Group treatment of problem-solving deficits in outpatients with traumatic brain injury: A randomised outcome study Joseph F. Rath, Dvorah Simon, Donna M. Langenbahn, Rose Lynn Sherr, and Leonard Diller Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, New York, USA Sixty higher-level outpatients with traumatic brain injury (TBI), all at least 1 year post-injury, were randomly assigned to either conventional group neuropsycho- logical rehabilitation or an innovative group treatment focused on the treatment of problem-solving deficits. Incorporating strategies for addressing underlying emotional self-regulation and logical thinking/reasoning deficits, the innovative treatment is unique in its attention to both motivational, attitudinal, and affective processes and problem-solving skills in persons with TBI. Participants in the innovative group improved in problem solving as assessed using a variety of measures, including (1) executive function, (2) problem-solving self-appraisal, (3) self-appraised emotional self-regulation and clear thinking, and (4) objective observer ratings of roleplayed scenarios. These improvements were maintained at follow-up. Baseline performance on timed attention tasks was related to improvement; individuals who processed the most slowly benefited the most. These participants did not show improvements on timed attention tasks, but did improve on problem-solving measures. Such findings are consistent with successful compensatory strategy use—the person may still have deficits and symptoms, but now has effective strategies for reducing their impact on daily functioning. Correspondence should be addressed to Dr Joseph F. Rath, Rusk Institute of Rehabilitation Medicine, Department of Rehabilitation Medicine, New York University School of Medicine, 400 East 34th Street, New York, NY, 10016, USA. Email: joseph.rath@med.nyu.edu. This research was supported by grant no. RO1-HD32943 to New York University School of Medicine from the National Institute of Child Health and Human Development (USA), Leonard Diller, Principal Investigator. Some of the data reported here were presented at the 109th annual convention of the American Psychological Association, August 2001, San Francisco. The authors thank Jason Fletcher for his contribution to this study. Ó 2003 Psychology Press Ltd http://www.tandf.co.uk/journals/pp/09602011.html DOI:10.1080/09602010343000039 NEUROPSYCHOLOGICAL REHABILITATION, 2003, 13 (4), 461–488 Downloaded by [New York University] at 07:24 08 June 2015