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Jan Stubberud - One of the best experts on this subject based on the ideXlab platform.

  • Goal Management training as a cognitive remediation intervention in depression a randomized controlled trial
    Journal of Affective Disorders, 2020
    Co-Authors: Bjorn Ingulfsvann Hagen, Jutta Joormann, Milada Cvancarova Smastuen, Nils Inge Landro, Jan Stubberud
    Abstract:

    Abstract Background Major depressive disorder (MDD) is associated with deficits in executive functioning (EF) that may have a detrimental effect on everyday functioning. Despite this, there are no established cognitive remediation interventions available targeting EF in MDD. Hence, the primary aim of the present pre-registered randomized controlled trial was to evaluate the effectiveness of Goal Management Training (GMT), a metacognitive and strategy-based cognitive remediation intervention to improve EF in MDD. Methods Sixty-three participants with current or previous mild or moderate MDD and self-reported executive deficits were included and randomized to nine sessions of either GMT (two hours, once weekly; n = 35) or computerized cognitive training (one hour, twice weekly; n = 28). Assessments were conducted at baseline (T1), immediately following training (T2), and at six-month follow-up (T3). The primary outcome measure was The Behavior Rating Inventory of Executive Function – Adult version, pertained to daily life EF. Secondary outcome measures included additional EF assessments (performance-based measures and questionnaires), and depressive symptom severity. Results Forty-three participants completed treatment. Both groups improved following training, and linear mixed model analyses revealed no statistically significant differences between the groups for any outcome measure. Additional exploratory within-group analyses revealed a statistically significant reduction of everyday executive dysfunction and reduced depressive symptoms at the six-month follow-up in GMT only. Limitations The study was single-blind, and the sample size was modest. Conclusions Our findings indicate comparable improvements in everyday and performance-based measures of EF, in addition to reductions in depressive symptoms following both GMT and CCT.

  • The feasibility and acceptability of Goal Management training of executive functions in children with spina bifida and acquired brain injury.
    Neuropsychological Rehabilitation, 2020
    Co-Authors: Jan Stubberud, Marianne Lovstad, Anne-kristine Schanke, Ingvil L. Holthe, Anne Elisabeth Brandt, Torun Gangaune Finnanger
    Abstract:

    Executive dysfunction causes significant real-life disability for children with spina bifida (SB) and acquired brain injury (ABI), and efficient interventions are needed. Goal Management Training (...

  • Paediatric Goal Management training in patients with acquired brain injury: study protocol for a randomised controlled trial.
    BMJ Open, 2019
    Co-Authors: Ruth Elizabeth Hypher, Anne Elisabeth Brandt, Torun Gangaune Finnanger, Kari R. Risnes, Torstein Baade Rø, Eva Skovlund, Stein Andersson, Jan Stubberud
    Abstract:

    Introduction Compromised integrity of the brain due to paediatric acquired brain injury (pABI) has been associated with cognitive impairment, particularly executive dysfunction, in addition to somatic and emotional symptoms and reduced everyday function. Goal Management Training (GMT) is a cognitive rehabilitation intervention for improving executive function (EF) that has received empirical support in studies of adults with ABI. The purpose of the present study is to determine the efficacy of a recently developed paediatric version of GMT (pGMT) for children and adolescents with ABI and reported executive dysfunction. Methods and analysis This study protocol describes a parallel randomised controlled trial including allocation concealment and assessor blinding. Eighty survivors after pABI, aged 10–17 years at the time of intervention, will be recruited. Participants will be randomly allocated to either pGMT (n=40) or a psychoeducative control intervention (n=40; paediatric Brain Health Workshop). Both interventions consist of seven group sessions for participants and parents, followed by external cueing and telephone counselling. The study also includes involvement of teachers. Assessments will be performed at baseline, immediately postintervention and at 6 months’ follow-up. Primary outcome measure will be changes in daily life EF as reported by parents (The Behavior Rating Inventory of Executive Function). Secondary outcomes include other assessments of EF (neuropsychological tests and questionnaires). Furthermore, we aim to assess generalisation effects of pGMT on other cognitive functions, as well as emotional, behavioural, adaptive and family function, academic performance, fatigue and quality of life. Ethics and dissemination Results from this study will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals, in addition to presentations at scientific conferences. The study will be conducted in accordance with the Helsinki declaration and the Ethical Research Involving Children (ChildWatch International and Unicef). In accordance to Good Clinical Practice our study includes safety and quality monitoring guarantees in compliance with research ethics and safety. The trial will be reported in accordance with the Consolidated Standards of Reporting Trials 2010 statement and Standard Protocol Items for Reporting in Trials recommendations, in addition to being registered at ClinicalTrials.gov. The study has been approved by the Regional Committees for Medical and Health Research Ethics Norway (2017/772). Trial registration number NCT03215342.

