaluated using the Adapted Measure of Support in Conversation Reveal Competence scale. 16 The research questions relating to acceptability, which are the focus of the present paper, were:…”

Telehealth in trauma: A scoping review

“…The follow-up duration also impacted on the reported positive health outcomes, with differences found between the telehealth intervention groups and standard care at 3, 6 and 18 months. 21,24,30,49,50 Process and system outcomes Process and system outcomes incorporate the steps taken or the systems implemented or affected that occurred due to the introduction of the telehealth intervention.…”