methods were understood. The trainer then called participants four to five times each week for 30-minute sessions. Participants in the spaced retrieval group received an instructional technique focused on selected goals. The therapist modeled correct responses to questions related to the goals and instructed the participants not to struggle to retrieve responses, but to respond immediately. Participants in the control arm received the same total amount of therapy time and sessions that focused on memory strategies such as association, verbal rehearsal, imagery and written reminders. Outcomes included goals mastered, generalization, the frequency of reported memory problems, a cognitive difficulties scale, and community integration and quality of life measures. Immediately and at 1 month posttraining, the space retrieval group (and their caregivers) reported more treatment goal mastery and use than the didactic instruction group (and their caregivers). Both groups reported some generalization to other nontargeted behaviors, but these improvements were not statistically significantly different between groups. There were no reported important or statistically significant improvements in quality of life for either group. One limitation was that data about “objective, observable behaviors” related to selected goals was obtained from memory logs, and those data were sometimes incomplete. Of the 51 pairs who agreed to participate, only 38 completed the study: 22 spaced-retrieval training pairs and 16 didactic control pairs.

Another small randomized trial involved 20 patients, most of whom had sustained a brain injury from a motor vehicle accident many years before (Ownsworth and McFarland 1999). The severity of the brain injury was not described. The trial compared two different approaches to training individuals to use a dairy to compensate for memory problems (a diary only approach and a diary and self-instructional approach that taught compensation using higher cognitive skills of self-awareness and self-regulation). In one session, some instructions for daily memory checklists were given verbally over the phone to both groups, but the 4-week intervention period mainly involved self-use of diaries. Follow-up phone calls to monitor progress or provide additional instruction were not included during the intervention phase of the study. Findings showed that the self-instruction group consistently made more diary entries and reported less memory problems than the diary only group.

Another trial involved 30 patients with memory disorders and a history of TBI who had had neurosurgery several months prior (Dou et al. 2006). Patients who had a history of previous psychiatric problems or who were computer phobic were excluded. Participants were randomly assigned to one of the following three groups: computer assisted memory training, therapist assisted memory training, and no specific memory training (the control group). In the computer assisted training, patients were asked to identify or define the information they needed help from a therapist to

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