  • Use It or Lose It? A 5-Year Follow-up Study of Goal Management Training in Patients with Acquired Brain Injury.
    Journal of The International Neuropsychological Society, 2019
    Co-Authors: Sveinung Tornås, Anne-kristin Solbakk, Marianne Lovstad, Anne-kristine Schanke, Jan Stubberud
    Abstract:

    Objectives: To determine the perceived 5-year outcome of Goal Management Training (GMT) for individuals with chronic acquired brain injury and executive dysfunction, when compared to a nonspecific psychoeducational intervention (Brain Health Workshop, BHW). Methods: Of the 67 subjects in the initial randomized controlled trial [Tornas et al. ( 2016 ). Journal of the International Neuropsychological Society , 1–17], 50 (GMT, n = 21; BHW, n = 29) subjects returned written consent and questionnaires (54% male, age 45.8 ± 10.9 years). The 5-year follow-up consisted of two questionnaires, including the Behavior Rating Inventory of Executive Function for daily life executive function (EF) and Quality of Life after Brain Injury to assess health-related quality of life (HRQoL). Changes related to daily life EF and HRQoL were assessed pre-treatment, post-treatment, 6-month follow-up, and 5-year follow-up. Data were analyzed using a 2 × 4 mixed-design ANOVA. Results: The findings indicate that GMT is efficacious in improving EF and HRQoL 6-month post-treatment. However, these changes failed to remain significant at 5-year follow-up. Conclusions: Data from 50 participants receiving either GMT or BHW suggested that the significant GMT-related improvements on perceived EF and HRQoL observed at 6-month follow-up were no longer present at 5-year follow-up. These findings indicate a need to promote maintenance of interventions post-treatment.

  • rehabilitation of executive functions in patients with chronic acquired brain injury with Goal Management training external cuing and emotional regulation a randomized controlled trial
    Journal of The International Neuropsychological Society, 2016
    Co-Authors: Sveinung Tornås, Anne-kristin Solbakk, Marianne Lovstad, Anne-kristine Schanke, Jonathan Evans, Tor Endestad, Jan Stubberud
    Abstract:

    Executive dysfunction is a common consequence of acquired brain injury (ABI), causing significant disability in daily life. This randomized controlled trial investigated the efficacy of Goal Management Training TM (GMT) in improving executive functioning in patients with chronic ABI. Seventy patients with a verified ABI and executive dysfunction were randomly allocated to GMT ( n =33) or a psycho-educative active control condition, Brain Health Workshop (BHW) ( n =37). In addition, all participants received external cueing by text messages. Neuropsychological tests and self-reported questionnaires of executive functioning were administered pre-intervention, immediately after intervention, and at 6 months follow-up. Assessors were blinded to group allocation. Questionnaire measures indicated significant improvement of everyday executive functioning in the GMT group, with effects lasting at least 6 months post-treatment. Both groups improved on the majority of the applied neuropsychological tests. However, improved performance on tests demanding executive attention was most prominent in the GMT group. The results indicate that GMT combined with external cueing is an effective metacognitive strategy training method, ameliorating executive dysfunction in daily life for patients with chronic ABI. The strongest effects were seen on self-report measures of executive functions 6 months post-treatment, suggesting that strategies learned in GMT were applied and consolidated in everyday life after the end of training. Furthermore, these findings show that executive dysfunction can be improved years after the ABI. ( JINS , 2016, 22 , 436–452)

Brian Levine - One of the best experts on this subject based on the ideXlab platform.

  • effectiveness of Goal Management training in improving executive functions a meta analysis
    Neuropsychological Rehabilitation, 2019
    Co-Authors: Vessela Stamenova, Brian Levine
    Abstract:

    ABSTRACTOur objective was to review the literature and quantitatively summarise the effectiveness of Goal Management Training® (GMT) (alone or in combination with other training approaches) in impr...

