Web-Based Psychoeducational Intervention for Postconcussion Symptoms: A Randomized Trial

Abstract

The objective of this study was to investigate the effectiveness of a web-based educational intervention for reducing postconcussion symptoms. 158 participants with self-reported symptomatic mild traumatic brain injury were randomized to intervention versus control. There was no effect of intervention on symptom severity or attributions. Subgroup analyses suggested benefit of the web-based intervention in those receiving concurrent mental health treatment and in those participants with the greatest time since injury (>1 year after mild traumatic brain injury). Web-based educational intervention was not effective overall in this sample. However, there is some suggestion of promise in those receiving concurrent mental health treatment and with more chronic symptoms. Findings also suggest potential benefit of interventions targeting self-efficacy.

Psychological Symptoms and Rates of Performance Validity Improve Following Trauma-Focused Treatment in Veterans with PTSD and History of Mild-to-Moderate TBI

“…Notably, many Veterans with a history of mTBI and their family members hold incorrect beliefs regarding mTBI, and only a small minority ever receive brain injury education while in the military (Block et al, 2014). In the post-acute and chronic phase following mTBI, preliminary studies evaluating combined approaches to treatments (e.g., psychoeducation with concurrent mental health treatment and multidisciplinary treatments including cognitive rehabilitation and integrated behavioral health care) have demonstrated improvement in PCS and mental health symptoms (Belanger et al, 2015;Janak et al, 2017). Furthermore, a growing body of research suggests that objective cognitive performance can also improve following cognitive rehabilitation in Veterans with chronic PCS complaints following mTBI (Cooper et al, 2017;Storzbach et al, 2017).…”

Traumatic brain injury education for adult patients and families: a scoping review

“…However, confidence in one’s ability to handle problems (i.e. self-efficacy)(39, 86, 101) and a greater degree of investment in one’s rehabilitation (92) are two outcomes that have been noted in previous studies and should be explored further, as gains in these areas have the potential to ‘snowball’ into additional improvements in functioning and emotional well-being.…”

“…Remote delivery of interventions including education, via telephone, internet, or text messages, has begun to be tested and will undoubtedly increase. Further study in this area should take note of the somewhat mixed findings to date, which suggest that web-based education may be valuable as a supplement, rather than a replacement, for more traditional delivery methods (39, 40).…”

“…Two RCTs examined the effects of education delivered remotely to persons with mTBI. Belanger and colleagues (39) compared a brief (10–45 minute) web-based educational module to usual care in Veterans with chronic symptomatic mTBI. Although a previous pilot study had suggested benefit (40), little change was observed in the RCT.…”

“…Moreover, participants who showed greater learning of the presented information also improved more on a measure of self-efficacy, i.e. perceived control over symptom management (39). The other remote intervention was an RCT using symptom assessment delivered 3 times daily for 14 days via SMS (text messages), starting on the day of injury.…”