Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence


Report at a Glance

Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the “signature wound” of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. The number of military service members diagnosed with a TBI nearly tripled from 2000 to 2010.

One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. Its goal is to help an individual with a brain injury to enhance his or her ability to move through daily life by recovering or compensating for damaged cognitive functions. CRT involves a variety of treatments and often involves the participation of family or caregivers.

The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI. The IOM was asked to consider whether existing research on CRT provides a conclusive evidence base to support using specific CRT interventions and to guide the use of CRT for members of the military and veterans. The committee recommends an investment in research to further define, standardize, and assess the outcomes of CRT interventions. CRT interventions are promising approaches, but further development of this therapy is required.