  • Emotional health and coping in spina bifida after Goal Management training: a randomized controlled trial.
    Rehabilitation Psychology, 2014
    Co-Authors: Jan Stubberud, Brian Levine, Donna Langenbahn, Johan K. Stanghelle, Anne-kristine Schanke
    Abstract:

    Objective Executive function impairments are common after spina bifida (SB) and potentially have a detrimental effect on the individual's emotional health and coping. Goal Management training (GMT) is a cognitive rehabilitation method for improving executive function. The purpose of this study was to determine the efficacy of GMT on aspects of perceived emotional health and coping in individuals with SB. Method Thirty-eight adult subjects with SB were included in this randomized controlled trial. Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n = 24) received 21 hr of GMT, with efficacy of GMT being compared with results of subjects in a wait-list condition (n = 14). Four self-report questionnaires assessing emotional health and coping were utilized as outcome measures. All subjects were assessed at baseline, postintervention, and at 6-month follow-up. Results Findings indicated positive effects of GMT relative to the control group on measures of emotional health. Of note, the GMT group showed significant improvement, compared with control subjects, on a self-report inventory of depressive and anxiety symptoms after training, lasting at least 6 months posttreatment. Furthermore, both groups showed improvements after training on mental health components of health-related quality of life. Finally, the GMT group showed a significant increase in task-focused coping and a decrease in avoidant coping after training compared with pretreatment baseline assessment scores. Conclusions Overall, findings indicate that by us a compensatory intervention to manage executive dysfunction, effective and lasting benefits can be achieved with regard to aspects of perceived emotional health and coping.

  • Goal Management Training improves everyday executive functioning for persons with spina bifida: Self-and informant reports six months post-training
    Neuropsychological Rehabilitation, 2013
    Co-Authors: Jan Stubberud, Brian Levine, Donna Langenbahn, Johan K. Stanghelle, Anne-kristine Schanke
    Abstract:

    Executive dysfunction accounts for significant disability for many patients with spina bifida (SB), thus indicating the need for effective interventions aimed at improving executive functioning in this population. Goal Management Training™ (GMT) is a cognitive rehabilitation approach that targets disorganised behaviour resulting from executive dysfunction, and has received empirical support in studies of other patient groups. The purpose of this study was to determine if GMT would lead to perceived improved executive functioning in the daily lives of patients with SB, as evidenced by reduced report of dysexecutive problems in daily life on self- and informant questionnaires. Thirty-eight adults with SB were included in this randomised controlled trial (RCT). Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n = 24) received 21 hours of GMT, with efficacy of GMT being compared to results of subjects in a wait-list condition (n = 14). All subjects were assesse...

  • Goal Management training of executive functions in patients with spina bifida: a randomized controlled trial.
    Journal of The International Neuropsychological Society, 2013
    Co-Authors: Jan Stubberud, Brian Levine, Donna Langenbahn, Johan K. Stanghelle, Anne-kristine Schanke
    Abstract:

    Executive dysfunction causes significant real-life disability for patients with spina bifida (SB). However, no previous research has been directed toward the amelioration of executive functioning deficits amongst persons with SB. Goal Management Training (GMT) is a compensatory cognitive rehabilitation approach, addressing underlying deficits in sustained attention to improve executive function. GMT has received empirical support in studies of other patient groups. The purpose of the present study was to determine the efficacy of GMT in treating subjects with SB, using inpatient intervention periods. We hypothesized post-intervention changes in scores on neuropsychological measures to reflect improved attentional control, including sustained attention and inhibitory control. Thirty-eight adult subjects with SB were included in this randomized controlled trial. Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n 5 24) received 21 hr of GMT, with efficacy of GMT being compared to results of subjects in a wait-list condition (n 5 14). All subjects were assessed at baseline, post-intervention, and at 6-month followup. Findings indicated superior effects of GMT on domain-specific neuropsychological measures and on a functional ‘‘real-life’’ measure, all lasting at least 6 months post-treatment. These results show that deficits in executive functioning can be ameliorated in patients with congenital brain dysfunction. (JINS, 2013, 19, 1–14)

