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

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 after chronic acquired brain injury. Design A randomized controlled trial with blinded outcome assessment at baseline, post-training and six-month follow-up. Setting Outpatient Participants Persons with acquired brain injury and executive dysfunction (N=70; 64% traumatic brain injury; 52% males; mean age 43 ± 13 years; mean time since injury 8.1 ± 9.4 years). 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 Trust Regulation of Emotions Questionnaire, the Emotional Control subscale and the Emotion Regulation factor (Behavior Rating Inventory of Executive Function-Adult), and the Positive and Negative Affect subscales from the Dysexecutive Questionnaire. Secondary outcome measures included Psychological Distress (Hopkins Symptom Checklist 25) and Quality of Life (Quality of Life after Brain Injury scale). Results Findings indicated beneficial effects of GMT on emotional regulation skills in everyday life and in quality of life six months post-treatment. No intervention effects on measures of psychological distress were registered. Conclusion Goal Management Training is a promising intervention for improving emotional regulation following 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.