RESUMO
OBJECTIVE: To evaluate the effectiveness of a replicable group treatment program for improving social competence after traumatic brain injury (TBI). DESIGN: Multicenter randomized controlled trial comparing 2 methods of conducting a social competency skills program, an interactive group format versus a classroom lecture. SETTING: Community and veteran rehabilitation centers. PARTICIPANTS: Civilian, military, and veteran adults with TBI and social competence difficulties (N=179), at least 6 months postinjury. INTERVENTIONS: The experimental intervention consisted of 13 weekly group interactive sessions (1.5h) with structured and facilitated group interactions to improve social competence, and the control consisted of 13 traditional classroom sessions using the same curriculum with brief supplemental individual sessions but without structured group interaction. MAIN OUTCOME MEASURES: Profile of Pragmatic Impairment in Communication (PPIC), an objective behavioral rating of social communication impairments after TBI. LaTrobe Communication Questionnaire (LCQ), Goal Attainment Scale (GAS), Satisfaction with Life Scale, Posttraumatic Stress Disorder Checklist-C (PCL) civilian version, Brief Symptom Inventory 18 (BSI-18), Scale of Perceived Social Self-Efficacy (PSSE). RESULTS: Social competence goals (GAS) were achieved and maintained for most participants regardless of treatment method. Significant improvements in the primary outcome (PPIC) and 2 of the secondary outcomes (LCQ and BSI) were seen immediately posttreatment and at 3 months posttreatment in the alternative treatment arm only; however, these improvements were not significantly different between the group interactive structured treatment and alternative treatment arms. Similar trends were observed for PSSE and PCL-C. CONCLUSIONS: Social competence skills improved for persons with TBI in both treatment conditions. The group interactive format was not found to be a superior method of treatment delivery in this study.
Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Competência Mental/psicologia , Reabilitação Psiquiátrica/métodos , Psicoterapia de Grupo/métodos , Transtorno de Comunicação Social/reabilitação , Adulto , Lesões Encefálicas Traumáticas/psicologia , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/psicologia , Centros de Reabilitação , Transtorno de Comunicação Social/psicologia , Habilidades Sociais , Resultado do Tratamento , Veteranos/psicologiaRESUMO
El trastorno del espectro autista (TEA) es un trastorno del neurodesarrollo con amplia problemática psicosocial y neurocognitiva. El uso de estrategias estructuradas en el abordaje de las personas con TEA es una metodología con reconocimiento internacional de utilidad. En la práctica clínica del equipo de diagnóstico y tratamiento del Servicio de Salud Mental Pediátrica del Hospital Italiano de Buenos aires (HIBA) se utilizan las mismas y también otras herramientas como la adquisición del lenguaje a través de la escritura en computadora. Así, es importante compartir la experiencia clínica en el empleo de diferentes estrategias de abordaje en la población con TEA. También, debatir los alcances de la utilización de herramientas tecnológicas en este abordaje y entretanto pensar diferentes formas de validar la utilización de dichas aplicaciones e intervenciones tecnológicas en el TEA. Evaluando sus ventajas y desventajas, buscamos generar un modelo educativo y terapéutico más integrador, centrado en la comunicación y la facilitación de la motivación y la expresividad, para homogeneizar a profesionales y padres con el mundo de los niños con TEA. Esperamos que el uso de dispositivos tecnológicos permita recolectar datos e información clave que luego se podrán utilizar para realizar distintos estudios que arrojen luz sobre aspectos vinculados al desarrollo psicológico-cognitivo de personas con TEA. Es una valiosa opción para considerar por los profesionales entre las alternativas de intervención terapéutica, y que a su vez ayude tanto a plantear nuevas hipótesis en este campo como a ofrecer herramientas ccesibles, innovadoras y eficaces que entrenen y faciliten la tarea de los profesionales de la salud mental. (AU)
The Autism Spectrum Disorder is a neurodevlopmental disorder with a wider psicosocial and neurocognitive problematic. The use of structured strategies in dealing with people with autism spectrum disorder (ASD) is an useful and internationally recognized methodology. In the clinical practice of diagnostic and treatment team of the service of Pediatric Mental Health of the HIBA, these and also other tools such as language acquisition through writing computer are used. So it is important to share clinical experience using different strategies in the population with ASD. Also, discuss the scope of the use of technological tools in this approach and while thinking about different ways to validate the use of such applications and technological interventions in ASD. Assessing their advantages and disadvantages, we seek to create a more inclusive educational and therapeutic model, focused on communication and facilitation of motivation and expression, to homogenize professionals and arents with the ASD children world. We hope that the use of technological devices allow the collection of data and valuable key information which can then be used to conduct studies that shed light on aspects related to psychological and cognitive development in people with ASD. It is a valuable option to consider for professionals in alternative therapeutic intervention, which in turn will help both raise new hypotheses in this field as well as providing accessible, innovative and efficient tools to train and facilitate the work of mental health professionals. (AU)