Cognitive Behavioral Therapy

Interns assigned to this project: Will Altaweel and Elliot Yim

Mentor & primary contact: Eloïse

We’ll be adding more resources as you work on the project, so make sure to check this page every day before you get started.

Introduction

We are very excited that you are going to create a treatment page for Cognitive Behavioral Therapy! We’ve needed this page for quite a while, as CBT is one of the three treatments that the 5th International Consensus Statement lists as having preliminary evidence of efficacy. Treatment pages need to cover specific points, which we will go over below. We will work on finding an expert to review your material.

You will also be making decisions regarding the structure of the page; how to present the material, what diagrams or multimedia presentations you want to include, and other readability, accessibility, and clarity considerations. We plan to give you access to our ConcussionAlliance.org website so that you can actually build the page yourself, with feedback from the CA team. You may want to read up on these Squarespace tutorials.

Our most recently written treatment page is the Physical Therapy page. We think the information is pretty well presented, but if you have ideas about a better design for a treatment page, feel free to create a draft for review & feedback.

Our understanding is that there is also a subspeciality, CBT for insomnia, and you will get to make decisions about how this is presented.

Your work space

Google Drive folder for your working documents.

Trello. We will be working with you to set up your Trello workspace.

Page design

We’ve handled page design in different ways — you can choose how you would like to handle it. Our treatment pages, for example, tend to be straightforward, which allows for including a lot of information. See Physical Therapy or Medication, as examples.

Our December 2019 interns created several pages with more innovative layouts. We like how they engage the reader, but the more involved design might limit how much information you can include — or it might be fine. See Concussions in Women and Girls, Pediatric Concussions, and Concussion in Sports.

One way to handle a lot of information is to have jump links (or anchor links) at the top of the page. It’s like a tiny menu, with the title of each section having a link that jumps down the page to that section. I wish we had jump link on all our pages, but we haven’t got to it yet. See this squarespace tutorial.

Special considerations

Our CBT page should probably address that 5th International Consensus on Concussion Support recommendations that CBT is part of a collaborative care approach for a patient— see quote below. My understanding of this section is that the Consensus recommends that the patient also receives care for physical issues (treatments 1 and 2).

There is a history of providers telling patients with persistent symptoms that it is “all in their head,” or simply a “pain loop,” and not referring for any treatment for persistent physical symptoms. The majority of healthcare providers don’t even know there are rehab treatments for persistent concussion symptoms.

We may want to warn patients about this problem, so they can better navigate the healthcare system. You can see how we handled this type of warning in the first paragraph of our Medication page.

From the 5th Consensus:

Treatment should be individualised and target-specific medical, physical and psychosocial factors identified on assessment. There is preliminary evidence supporting the use of:

  1. an individualised symptom-limited aerobic exercise programme in patients with persistent post-concussive symptoms associated with autonomic instability or physical deconditioning, and

  2. a targeted physical therapy programme in patients with cervical spine or vestibular dysfunction, and

  3. a collaborative approach including cognitive behavioural therapy to deal with any persistent mood or behavioural issues.


Resources

Newsletter synopses and pages on our website:

Best Therapies for Post-concussion Syndrome in Children and Adolescents (blog post)

4/2/20 newsletter (see Mental Health)

4/16/20 newsletter (see #StayHome tools)

4/30/20 newsletter (see Mental Health)

11/7/19 newsletter (see Mental Health)

8/22/19 newsletter (see Mental Health)

8/15/19 newsletter (see Mental Health)

Sleep (self-care) page on our website

Medication treatment page (see the section “From a 2019 study…”

Treatment & Recovery paths (this is an older page which is not linked from anywhere. Maybe this should be fixed.)

Guidelines for Recovery (just a cursory mention)

Veterans (apps section)

Research and Resources

5th International Consensus statement on concussion in sport

Review of the Management of Pediatric Post-Concussion Syndrome—a Multi-Disciplinary, Individualized Approach
(section on Emotional Symptoms and Psychological Treatment). This study may be covered in one of our newsletter synopses or blog posts listed above.

Digital Therapeutics for Symptoms of Concussive Traumatic Brain Injury in United States Military Service Members and Veterans: Developments at the Center for Neuroscience and Regenerative Medicine

This is a poster presented at Frontiers in Traumatic Brain Injury online conference 6/16/20. Please note:

3.2. 2 Posters are not peer-reviewed by conferences and may not describe all aspects of the research. Posters should therefore not be viewed as a substitute for a full article in a peer-reviewed journal. Research Integrity and Peer Review Journal

How to find a CBT therapist

Google doc on how to find a therapist (in your CBT project folder)

Screen recording on how to navigate the Psychology Today find a therapist tool (In your CBT project folder)
This is a draft screen recording. (In Google Drive, it appears as super low resolution; Malayka will look into uploading it to our YouTube channel.)

This draft screen recording doesn’t show the URL at the top of the screen, and it a bit slow-moving. If you want to create a recording like this, maybe with a voice-over explaining what you are doing, then we could host the video on our YouTube channel and embed the video on the CBT webpage.

Treatment page sections

  • An explanation of what the treatment is

  • How the treatment pertains to concussion symptoms

  • How to find a provider (search tools) and what to ask a potential provider (how to screen for a expertise or experience)

We’ve handled this layout in different ways — you can choose how you would like to handle it. Look at several of our treatment pages for different layout structures. Physical Therapy is our most recently written page, but it doesn’t have search tools, so please look at other pages as well.