Persistent memory symptoms after concussion are common, and likely perpetuated by unhelpful illness beliefs and coping behaviors. Results from a pilot study suggested that traditional cognitive rehabilitation and a novel cognitive-behavioral therapy (CBT) protocol were both associated with improvements in subjective memory functioning. The present study will more definitively compare the effectiveness of these interventions for improving subjective memory functioning after concussion.
The primary research aims of this study are to determine whether cognitive behavioral therapy (CBT) and cognitive compensatory strategy training (CCST) improves subjective memory functioning compared to usual care, and to compare the effectiveness of CBT and CCST. This study is a multisite three-armed randomized control trial (RCT) that will randomize adults with persistent memory symptoms following concussion to CBT, CCST, or a covert waitlist condition (2:2:1). Participants will be blinded to the other arms of the study and the study hypotheses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
184
Cognitive behavioral therapy (CBT) is delivered by a psychologist over 10 individual (1:1) manualized videoconference sessions. The goal of this therapy is for participants to use their memory more normally (i.e., reduce avoidance and safety behaviors) and view memory lapses as less threatening.
Cognitive compensatory strategy training (CCST), a traditional cognitive rehabilitation intervention, is delivered by a Occupational Therapist over 10 individual (1:1) manualized videoconference sessions. Participants optimize their use of current compensatory strategies and/or learn new ones suited to their needs and lifestyle. The goal is to minimize memory lapses in daily life.
Calgary Brain Injury Program
Calgary, Alberta, Canada
RECRUITINGFraser Health Acquired Brain Injury and Concussion Services
Langley, British Columbia, Canada
RECRUITINGMultifactorial Memory Questionnaire-Satisfaction scale
Measures participants' concern, satisfaction, and overall appraisal of their memory ability. Participants rate their agreement with 18 statements. Total scores range from 0 to 72, with lower total scores indicating worse subjective memory functioning.
Time frame: Week 20
Fear-Avoidance of Memory Loss Scale
Assesses fears and avoidance behaviors associated with memory decline. Participants rate 24 items on a 5-point scale, where the higher scores indicate greater memory concern and maladaptive coping.
Time frame: Week 1 and week 20
Patient Global Impression of Change scale
Participants rate how much their memory functioning has improved or declined overall since the beginning of the study, on a single item rated on a 7-point scale where the midpoint is no change.
Time frame: Week 20
Work and Social Adjustment Scale
Participants rate how much their condition interferes with their ability to carry out occupational and social activities across 5 items, on a scale from 1-7 where higher scores indicate more difficulty.
Time frame: Week 1 and week 20
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G.F. Strong Adult Concussion Services
Vancouver, British Columbia, Canada
Integrated Adult Concussion Program at Hamilton Health Sciences
Hamilton, Ontario, Canada
ACTIVE_NOT_RECRUITING360 Concussion Care Clinic
Ottawa, Ontario, Canada
RECRUITINGSunnybrook Traumatic Brain Injury Clinic
Toronto, Ontario, Canada
RECRUITINGHull-Ellis Concussion and Research Clinic at University Health Network
Toronto, Ontario, Canada
RECRUITINGCanadian Concussion Centre at Toronto Western Hospital
Toronto, Ontario, Canada
RECRUITING