Telehealth Intervention to Improve Emotion Regulation Following TBI

While the use of telehealth in rehabilitation has increased dramatically during the pandemic, a group of clinicians at the Department of Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai has been researching the use of telehealth and web-based interventions in the treatment of emotional regulation since 2012. The following overview of this project is provided by two members of the Brain Injury Research Center at Mount Sinai, Maria Kajankova, Ph.D. and Theodore Tsaousides, Ph.D., ABPP.

In 2006, the Brain Injury Research Center developed an intervention to improve emotion regulation (EmReg) after brain injury as part of a larger treatment targeting executive functioning. Emotion regulation is the ability to recognize and manage our emotions and it allows us to explore how we feel at any given moment, why we feel this way, and what to do about these feelings. Good emotion regulation skills are helpful in solving life problems more effectively, having better relationships, and maintaining high levels of mental health. These skills are essential for those living with brain injury due to unexpected changes in their lives that the injury caused and common feelings such as frustration, worry, dismay, anger, fear, sadness, grief, confusion, guilt, shame, or helplessness. 

Understanding the limitations that people with brain injuries have in terms of easy access to rehabilitation treatment, our team developed a telehealth version of our EmReg intervention in 2012 to be delivered using synchronous group videoconferencing. Each online group had a maximum of five individuals plus the facilitator. Exhibit 1 shows the emotional cycle that is discussed during the EmReg intervention.

After testing the feasibility of the online EmReg intervention, we conducted a 5-year study to test how effective online EmReg was in helping people with traumatic brain injuries improve their emotion regulation skills. A total of 81 individuals completed the intervention during the study and the results were very encouraging. Utilizing the Difficulties in Emotion Regulation Scale (DERS), participants showed significant improvements in emotion regulation and also reported high satisfaction with the intervention, as it provided treatment and support that they wouldn’t normally have access to.

Given the positive results of the 5-year study, the Research Center is currently recruiting participants for a second study of online EmReg, in which we compare people who receive the intervention with those who do not receive the experimental treatment, but who are put on a waiting list to receive the intervention after the active treatment group does.

EmReg is a skill-based intervention that includes psychoeducation about the role and nature of emotions and skill-development and consists of training participants in evidence-based strategies to improve awareness and self-regulation. The Brain Injury Research Center also provides training to rehabilitation professionals for this evidence-supported intervention. The trainings are delivered in person or virtually by Drs. Theodore Tsaousides and Teresa Ashman and are open to clinicians who preferably have prior experience delivering cognitive-behaviorally based interventions. We encourage those who are interested to reach out so we can help them determine whether they are a good fit.

To request a training, individuals are encouraged to reach out to us directly at birc@mountsinai.org or 212-241-5152.