  • rehabilitation of executive functioning in patients with frontal lobe brain damage with Goal Management training
    Frontiers in Human Neuroscience, 2011
    Co-Authors: Brian Levine, Donald T Stuss, Tom A Schweizer, Charlene Oconnor, Gary R Turner, Susan Gillingham, Tom Manly, Ian H Robertson
    Abstract:

    Executive functioning deficits due to brain disease affecting frontal lobe functions cause significant real-life disability, yet solid evidence in support of executive functioning interventions is lacking. Goal Management Training (GMT), an executive functioning intervention that draws upon theories concerning Goal processing and sustained attention, has received empirical support in studies of patients with traumatic brain injury, normal aging, and case studies. GMT promotes a mindful approach to complex real-life tasks that pose problems for patients with executive functioning deficits, with a main Goal of periodically stopping ongoing behavior to monitor and adjust Goals. In this controlled trial, an expanded version of GMT was compared to an alternative intervention, Brain Health Workshop (BHW) that was matched to GMT on non-specific characteristics that can affect intervention outcome. Participants included 19 individuals in the chronic phase of recovery from brain disease (predominantly stroke) affecting frontal lobe function. Outcome data indicated specific effects of GMT on the Sustained Attention to Response Task (SART) as well as the Tower Test, a visuospatial problem solving measure that reflected far transfer of training effects. There were no significant effects on self-report questionnaires, likely owing to the complexity of these measures in this heterogeneous patient sample. Overall, these data support the efficacy of GMT in the rehabilitation of executive functioning deficits.

Roy P. C. Kessels - One of the best experts on this subject based on the ideXlab platform.

  • Transfer effects of errorless Goal Management Training on cognitive function and quality of life in brain-injured persons
    NeuroRehabilitation, 2016
    Co-Authors: Dirk Bertens, Danielle H E Boelen, Roy P. C. Kessels, Luciano Fasotti
    Abstract:

    BACKGROUND: Previous findings had shown that the addition of errorless learning to traditional Goal Management Training (GMT) resulted in superior results when training everyday tasks in persons with executive deficits after brain injury. OBJECTIVE: To investigate the additional effects of an errorless GMT on cognitive function and quality of life after acquired brain injury. METHODS: This is a supplementary analysis of findings from an RCT in which 67 patients with executive impairments after acquired brain injury were randomly allocated to an experimental errorless GMT (n = 33) or conventional GMT (n = 34) to train two individually chosen everyday tasks. Objective cognitive function using neuropsychological tests, subjective cognitive complaints and quality of life using questionnaires were assessed before and after training. RESULTS: No significant interaction effects between these three types of outcome measures and the two forms of GMT were found. Irrespective of treatment, performance on two executive tests (Modified Six Elements Test; p = 0.006, Zoo Map test; p = 0.001) improved and daily executive function problems as reported by the participants (EFI; p = 0.001) and proxies (DEX; p = 0.01) diminished. CONCLUSIONS: Besides the previously found superiority of errorless GMT when training everyday tasks, additional improvements in cognition and quality of life did not differ between the two treatments.

  • do old errors always lead to new truths a randomized controlled trial of errorless Goal Management training in brain injured patients
    Journal of The International Neuropsychological Society, 2015
    Co-Authors: Dirk Bertens, Danielle H E Boelen, Roy P. C. Kessels, Eleonora Fiorenzato, Luciano Fasotti
    Abstract:

    Both errorless learning (EL) and Goal Management Training (GMT) have been shown effective cognitive rehabilitation methods aimed at optimizing the performance on everyday skills after brain injury. We examine whether a combination of EL and GMT is superior to traditional GMT for training complex daily tasks in brain-injured patients with executive dysfunction. This was an assessor-blinded randomized controlled trial conducted in 67 patients with executive impairments due to brain injury of non-progressive nature (minimal post-onset time: 3 months), referred for outpatient rehabilitation. Individually selected everyday tasks were trained using 8 sessions of an experimental combination of EL and GMT or via conventional GMT, which follows a trial-and-error approach. Primary outcome measure was everyday task performance assessed after treatment compared to baseline. Goal attainment scaling, rated by both trainers and patients, was used as secondary outcome measure. EL-GMT improved everyday task performance significantly more than conventional GMT (adjusted difference 15.43, 95% confidence interval [CI] [4.52, 26.35]; Cohen's d=0.74). Goal attainment, as scored by the trainers, was significantly higher after EL-GMT compared to conventional GMT (mean difference 7.34, 95% CI [2.99, 11.68]; Cohen's d=0.87). The patients' Goal attainment scores did not differ between the two treatment arms (mean difference 3.51, 95% CI [-1.41, 8.44]). Our study is the first to show that preventing the occurrence of errors during executive strategy training enhances the acquisition of everyday activities. A combined EL-GMT intervention is a valuable contribution to cognitive rehabilitation in clinical practice.

