Cognitive rehabilitation following Traumatic Brain Injury: an international survey of current clinician practice

Clinicians were surveyed internationally to explore their cognitive rehabilitation practices including approaches, training and resource utilisation. 606 clinicians of various disciplines and years of experience, from 45 countries, completed an online survey regarding their current cognitive rehabilitation practice. Data were analysed utilising descriptive statistics and qualitatively via content analysis. Clinicians most frequently employed external compensatory strategies (86%) and environmental adaptations and restructuring (87% using often/always) within cognitive rehabilitation. Beyond repetition, restorative approaches were utilised less frequently. Common components of cognitive rehabilitation included assessment, goal setting, psychoeducation, and progress monitoring. Occupational therapy and speech pathology were most routinely involved in cognitive rehabilitation. Practice occurred most frequently in inpatient settings, followed by the community noted to promote real-world integration. Less than half of clinicians (44%) deemed formal training sufficient in preparing them to provide cognitive rehabilitation. Whilst awareness of clinical practice guidelines and other resources was high, usage was relatively infrequent. A preference for compensatory strategies highlights current practice trends in cognitive rehabilitation. Gaps in training and infrequent use of clinical practice guidelines underscore the need for targeted training and development of required evidence to promote best practice of evidence-based care and outcomes following TBI. Cognitive difficulties often persist after moderate or severe traumatic brain injury (TBI) with cognitive rehabilitation recommended to enhance functioning.Recent clinical practice guidelines are available to inform practice, however, the current state of clinician practice is unclear.In an international survey, clinicians indicated most commonly using compensatory strategies within cognitive rehabilitation following TBI.Less than half the clinicians felt sufficiently trained to deliver cognitive rehabilitation, highlighting a need for improved education and training. Cognitive difficulties often persist after moderate or severe traumatic brain injury (TBI) with cognitive rehabilitation recommended to enhance functioning. Recent clinical practice guidelines are available to inform practice, however, the current state of clinician practice is unclear. In an international survey, clinicians indicated most commonly using compensatory strategies within cognitive rehabilitation following TBI. Less than half the clinicians felt sufficiently trained to deliver cognitive rehabilitation, highlighting a need for improved education and training.