Strengthening neuro-cognitive skills for success in school, work and beyond

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In order to advance the development of tele-rehabilitation that addresses issues related to traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and related issues, this project will deploy and test two interventions designed to build strengths valuable for achieving personal goals such as in school and work. The interventions will be based on two different lines of theory for improving goal-directed functioning, targeting either goal-directed brain state regulation skills (GSR) or knowledge for optimizing brain functioning (OPT). Both interventions will utilize advances in tele-rehabilitation (e.g., online resources, digital apps, and coaching over tele-video) to provide access to guided learning experiences for Veterans in different locations and settings. We will examine the impact of these interventions on multiple levels of goal-directed functioning, and we will investigate changes in hypothesized neurocognitive pathways. Post-9/11 Veterans with a history of TBI (age 25-60) will be allocated to one of the two training interventions in a randomized, controlled design. Assessments will focus on indexing tiers of goal-directed functioning (neurocognitive tests, functional performance with complex tasks, and goal attainment in personal life) and will be collected for double-baseline, after training, and at 3 months follow-up. The knowledge generated by this project will inform Veteran-centered intervention development, including informing and providing tools for tele-rehabilitation that Veterans can access at home, in school, and other settings remote from VA facilities.