  • Moderators, mediators, and nonspecific predictors of treatment outcome in an intervention for everyday task improvement in persons with executive deficits after brain injury
    Archives of Physical Medicine and Rehabilitation, 2015
    Co-Authors: Dirk Bertens, Danielle H E Boelen, Luciano Fasotti, Roy P. C. Kessels
    Abstract:

    OBJECTIVE: To identify moderators, mediators, and predictors of everyday task performance after an experimental combination of errorless learning and Goal Management training. DESIGN: Predictor analysis of a randomized controlled intervention trial. SETTING: Outpatient rehabilitation centers. PARTICIPANTS: Patients (N=60) with acquired brain injury of nonprogressive nature with a minimal postonset time of 3 months. INTERVENTIONS: Participants were randomly allocated to 8 sessions of errorless or conventional Goal Management training. MAIN OUTCOME MEASURE: Everyday task performance, assessed at baseline and after treatment by evaluating correct, ineffective, and missing task steps. RESULTS: Demographic variables, neuropsychological test performance, subjective cognitive function, and quality of life were selected as candidate predictors. The results showed that age (P=.03) and estimated intelligence quotient (IQ) (P=.02) emerged as moderators. Higher age was associated with better everyday task performance after conventional Goal Management training, whereas higher IQ was associated with better performance after errorless Goal Management training. Higher executive function scores after training predicted improved everyday task performance across the 2 treatment conditions (P=.04). CONCLUSIONS: The identified predictors may contribute to a more tailored cognitive rehabilitation approach in which treatments and patients are better matched when clinicians decide to train everyday tasks.

  • a randomized controlled trial on errorless learning in Goal Management training study rationale and protocol
    BMC Neurology, 2013
    Co-Authors: Dirk Bertens, Danielle H E Boelen, Luciano Fasotti, Roy P. C. Kessels
    Abstract:

    Background Many brain-injured patients referred for outpatient rehabilitation have executive deficits, notably difficulties with planning, problem-solving and Goal directed behaviour. Goal Management Training (GMT) has proven to be an efficacious cognitive treatment for these problems. GMT entails learning and applying an algorithm, in which daily tasks are subdivided into multiple steps. Main aim of the present study is to examine whether using an errorless learning approach (preventing the occurrence of errors during the acquisition phase of learning) contributes to the efficacy of Goal Management Training in the performance of complex daily tasks.

Anne-kristine Schanke - One of the best experts on this subject based on the ideXlab platform.

  • The feasibility and acceptability of Goal Management training of executive functions in children with spina bifida and acquired brain injury.
    Neuropsychological Rehabilitation, 2020
    Co-Authors: Jan Stubberud, Marianne Lovstad, Anne-kristine Schanke, Ingvil L. Holthe, Anne Elisabeth Brandt, Torun Gangaune Finnanger
    Abstract:

    Executive dysfunction causes significant real-life disability for children with spina bifida (SB) and acquired brain injury (ABI), and efficient interventions are needed. Goal Management Training (...

  • Use It or Lose It? A 5-Year Follow-up Study of Goal Management Training in Patients with Acquired Brain Injury.
    Journal of The International Neuropsychological Society, 2019
    Co-Authors: Sveinung Tornås, Anne-kristin Solbakk, Marianne Lovstad, Anne-kristine Schanke, Jan Stubberud
    Abstract:

