CONTACT Study Background
Since 2000, over 327,000 US service members have been diagnosed with traumatic brain injury (TBI), most of which were mild TBI (mTBI)1. While most people with mTBI recover well, some continue to experience symptoms such as memory problems, headache and sensitivity to sound and light, known as persistent post-concussive symptoms (PPCS). Anxiety, post-traumatic stress, depression and sleep problems complicate the picture. PPCS can interfere with ability to work, engagement in usual activities, and interpersonal relationships, impacting quality of life and troop readiness.
Service members (SM) may be difficult to engage in treatment due to military obligations, mobility from base-to-base, transportation, financial resources and concern about stigma. Only about one third of SMs with post-deployment adjustment problems seek treatment2,3. As many as two-thirds of SMs believe that admitting to mental health concerns and seeking treatment will negatively impact their military career4.
Telephone-delivered interventions, which have been shown to result in high satisfaction5,6, may help overcome these barriers. One survey of active duty SM found that 33% who were not willing to engage in in-person counseling were amenable to a technology-based service7.
The CONTACT intervention was based on a problem solving training (PST) framework, which provides a flexible algorithm of steps for assessing a problem, concern or goal, then planning, carrying out and evaluating a strategy for dealing with the issue at hand. PST has been shown to be effective for dealing with problems of everyday life, as well as chronic pain, general distress, anxiety, depression and suicidal thoughts8,9. Further, telephone delivery of PST has been effective in other populations10,11, and has been used successfully to improve quality of life by persons with cognitive impairment due to TBI12,13.