Acute Cognitive and Neurobehavioral Intervention: Efficacy Evaluation

To evaluate the efficacy of the First Steps intervention for improving neurobehavioral
functioning, functional status, and life satisfaction, and for increasing knowledge about
TBI and compensatory strategies. The First Steps program was developed to address the
neurobehavioral and emotional concerns of survivors of TBI during the course of inpatient
rehabilitation. Program format and content reflects clinical experience and extensive
research review. Input from survivors, family members, and rehabilitation staff trained in
working with the TBI population has also helped shape the implementation protocol. The
foundation of the protocol is a curriculum [Niemeier, J., Kreutzer, J., & Taylor, L. (2005).
Acute cognitive and neurobehavioral intervention for individuals with acquired brain injury:
Preliminary outcome data. Neuropsychological Rehabilitation, 15(2), 129-146.] The First
Steps curriculum consists of ten lessons and was developed to address the common needs,
issues, and concerns of TBI survivors admitted acutely for inpatient rehabilitation.

Inclusion Criteria:

- adults (18 years or older) who have experienced a TBI (damage to brain tissue caused
by an external mechanical force as evidenced by: loss of consciousness due to brain
trauma, or post traumatic amnesia, or skull fracture, or objective neurological
findings that can be reasonably attributed to TBI on physical examination or mental
status examination).

Exclusion Criteria:

- imminent risk of psychiatric hospitalization, or in imminent danger of hurting
themselves or others.

- unable to tolerate treatment sessions due to physical, cognitive, behavioral, or
other difficulties.