    Objectives: To determine the perceived 5-year outcome of Goal Management Training (GMT) for individuals with chronic acquired brain injury and executive dysfunction, when compared to a nonspecific psychoeducational intervention (Brain Health Workshop, BHW). Methods: Of the 67 subjects in the initial randomized controlled trial [Tornas et al. ( 2016 ). Journal of the International Neuropsychological Society , 1–17], 50 (GMT, n = 21; BHW, n = 29) subjects returned written consent and questionnaires (54% male, age 45.8 ± 10.9 years). The 5-year follow-up consisted of two questionnaires, including the Behavior Rating Inventory of Executive Function for daily life executive function (EF) and Quality of Life after Brain Injury to assess health-related quality of life (HRQoL). Changes related to daily life EF and HRQoL were assessed pre-treatment, post-treatment, 6-month follow-up, and 5-year follow-up. Data were analyzed using a 2 × 4 mixed-design ANOVA. Results: The findings indicate that GMT is efficacious in improving EF and HRQoL 6-month post-treatment. However, these changes failed to remain significant at 5-year follow-up. Conclusions: Data from 50 participants receiving either GMT or BHW suggested that the significant GMT-related improvements on perceived EF and HRQoL observed at 6-month follow-up were no longer present at 5-year follow-up. These findings indicate a need to promote maintenance of interventions post-treatment.

  • rehabilitation of executive functions in patients with chronic acquired brain injury with Goal Management training external cuing and emotional regulation a randomized controlled trial
    Journal of The International Neuropsychological Society, 2016
    Co-Authors: Sveinung Tornås, Anne-kristin Solbakk, Marianne Lovstad, Anne-kristine Schanke, Jonathan Evans, Tor Endestad, Jan Stubberud
    Abstract:

    Executive dysfunction is a common consequence of acquired brain injury (ABI), causing significant disability in daily life. This randomized controlled trial investigated the efficacy of Goal Management Training TM (GMT) in improving executive functioning in patients with chronic ABI. Seventy patients with a verified ABI and executive dysfunction were randomly allocated to GMT ( n =33) or a psycho-educative active control condition, Brain Health Workshop (BHW) ( n =37). In addition, all participants received external cueing by text messages. Neuropsychological tests and self-reported questionnaires of executive functioning were administered pre-intervention, immediately after intervention, and at 6 months follow-up. Assessors were blinded to group allocation. Questionnaire measures indicated significant improvement of everyday executive functioning in the GMT group, with effects lasting at least 6 months post-treatment. Both groups improved on the majority of the applied neuropsychological tests. However, improved performance on tests demanding executive attention was most prominent in the GMT group. The results indicate that GMT combined with external cueing is an effective metacognitive strategy training method, ameliorating executive dysfunction in daily life for patients with chronic ABI. The strongest effects were seen on self-report measures of executive functions 6 months post-treatment, suggesting that strategies learned in GMT were applied and consolidated in everyday life after the end of training. Furthermore, these findings show that executive dysfunction can be improved years after the ABI. ( JINS , 2016, 22 , 436–452)

  • Goal Management Training Combined With External Cuing as a Means to Improve Emotional Regulation, Psychological Functioning, and Quality of Life in Patients With Acquired Brain Injury: A Randomized Controlled Trial
    Archives of Physical Medicine and Rehabilitation, 2016
    Co-Authors: Sveinung Tornås, Anne-kristin Solbakk, Marianne Lovstad, Anne-kristine Schanke, Jan Stubberud
    Abstract:

    Objective To investigate whether Goal Management training (GMT) expanded to include external cuing and an emotional regulation module is associated with improved emotional regulation, psychological functioning, and quality of life (QOL) after chronic acquired brain injury (ABI). Design Randomized controlled trial with blinded outcome assessment at baseline, posttraining, and 6-month follow-up. Setting Outpatient. Participants Persons with ABI and executive dysfunction (N=70; 64% traumatic brain injury; 52% men; mean age ± SD, 43±13y; mean time since injury ± SD, 8.1±9.4y). Intervention Eight sessions of GMT in groups, including a new module addressing emotional regulation, and external cuing. A psychoeducative control condition (Brain Health Workshop) was matched on amount of training, therapist contact, and homework. Main Outcome Measures Emotional regulation was assessed with the Brain Injury Rehabilitation Trust Regulation of Emotions Questionnaire, the Emotional Control subscale and the Emotion Regulation factor (Behavior Rating Inventory of Executive Function–Adult Version), and the Positive and Negative Affect subscales from the Dysexecutive Questionnaire. Secondary outcome measures included psychological distress (Hopkins Symptom Checklist-25) and QOL (Quality of Life After Brain Injury Scale). Results Findings indicated beneficial effects of GMT on emotional regulation skills in everyday life and in QOL 6 months posttreatment. No intervention effects on measures of psychological distress were registered. Conclusions GMT is a promising intervention for improving emotional regulation after ABI, even in the chronic phase. More research using objective measures of emotional regulation is needed to investigate the efficacy of this type of training.

