The Rehabilitation Research and Training Center (RRTC) on Community Integration of Persons with Traumatic Brain Injury at TIRR

R4: Effectiveness of a Brief Educational Intervention for Reducing Substance Abuse after TBI

Co-Principal Investigators: Angelle M. Sander, Ph.D., John Corrigan, Ph.D. & Jennifer Bogner, Ph.D.

Overview:

Many persons with TBI have a history of heavy use of alcohol and/or drugs. Alcohol or drug use may have even contributed to their injuries, such as leading to a motor vehicle accident. After injury, many people return to using alcohol and drugs. People who did not use alcohol or drugs before injury may begin to do so after injury because they are bored and/or depressed.

Research studies have shown that use of alcohol and other drugs can have a negative impact upon recovery. For example, alcohol abuse has been associated with emotional difficulties, subsequent injuries, slowed brain activity, poorer thinking abilities, decreased employment, and less independence.

Few studies have investigated treatments for substance abuse after TBI. For persons without TBI, treatments work best when people are ready to change their behaviors. After a TBI, people may be more ready to change their behaviors because the occurrence of a life-threatening injury may cause them to re-evaluate their actions and the consequences of those actions. Brief interventions, involving motivational interviewing and education, have been shown to be effective in reducing substance use for general trauma patients.

The purpose of the study was to assess the effectiveness of a brief educational and motivational intervention for decreasing positive expectations regarding the effects of alcohol use, increasing negative expectations, increasing readiness to change, and decreasing actual use of alcohol and drugs. The intervention was conducted as early as possible, up to a month following discharge from the acute trauma hospital. Effectiveness of the intervention was assessed by randomly assigning persons who met the criteria for at-risk use of substances to receive either the brief educational intervention or the hospital standard of care. Follow-up assessment was conducted at 3-4 months.

Significant Developments: