None listed
Conditions
Brief summary
Understanding emotions, understanding that other people think or feel things differently to ourselves, and thinking and feeling from another’s perspective are all skills associated with social cognition. There are many reasons why some people find it more difficult to do these things, and having a brain injury is one of them: the regions in the brain that can be damaged through injury often affect the areas we know are important for social cognition. What is less well understood is whether it is possible to treat social cognitive deficits after such an injury. This is because very little research has been done trialling these kinds of treatments for people with a brain injury, and there have been no trials that have ‘comprehensively’ targeted the interrelating process of social cognition. The aim of this study, therefore, is to trial a novel social cognition treatment (SIFT IT), a therapy that has been developed considering the needs of those living with a brain injury, yet still informed by treatments developed in other clinical populations. SIFT IT: The Social Thinking Therapy has been designed as a group program that will run for 14 weekly sessions, each 90-120 minutes. It combines principles of cognitive behavioural therapy (CBT) with cognitive remediation to help participants understand the breadth of processes involved in social cognition and then to apply them to their everyday lives. As SIFT IT is a new psychotherapeutic group intervention, the focus of this study is on whether it is possible to treat social cognitive deficits in this way in this population: i.e. to examine the intervention’s feasibility. Feasibility will be examined by looking at the demand for the therapy, how well the therapy can be implemented, the acceptability of the treatment, and whether it looks like the therapy is helping people improve their social cognitive skills. The study will run as a randomised controlled trial. Participants with a brain injury who have scored lower than expected on at least one social cognition assessment measure will be randomly allocated to the SIFT IT therapy group or to a waitlist control. Testing will take place after initial recruitment to gather baseline performance, then again after the SIFT IT therapy group has finished, then again after a further three months. The participants in the waitlist control will be offered to take part in the therapy group after the second round of testing. All participants will be asked to take part in a semi-structured interview after they have taken part in the therapy group to find out more detailed information about how they found the program. Data gathered from the trial will be analysed in a mixed methods approach. Some data will provide descriptive information about the participants and feasibility outcomes. Some data will allow for examination of changes in outcomes pre- to post-intervention. Other data will be analysed for common themes from feedback to examine therapy acceptability.
Interventions
Name: SIFT IT! The Social Thinking Therapy
SIFT IT is a group treatment with up to four participants per group delivered in face-to-face sessions. It uses transdiagnostic CBT techniques (guided discovery, Socratic questioning, generating alternative beliefs, testing alternative beliefs in different responses) to support participants to understand self- and other- thought-feeling-behaviour cycles involved in each of the ‘SIFT IT’ social cognitive processes. It also applies principles of cognitive
Name: SIFT IT! The Social Thinking Therapy SIFT IT is a group treatment with up to four participants per group delivered in face-to-face sessions. It uses transdiagnostic CBT techniques (guided discovery, Socratic questioning, generating alternative beliefs, testing alternative beliefs in different responses) to support participants to understand self- and other- thought-feeling-behaviour cycles involved in each of the ‘SIFT IT’ social cognitive processes. It also applies principles of cognitive remediation, i.e. repetition, practice, and building on single processes to culminate in complex interactions. Each group session involves an Introduction & agenda setting, Previous session review, Check in with participants, Homework review, Current topic for today’s session, Homework setting, and Take home messages. Session content involves group discussions, whiteboard activities, interactive games and activities using pictures, videos, ‘playing cards’ of social situations, and personalised role play. Homework consists of worksheets continuing the topic of the session: they aim to support the participant to relate the concepts discussed in the session to their own life examples (e.g. practice generating alternative ínterpretations to situations encountered using different 'filters') and may involve an 'experiment' to trial the techniques used in the session. Completing these worksheets may take up to 30 minutes per week. The treatment comprises 14 sessions, delivered once a week in 90 to 120 minute sessions (including a break). The first group session introduces participants to SIFT IT; Phase I (approx. Sessions 2-6) cover psychoeducation of processes important in social cognition (Sensing, Interpreting… Feelings, Thoughts, Intentions); in Phase II (approx. Sessions 7-10) the interrelations between processes are highlighted using participants real life experiences to improve perspective taking; Phase III (approx. Sessions 11-13) support participants to choose adaptive ways to ‘try’ out their response to reach their goals; and Session 14 will review topics covered throughout the treatment. An AHPRA registered Clinical Psychologist will deliver the intervention with experience working with people with brain injury. The location of the group sessions will depend on participant needs and location of participant recruitment. They will all occur in a large room suitable for group therapy, in either academic or clinical service locations. As each participant will develop individualised goals of what they would like to achieve through participation and they will be encouraged to bring personal examples to discuss in the group and relate to key concepts discussed, each group will be personalised to the particular participants attending. Even so, each group will follow the core processes described above. Adherence will be assessed by monitoring attendance to group sessions; attempts to complete homework. Fidelity will be assessed by random selection of 10% of completed group sessions in which a trained member of the research team will rate the facilitator on SIFT IT Fidelity Scale (Agenda setting, Previous session review, Check-in, Homework, Adherence to session content, Quality of delivery, Session homework, Take-home messages).
Sponsors
University of New South Wales
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
(1) experienced a moderate to severe acquired brain injury (for traumatic brain injury: score on the Glasgow Coma Scale of 9-12 [moderate], 8 or less [severe] and/or a period of post traumatic amnesia of 1-24 hours [moderate], more than 24 hours [severe]) (2) at least six months post-injury (3) residing in the community for at least six months (4) between 18 and 65 years of age (5) sufficient cognitive capabilities to participate in assessment and group tasks (6) sufficient English language proficiency to participate in assessment and group tasks (7) performance at least one standard deviation below normative sample on social cognition measures at baseline assessment
Exclusion criteria
(1) diagnosed developmental delay (2) substantive expressive and/or receptive language impairment (3) recent history or current risk of major psychiatric crisis (e.g. suicide attempt, psychotic relapse) (4) uncorrected visual or hearing impairment
Outcome results
None listed