Abstract

Objective: Some of the most disabling consequences of brain injury are impairments in executive control functions. Goal-Oriented Attentional Self-Regulation (GOALS) training was designed to target deficits in executive control processes with attention regulation and problem solving training applied to participant-defined goals. In an initial study individuals with chronic brain injury significantly improved post GOALS, but not control training, on measures of attention/executive function, functional task performance, and goal-directed control over neural processing on fMRI. The objective of ongoing study is to assess long term effectiveness of GOALS training in Veterans with chronic TBI. Method: 16 Veterans with chronic TBI and mild-moderate executive dysfunction completed structured interview, neuropsychological and functional assessments, and self-report measures of emotional regulation and daily functioning 6 or more months post completion of GOALS training. Results: Relative to their baseline performance, 6 or more months post training, participants showed significant improvements on measures of attention/executive function, complex functional task performance, and on emotional regulation and daily functioning self-report measures. Furthermore, a majority reported incorporating some trained strategies into their daily life. Conclusion(s): GOALS training may be promising in Veterans with chronic TBI. Improving cognitive control functioning may also improve functioning in other domains such as emotional regulation and functional performance. The challenges and importance of: a) using ecologically valid assessment measures; b) assessing change in functioning at different levels; and c) using participant-defined goals applied to relevant training, will be discussed.