

Among the most common and debilitating cognitive impairments after Traumatic Brain Injury (TBI) is disruption of executive functions and related emotional and behavioral dysregulation. Executive dysfunction after TBI represents one of the most significant barriers to recovery, community reintegration, and return to duty in military personnel with TBI. Investigators at the Brain Injury Research Center of Mount Sinai (BIRC-MS) have developed two theoretically- and empirically-based intensive group cognitive rehabilitation interventions that combine three distinct types of training (attention, emotional regulation and problem solving): Executive Plus and Short Term Executive Plus (STEP). A federally funded randomized controlled trial (RCT) to examine the effectiveness of Executive Plus was recently completed and an RCT of STEP is currently under way at the BIRC-MS. The proposed presentation will describe the methodology of these two RCTs. Preliminary findings from the Executive Plus study will be presented that treatment resulted in lasting benefits in the domains of self-efficacy, problem solving, attention, and quality of life even after treatment was withdrawn. In addition, MIL-STEP, a proposed adaptation of the model for treatment of veterans of OEF/OIF with TBI will be described.