Evaluating the Social Brain Toolkit Virtual Clinic: Rebuilding communication skills after traumatic brain injury via an online service

What is the intervention? The intervention is the Social Brain Toolkit Virtual Clinic, a 12-week structured communication rehabilitation program for people with TBI and their communication partners. It is based on the convers-ABI-lity program and delivers communication training through a combination of clinician-facilitated videoconferencing, self-guided online modules, peer mentorship, and supported online group interaction. The intervention is expected to integrate four core components: - (a) Videoconferencing sessions facilitated by student speech pathologists, in which people with TBI practise and receive feedback on conversation skills with their communication partner, a speech pathology student, or a peer mentor, supported by the Convers-ABI-lity manual and a clinical practice educator. - (b) Convers-ABI-lity self-guided online modules completed by people with TBI alongside a communication partner (if available), or with a speech pathology student or peer mentor. - (c) An online discussion group moderated by speech pathology students and peer mentors (with practice educator support), providing a safe and supportive environment for practising social media skills and connecting with peer mentorship. - (d) Home practice activities assigned by student speech pathologists based on individual participant goals, supported by the Convers-ABI-lity manual and practice educators. Home-practice activities (such as practising real-life conversations, using strategy checklists, or completing reflection tasks) will be strategically selected to directly support each participant’s personalised communication goals, initially identified at baseline. The intervention is tailored to each participant’s individual goals through the initial collaborative goal-setting, which then guides personalised elements of the program such as home-practice activities, teleconference session content, and discussion group topics. Personalisation occurs at multiple points: Baseline: During initial goal-setting at baseline, where participants identify their priorities and everyday communication challenges. Throughout the program: During teleconference sessions, where goals are reviewed, refined, and used to guide session content. Between sessions: When home-practice tasks are selected or adapted to match the participant’s goals and daily routines. A clinician works with the participant (and optionally a communication partner) to identify personalised goals using structured goal-setting tools. These goals inform the selection of discussion group topics, strategy practice, etc. Home-practice activities are chosen or modified to align with the participant’s goals and real-life communication contexts. Teleconference sessions are used to monitor progress, adjust goals, and refine strategies to ensure ongoing relevance. Participants who do not own a suitable device are provided with a loan iPad with internet access to ensure equitable access to the program. The convers-ABI-lity program, part of the Social Brain Toolkit, is a structured 10-week clinical resource designed for individuals with acquired brain injury (ABI) and their communication partners to complete together. The self-guided online modules cover the following key topics and activities: Goal Setting: Collaboratively setting specific goals to improve daily conversations. Approaching Conversations: Learning new ways to handle communication after a brain injury. Conversation Strategies: Participating in web-based video rating tasks and selecting personal strategies for speaking and listening. Structured Practice: Engaging in "practice conversations" together using the platform's recording library. Reflection and Feedback: Reviewing recorded conversations and receiving guidance from a speech pathologist. Clinical Lessons: Education on brain injury and its impact on communication and behaviour. Managing Challenges: Specific modules addressing communication barriers like disinhibition and apathy. Self-Care: Support for carers and family members to manage emotional states, stress, and mood. Who delivers it and their relevant expertise? The Virtual Clinic is delivered by a multidisciplinary team comprising three distinct roles: - Clinical Practice Educators: Qualified speech pathologists with experience working with people with TBI, employed by the University. They provide clinical supervision to student speech pathologists, support intervention delivery using the Convers-ABI-lity manual, and oversee the quality and safety of the clinic. - Student Speech Pathologists: Speech pathology students completing a clinical placement as part of their degree. They have received specific training in delivery of the Social Brain Toolkit interventions and work under the direct supervision of clinical practice educators. They facilitate videoconferencing sessions, support module completion, moderate the online discussion group, and assign home practice tasks. - Peer Mentors with TBI: People with lived experience of TBI who are employed by the University. They will provide peer mentoring support to participants with TBI through planned online activities supported by the student speech pathologists and clinical practice educators. This model reflects a supported student-led clinic structure, with qualified clinician oversight embedded throughout. How is it delivered? The intervention is delivered entirely online via videoconferencing and digital platforms, combining several modes of delivery: - Individual and dyadic sessions via videoconferencing (person with TBI with their communication partner, student speech pathologist, or peer mentor) - Self-guided online learning through the Convers-ABI-lity modules, completed independently or with support - Group-based online interaction via a moderated online discussion group for peer connection and social media skills practice - Asynchronous home practice activities assigned and monitored by student speech pathologists The model therefore integrates synchronous (real-time videoconferencing, discussion group) and asynchronous (self-guided modules, home practice) components, and spans both individual and group formats depending on the activity. How often and for how long? The intervention runs over 12 weeks (T0 to T2). Participants with TBI and their communication partners are advised to expect approximately 90–120 minutes of participation per week, encompassing both scheduled activities (e.g., videoconferencing sessions, discussion group) and independent practice (e.g., self-guided modules, home practice tasks). The specific session frequency and duration of individual videoconferencing sessions are not prescribed in detail in the provided protocol, as the intervention is tailored to individual participant goals and will be further defined through a co-design phase. As such, there is no standard duration or minimum or maximum number of sessions throughout the program. However, across the 12-week program the total expected time commitment is approximately 18–24 hours per participant. Outcome measures are collected at: - T1 — 6 weeks after T0 (mid-intervention) - T2 — 12 weeks after T0 (end of intervention) - T3 — 18 weeks after T0 (6-week follow-up / maintenance phase) - T4 - 24 weeks after T0 (12-week follow-up / maintenance phase) - T5 - 30 weeks after T0 (18 week follow-up / maintenance phase Where is it delivered? The intervention is delivered entirely remotely via participants' own home computers or tablets, meaning no clinic attendance or travel is required. All components — videoconferencing sessions, self-guided modules, online discussion group, and home practice — are accessed from the participant's home. For participants without a suitable device, a loan iPad with internet access is provided, ensuring the home-based delivery model is accessible to all enrolled participants. Adherence Review of the data analytics within the online programs will be completed to determine the number, type and timing of activities completed by participants. Deidentified minutes from research team meetings will be used to log strategies used to maintain fidelity, and modification and adaptations to intervention delivery.