  • Emotional health and coping in spina bifida after Goal Management training: a randomized controlled trial.
    Rehabilitation Psychology, 2014
    Co-Authors: Jan Stubberud, Brian Levine, Donna Langenbahn, Johan K. Stanghelle, Anne-kristine Schanke
    Abstract:

    Objective Executive function impairments are common after spina bifida (SB) and potentially have a detrimental effect on the individual's emotional health and coping. Goal Management training (GMT) is a cognitive rehabilitation method for improving executive function. The purpose of this study was to determine the efficacy of GMT on aspects of perceived emotional health and coping in individuals with SB. Method Thirty-eight adult subjects with SB were included in this randomized controlled trial. Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n = 24) received 21 hr of GMT, with efficacy of GMT being compared with results of subjects in a wait-list condition (n = 14). Four self-report questionnaires assessing emotional health and coping were utilized as outcome measures. All subjects were assessed at baseline, postintervention, and at 6-month follow-up. Results Findings indicated positive effects of GMT relative to the control group on measures of emotional health. Of note, the GMT group showed significant improvement, compared with control subjects, on a self-report inventory of depressive and anxiety symptoms after training, lasting at least 6 months posttreatment. Furthermore, both groups showed improvements after training on mental health components of health-related quality of life. Finally, the GMT group showed a significant increase in task-focused coping and a decrease in avoidant coping after training compared with pretreatment baseline assessment scores. Conclusions Overall, findings indicate that by us a compensatory intervention to manage executive dysfunction, effective and lasting benefits can be achieved with regard to aspects of perceived emotional health and coping.

Ian H Robertson - One of the best experts on this subject based on the ideXlab platform.

  • rehabilitation of executive functioning in patients with frontal lobe brain damage with Goal Management training
    Frontiers in Human Neuroscience, 2011
    Co-Authors: Brian Levine, Donald T Stuss, Tom A Schweizer, Charlene Oconnor, Gary R Turner, Susan Gillingham, Tom Manly, Ian H Robertson
    Abstract:

    Executive functioning deficits due to brain disease affecting frontal lobe functions cause significant real-life disability, yet solid evidence in support of executive functioning interventions is lacking. Goal Management Training (GMT), an executive functioning intervention that draws upon theories concerning Goal processing and sustained attention, has received empirical support in studies of patients with traumatic brain injury, normal aging, and case studies. GMT promotes a mindful approach to complex real-life tasks that pose problems for patients with executive functioning deficits, with a main Goal of periodically stopping ongoing behavior to monitor and adjust Goals. In this controlled trial, an expanded version of GMT was compared to an alternative intervention, Brain Health Workshop (BHW) that was matched to GMT on non-specific characteristics that can affect intervention outcome. Participants included 19 individuals in the chronic phase of recovery from brain disease (predominantly stroke) affecting frontal lobe function. Outcome data indicated specific effects of GMT on the Sustained Attention to Response Task (SART) as well as the Tower Test, a visuospatial problem solving measure that reflected far transfer of training effects. There were no significant effects on self-report questionnaires, likely owing to the complexity of these measures in this heterogeneous patient sample. Overall, these data support the efficacy of GMT in the rehabilitation of executive functioning deficits.

  • cognitive rehabilitation in the elderly effects on strategic behavior in relation to Goal Management
    Journal of The International Neuropsychological Society, 2007
    Co-Authors: Brian Levine, Donald T Stuss, Gordon Winocur, Malcolm A Binns, Louise Fahy, Marina Mandic, Kristen Bridges, Ian H Robertson
    Abstract:

    Executive functions are highly sensitive to the effects of aging and other conditions affecting frontal lobe function. Yet there are few validated interventions specifically designed to address executive functions, and, to our knowledge, none validated in a healthy aging sample. As part of a large-scale cognitive rehabilitation randomized trial in 49 healthy older adults, a modified Goal Management Training program was included to address the real-life deficits caused by executive dysfunction. This program emphasized periodic suspension of ongoing activity to establish Goal hierarchies and monitor behavioral output. Tabletop simulated real-life tasks (SRLTs) were developed to measure the processes targeted by this intervention. Participants were randomized to two groups, one of which received the intervention immediately and the other of which was wait-listed prior to rehabilitation. Results indicated improvements in SRLT performance and self-rated executive deficits coinciding with the training in both groups. These gains were maintained at long-term follow-up. Future research will assess the specificity of these effects in patient groups ( JINS , 2007, 13 , 143–152.)

