Narrative Discourse Intervention for Patients in Posttraumatic Amnesia: A Feasibility Study.

PURPOSE: Recent INCOG 2.0 guidelines for posttraumatic amnesia (PTA) recommend commencing multidisciplinary functional intervention for patients who do not demonstrate severe behavioral disturbance. This pilot feasibility study aimed to determine if people with traumatic brain injury (TBI) could engage in a narrative discourse intervention during PTA.

METHOD: A narrative discourse intervention was developed based on existing evidence for discourse treatment and allied health treatments with patients in PTA. The study setting was a TBI-specific facility. Participants were screened on ward admission for PTA status and received daily discourse intervention comprising a story retell with visual supports and self-generated task during PTA. Measures included the Pittsburgh Rehabilitation Participation Scale (PRPS), the Agitated Behavior Scale (ABS), number of sessions attended, length of session, narrative organization, and patient enjoyment of sessions.

RESULTS

Ten patients participated in this pilot study, in a total of 56 sessions overall. Average session duration was approximately 25 min. Participation (PRPS) scores ranged from 3 to 5 (good to very good), and agitation scores were mostly within normal limits on the ABS. Narrative samples produced with picture supports were more organized than self-generated samples. Participants reported enjoying sessions.

CONCLUSIONS

Discourse intervention conducted in the early PTA recovery period was feasible for this cohort, within a specialized TBI setting. Future research is required to examine the feasibility of intervention with patients in PTA in other settings, and the potential efficacy of narrative discourse intervention during PTA.