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Study Shows Effectiveness of Person-Centered Goals in Directing Care

SHARE Military Initiative Researchers Aim to Set Standard for Care for Veterans and Service Members with Mild Traumatic Brain Injury and Co-Occurring Psychological Conditions

In a research study recently published in Frontiers in Neurology, researchers at Shepherd Center’s SHARE Military Initiative found that service members and veterans with mild TBI (mTBI) and co-occurring psychological conditions experienced increased goal attainment following intensive, interdisciplinary, person-centered goal (PCG) directed care, which further increased with transition support over the year post-discharge. Results of the four-year study, which included a retroactive chart review of 146 veterans and service members who have received care at SHARE, suggest that PCG-directed care is a feasible, promising methodology for individualizing treatment in veterans and service members. 

“Person-centered goal-directed care helps us determine what is most important to our clients so we can personalize their care and get their full investment in getting better,” said Tracey Wallace, MS, CCC-SLP, FACRM, projects and education coordinator for the SHARE Military Initiative at Shepherd Center, associate director of the mTBI Brain Health and Recovery Lab, and principal investigator of the study. “While our clients may have similar traumatic brain injuries, they all have different experiences, histories, and goals that shape how they respond to care and how we need to provide care for them. This study provides evidence that this population responds to person-centered goal-directed care.”

SHARE Military Initiative is a comprehensive rehabilitation program that delivers world-class, interdisciplinary care at no cost to veterans, service members, and first responders dealing with traumatic brain injuries (TBI) and mental health concerns through flexible programming and collaborative care, transition support, and community reintegration. 

More than 450,000 traumatic brain injuries (TBI) have been documented among U.S. service members since 2000, according to the Traumatic Brain Injury Center of Excellence. While most recover from a single mild TBI within weeks, as many as 20% of adults have a more prolonged course of recovery, negatively affecting their physical and mental health, ability to function, and participation in important roles in their families and careers – all factors that make treatment complex and challenging.

At SHARE, clients identify between one and three person-centered program goals, which the SHARE team uses to develop a comprehensive, PCG-directed plan of care. The team determines the program length of stay and the type and amount of therapy provided based on given strengths, barriers, symptoms, resources, comorbidities, and other factors unique to each patient. Treatment interventions address barriers to goal attainment, and additional services are added to match goals. 

Over the course of the study, 146 participants set 281 goals. 252 goals – or 89.68% – were met or exceeded by program discharge. Goal attainment increased at six, nine, and 12 months post-discharge from SHARE Military Initiative with transition support from a transition support specialist at SHARE.

“In this study, we also found that longer, sustained participation in treatment was the most important predictor of goal attainment,” said Russell Gore, M.D., medical director of the SHARE Military Initiative at Shepherd Center, director of the mTBI Brain Health and Recovery Lab, and co-principal investigator of the study. “Our treatment program has a flexible length of stay that is individualized based on the client’s needs and goals. We were pleased to see that the study results validated this approach to care.” 

SHARE researchers Tracey Wallace, MS, CCC-SLP, Katherine McCauley, Ph.D., April Hodge, PT, DPT, NCS, Maya Whaley, and Russell Gore, M.D., collaborated with researchers Tim Moran, Ph.D., and Stephen Porter, M.D., from Emory University School of Medicine on the study.

Learn more about mild brain injury research at Shepherd Center.

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.