Building Emotional Self-Awareness Teletherapy (BEST)

Building Emotional Self-Awareness Teletherapy (BEST): a Tool to Optimize Psychological Health Outcomes for Persons with Traumatic Brain Injury

To examine the feasibility, acceptability, and preliminary efficacy of a remotely delivered intervention for civilians and service members with mild traumatic brain injury (mTBI) who have difficulty recognizing and regulating their emotions. Post-treatment outcomes of interest include emotional self-awareness and regulation, resiliency, and affective symptoms.

This Phase I proof of principle pilot study of the Building Emotional Self-awareness Teletherapy (BEST) intervention will use a quasi-experimental, non-randomized, one-group pretest-posttest design with a double pretest and a 3-month follow-up in approximately 40 participants with mTBI (~20 civilians and ~20 service members). Study objectives are to explore the feasibility and early efficacy of BEST to improve psychological health outcomes in civilian and Service Member (SM) participants with mTBI who have alexithymia (poor emotional self-awareness) and emotion dysregulation. We anticipate BEST will have good feasibility and acceptability in both civilian and service member participants, and post-treatment assessments will show significant improvements in alexithymia, emotion regulation, resiliency, and affective symptoms.

Inclusion Criteria:

• Mild TBI (determined by Ohio State University TBI Identification Method)
• ≥18 years old
• U.S. resident (exclusion for California residents)
• ≥6 months post-TBI
• elevated alexithymia and emotion dysregulation (defined by >.5 standard deviation above means on the TAS-20 and DERS)
• capacity to consent
• proficient English
• if on medications that influence affect, must be stable for at least 6 weeks
• access to a device capable of video conferencing and high speed internet.

Exclusion Criteria:

• Premorbid neurological disorder other than TBI (e.g., stroke), active or uncontrolled major psychiatric disorder and/ or disorder that would pose a safety concern (e.g., borderline personality disorder)
• degenerative neurologic condition
• visual, hearing, communication, or cognitive impairments that would impede participation
• unstable or anticipated medication changes that will influence mood/ affect during study participation
• active involvement in an intensive rehabilitation program
• individuals who recently started psychotherapy (e.g., < 3 months ago)
• participant behaviors that cause concern for their ability to participate in accordance with the study requirements and protocol (e.g., unreliable correspondences, no-shows, no-replies to multiple contacts, habitual rescheduling, unable to complete study requirements in timely manner)
• concurrent participation in any other clinical trial that aims to improve mood/ behavioral functioning will be an exclusion criterion.
• participants will be excluded if at any point, they participated in TREAT (in-person clinical trial of BEST - NCT03414463)