Trial Summary
What is the purpose of this trial?This trial tests a new therapy to help Veterans with TBI improve their storytelling skills. The therapy aims to make their stories better organized and more meaningful, which can help them communicate better in daily life. Storytelling interventions are increasingly being proposed as a tool for rehabilitation after Traumatic Brain Injury (TBI).
Is Narrative Discourse Treatment a promising treatment for traumatic brain injury?Yes, Narrative Discourse Treatment is promising for traumatic brain injury as it improves how well people can communicate by making their speech more informative and coherent. It helps people with TBI better express their thoughts and ideas, which is important for daily life and social interactions.23457
What safety data exists for Narrative Discourse Treatment for TBI?The provided research does not explicitly mention safety data for Narrative Discourse Treatment or its variants. The studies focus on the effectiveness of treatments like Discourse Processing Treatment (DPT) and Cognitive Pragmatic Treatment (CPT) in improving discourse and cognitive abilities in individuals with TBI. However, there is no specific mention of safety concerns or adverse effects related to these treatments in the abstracts provided.34567
What data supports the idea that Narrative Discourse Treatment for Traumatic Brain Injury is an effective treatment?The available research shows that Narrative Discourse Treatment (DPT) is effective in improving communication skills in people with traumatic brain injury. One study found that DPT led to better storytelling and clearer communication compared to another treatment focused on attention skills. When DPT was combined with the attention-focused treatment, there was even more improvement in using these skills in new situations. This suggests that DPT is a strong option for helping people with TBI improve their communication abilities.13457
Do I need to stop my current medications for this trial?The trial protocol does not specify if you need to stop taking your current medications. However, it does mention that regular marijuana use that interferes with daily functioning is not allowed.
Eligibility Criteria
This trial is for Veterans with mild to moderate TBI who experience communication difficulties. They must have a significant other to report on their discourse ability, be able to engage in telehealth sessions, and have stable housing. Excluded are those with penetrating head injuries, developmental disabilities, psychotic disorders, neurological illnesses other than TBI, aphasia or APD, or recent substance abuse.Inclusion Criteria
I have trouble communicating after a brain injury, affecting my daily activities.
I am a veteran with a brain injury affecting my thinking or memory.
I am a veteran diagnosed with mild to moderate traumatic brain injury.
Exclusion Criteria
I have a history of or currently have a developmental, psychotic, or neurological condition.
Treatment Details
The study tests a new narrative discourse treatment aimed at improving story content and organization for better daily communication in Veterans with TBI. It's evaluated based on tolerability and acceptability through telehealth sessions.
2Treatment groups
Experimental Treatment
Active Control
Group I: Discourse TreatmentExperimental Treatment1 Intervention
Biweekly discourse treatment sessions.
Group II: Treatment as UsualActive Control1 Intervention
No treatment. Participants will engage in their usual care.
Find a clinic near you
Research locations nearbySelect from list below to view details:
VA Connecticut Healthcare System West Haven Campus, West Haven, CTWest Haven, CT
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Who is running the clinical trial?
VA Office of Research and DevelopmentLead Sponsor
References
Using narrative as a bridge: linking language processing models with real-life communication. [2022]In chronic aphasia, maximizing generalization of improved language abilities from clinical tasks to everyday communication can require the same systematic planning process as the early stages of therapy, often drawing on additional areas of knowledge and successes from other clinical populations. The use of narrative structure is shown here to be a useful framework for building on the developments within sentence processing impairments in aphasia and creating a bridge to more real-life language tasks. An intervention based on narrative structure is described with two people with different language profiles and at different stages of the chronic aphasia spectrum. The insights gained in assessing language ability, underpinning intervention, and capturing therapeutic changes are demonstrated.
Correct information unit analysis for determining the characteristics of narrative discourse in individuals with chronic traumatic brain injury. [2022]To investigate differences between individuals with traumatic brain injury (TBI) and a control group regarding quantitative characteristics of narrative discourse including correct information units (CIUs). The secondary objective was to explore cognitive correlations with narrative discourse measurements.
Cognitive Pragmatic Treatment: A Rehabilitative Program for Traumatic Brain Injury Individuals. [2022]To verify the efficacy of Cognitive Pragmatic Treatment (CPT), a new rehabilitation training program for improving communicative-pragmatic abilities.
Improving Discourse following Traumatic Brain Injury: A Tale of Two Treatments. [2021]Persons with traumatic brain injury (TBI) often present with discourse-level deficits that affect functional communication. These deficits are not thought to be primarily linguistic in nature but instead are thought to arise from the interaction of linguistic and cognitive processes. Discourse processing treatment (DPT) is a discourse-based treatment protocol which targets discourse deficits frequently seen in TBI. Attention Process Training-2 (APT-2) is a published treatment protocol which targets four levels of attention. The purpose of this article is to investigate the effectiveness of DPT and APT-2 in improving discourse production and cognition in adults with TBI. Our results suggest that DPT results in greater improvement in discourse informativeness and coherence, but the combination of DPT and APT-2 resulted in greater generalization to untrained stimuli. Both DPT and APT-2 appear to have some potential to improve cognition, but there was intersubject variability with regard to which treatment is more effective.
How do speech-language pathologists assess and treat spoken discourse after TBI? A survey of clinical practice. [2023]Spoken discourse is commonly affected after traumatic brain injury (TBI). Although guidelines recommend prioritizing discourse-level skills in cognitive communication management, previous literature has highlighted challenges in managing discourse clinically. Little is known about how speech-language pathologists (SLPs) assess and treat discourse after TBI.
Telehealth administration of narrative and procedural discourse: A UK and US comparison of traumatic brain injury and matched controls. [2022]Impaired discourse production is commonly reported for individuals with traumatic brain injury (TBI). Discourse deficits can negatively impact community integration, return to employment and quality of life. COVID-19 restrictions have reduced in-person assessment services for people with communication impairments. Advances in telehealth may help speech and language therapists (SLTs) to assess monologic discourse more systematically and improve access to services for patients who may find it difficult to attend in-person.
A qualitative exploration of speech-language pathologists' approaches in treating spoken discourse post-traumatic brain injury. [2023]Spoken discourse impairments post-traumatic brain injury (TBI) are well-documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech-language pathologist (SLP) is recommended for adults with discourse impairments post-TBI, with an emphasis on context-sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice.