Psychoeducation as Precision Health in Military-Related Mild Traumatic Brain Injury

• Published in: Archives of physical medicine and rehabilitation Vol. 103; no. 6; pp. 1222 - 1232
• Main Authors: Venkatesan, Umesh M., Ramanathan-Elion, Deepa M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022
• Subjects: Brain concussion; Brain Concussion - psychology; Cognitive remediation; Humans; Military Personnel; Neurological rehabilitation; Neuropsychology; Patient education as topic; Post-concussion syndrome; Precision Medicine; Psychiatric rehabilitation; Rehabilitation; Stress disorders, post-traumatic; Stress Disorders, Post-Traumatic - psychology; Veterans; RTSS; Veterans; VA; mil-mTBI; SMI; Brain concussion; CR; Stress disorders, post-traumatic; Cognitive remediation; Neurological rehabilitation; Military personnel; Post-concussion syndrome; TBI; Neuropsychology; Rehabilitation; Psychiatric rehabilitation; mTBI; SMV; Patient education as topic
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2021.08.012

A significant proportion of Service Members and Veterans (SMVs) experience at least 1 mild traumatic brain injury during military activities (mil-mTBI), which can result in enduring cognitive symptoms. Although multiple cognitive rehabilitation (CR) interventions have been developed for this population, patient psychoeducation focusing on biopsychosocial relationships and health behaviors is often cited as the first line of defense for mil-mTBI sequelae. However, theoretical and conceptual foundations of these psychoeducational techniques are not well articulated. This raises questions about the potency of attempts to boost health literacy in affected SMVs, who represent a highly heterogeneous patient population within a special cultural milieu. To elucidate the significance of this problem and identify opportunities for improvement, we view the psychoeducation of SMVs through the lens of educational principles described in serious mental illness, where “psychoeducation” was first formally defined, as well as contextual and phenomenological aspects of mil-mTBI that may complicate treatment efforts. To advance psychoeducation research and practice in mil-mTBI, we discuss how treatment theory, which seeks to link active treatment ingredients with specific therapeutic targets, and an associated conceptual framework for medical rehabilitation—the Rehabilitation Treatment Specification System—can be leveraged to personalize educational content, integrate it into multicomponent CR interventions, and evaluate its effectiveness.