Establishing 'proof of concept' for a social cognition group treatment program (SIFT IT) after traumatic brain injury: two case studies

Objective Social cognitive deficits are prevalent after traumatic brain injury (TBI). Despite this, few remediation studies exist. This study aimed to demonstrate 'proof of concept' for a novel group treatment that comprehensively targeted the core processes of social cognition. Design Pre-post case study with two participants, "Greg" and "Aaron", living with severe TBI, with three assessment time points. Method Participants were screened at baseline to confirm social cognitive deficits: Greg exhibited difficulties with emotion perception and detecting hints; Aaron with detecting sarcasm and hints. Both reported everyday social problems. Participants then completed the 14-week group treatment program (SIFT IT). Feasibility and outcome measures were repeated post-group and at three-month follow-up. Results The study procedure was implemented with 100% assessment and 89% SIFT IT session attendance, albeit with a lack of proxy-report measures. Both participants described procedures as acceptable, although suggested more group participants could be beneficial. They both demonstrated reliable improvements (RCI > 1.96) on relevant social cognitive measures. Qualitative feedback corroborated findings: Greg reported generalization of therapeutic gains, Aaron reported increased self-awareness but nominal generalization. Conclusion Feasibility and limited efficacy outcomes established 'proof of concept' of SIFT IT. Findings will inform the study protocol for a larger randomized-controlled trial.