  • Effect of a structured course involving Goal Management training
    2006
    Co-Authors: Susan Van Hooren, Brian Levine, Rudolf W. H. M. Ponds, Ian H Robertson, Susanne A. M. Valentijn, Hans Bosma, Martin P.j. Van Boxtel, Jelle Jolles
    Abstract:

    Objective: The objective of this study was to investigate the effects of a structured 6-week neuropsychological course on the executive functioning of older adults with cognitive complaints. Methods: A randomised controlled design was used involving 69 community dwelling individuals aged 55 years and older. Both objective and subjective measures were included to assess executive functioning. General linear model with repeated measures analysis of variance was used to examine the intervention effects. Results: After the intervention, the participants in the intervention group were significantly less annoyed by their cognitive failures, were better able to manage their executive failures and reported less anxiety symptoms than those in the waiting list control group. Conclusion: These findings indicate that a combination of psycho-education and training has the potential to change the attitude of older individuals towards their cognitive functioning. Practice implications: Because this training focussed on cognitive functions that are among the first to decline in older adults and the subjective evaluation of the people after training was quite favourable, the proposed intervention may be considered a valuable contribution to cognitive interventions for older adults.

  • rehabilitation of executive function facilitation of effective Goal Management on complex tasks using periodic auditory alerts
    Neuropsychologia, 2002
    Co-Authors: Tom Manly, Kari Hawkins, Jon Evans, Karina Woldt, Ian H Robertson
    Abstract:

    The 'dysexecutive syndrome' represents a major challenge to functional recovery and adaptation following brain injury--and an important target for rehabilitation. Previous reports of everyday difficulties, and performance on complex, life-like tasks, indicate that an adequately represented Goal may become neglected as patients become overly engaged in current activity. Here we examine whether the provision of brief auditory stimuli, acting to interrupt current activity and to cue patients to consider their overall Goal, would improve performance in a complex task. Ten brain injured patients completed a modification of Shallice and Burgess' Six Elements task under two conditions. In the 'Hotel' test, the patients were asked to try and do some of each of five sub-tasks within 15 min. As the total time to complete all of the tasks would exceed an hour, the measure emphasises patients' ability to monitor the time, switch between the tasks and keep track of their intentions. Without the external auditory cues, the patients performed significantly more poorly than age- and IQ-matched control volunteers, a common error being to continue performing one task to the detriment of beginning or allocating sufficient time to others. When exposed to the interrupting tones, however, their performance was both significantly improved and no longer significantly different from the control group on important variables. The results have value in assessment in helping to attribute poor performance to 'Goal neglect' rather than, for example, poor memory or comprehension. They also suggest that providing environmental support to one aspect of executive function may facilitate monitoring and behavioural flexibility--and therefore the useful expression of other skills that may be relatively intact.

  • rehabilitation of executive functioning an experimental clinical validation of Goal Management training
    Journal of The International Neuropsychological Society, 2000
    Co-Authors: Brian Levine, Ian H Robertson, Linda Clare, Gina Carter, Julia Hong, Barbara A Wilson, John S Duncan, Donald T Stuss
    Abstract:

    Two studies assessed the effects of a training procedure (Goal Management Training, GMT), derived from Duncan’s theory of Goal neglect, on disorganized behavior following TBI. In Study 1, patients with traumatic brain injury (TBI) were randomly assigned to brief trials of GMT or motor skills training. GMT, but not motor skills training, was associated with significant gains on everyday paper-and-pencil tasks designed to mimic tasks that are problematic for patients with Goal neglect. In Study 2, GMT was applied in a postencephalitic patient seeking to improve her meal-preparation abilities. Both naturalistic observation and self-report measures revealed improved meal preparation performance following GMT. These studies provide both experimental and clinical support for the efficacy of GMT toward the treatment of executive functioning deficits that compromise independence in patients with brain damage. (JINS, 2000, 6, 299‐312.)