emotion perception training. To be included, participants generally had to have sufficient language and cognitive capability to participate in a group, and have impairment in social communication skills either based on a questionnaire or a referring clinician’s assessment. One of the four RCTs had some form of CRT in both trial arms but also included comparison to a waitlist arm. The committee also identified one nonrandomized, parallel group controlled design (Hashimoto et al. 2006). This study was in the chronic phase of recovery for patients with moderate-severe TBI. Subjects were instructed on social skills training; no treatment was provided to the comparator arm (Hashimoto et al. 2006). Table 9-1 presents a summary of all included studies in this review.

CHRONIC, MODERATE-SEVERE TBI

Randomized Controlled Trials

Two trials focusing on treatment of emotion perception deficits were reported by Bornhofen and McDonald (2008a, 2008b). Emotion perception was defined as “accurate decoding and interpretation of visual and aural stimuli that signal 1 of 6 emotional states.” The CRT program reported by Bornhofen and McDonald (2008a) included group activities, and a notebook and home practice to teach increasingly complex skills on emotion perception. Sessions were held twice weekly, for 1.5 hours each over 8 weeks; 25 hours total. One therapist (background not described) was assigned to every two or three participants. The 12 participants were receiving outpatient services for TBI and were recruited and allocated at random to treatment or to a waitlist group; there was one dropout. Study outcomes were measures of facial expression (naming and matching), The Awareness of Social Inference Test (TASIT), and psychosocial reintegration. Immediately posttreatment, the intervention yielded significantly better TASIT scores relative to the waitlist group. While the intervention group scored better posttreatment on one form of the facial expression measure (matching), the groups scored the same on the alternate form of the facial expression measure (naming), and psychosocial reintegration. One month follow-up scores in the treatment arm were significantly higher than scores prior to treatment on all measures.

The other trial reported by Bornhofen and McDonald (2008b) had the goal of teasing apart the effective components of the intervention in the trial described above, by separating and comparing an errorless learning strategy with self-instruction training (which were combined in the 2008a study intervention), with a waitlist control group; both interventions also aimed to remediate emotion perception deficits. The interventions comprised a total of 25 hours of treatment across 10 weeks, divided into weekly, 2.5-hour



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