# Problem-Solving Training for Concussion (PST-Concussion):  A Brief, Skills-Focused Intervention to Improve Functional Outcomes in Veterans with mTBI and Co-occurring Mental Health Symptoms

> **NIH VA I01** · VA WESTERN NEW YORK HEALTHCARE SYSTEM · 2024 · —

## Abstract

TBI is a major population health concern in U.S. service members and Veterans. Research has shown that
Veterans who sustain the most common form of TBI, mild TBI (mTBI, or concussion), often report varied and
lasting neurobehavioral complaints and functional impairments, placing them at-risk for long-term disability.
Other factors, such as distress brought about by co-occurring mental health conditions and chronic pain, are
thought to contribute to these negative outcomes, and recent studies have shown that mental health
intervention can improve neurobehavioral functioning in these Veterans. However, barriers to accessing
effective mental health care are evident. For instance, many mental health treatments require a high time and
resource investment for both patients and providers, and many mTBI-focused treatments are only accessible in
specialty treatment environments. Further, interventions capable of addressing the variety of neurobehavioral
complaints cited in this clinical cohort are lacking. To address these gaps in care, our team recently adapted
Problem-Solving Training for Concussion (PST-Concussion), a brief, primary care-based cognitive-behavioral
intervention designed to improve recovery from mTBI. PST-Concussion was specifically adapted for use in the
primary care setting given its practical advantages for easy access to care, and the emphasis on primary care
management present in current mTBI clinical practice guidelines. While our preliminary work established that
PST-Concussion is acceptable and feasible, a more comprehensive evaluation is needed to determine
whether it is clinically effective. To this end, the proposed study will be a longitudinal randomized two-arm
parallel group clinical trial. One hundred thirty-four participants will be randomized 1:1 to either PST-
Concussion or treatment as usual (TAU). Eligible participants will be Veterans ages 18 and older who are
enrolled in Veterans Health Administration (VHA) care and evidence: a) history of mTBI; b) current
psychological distress; and c) persistent neurobehavioral symptoms of ≥ 3 months. Participants assigned to
PST-Concussion will receive six, approximately 30-minute telehealth treatment sessions. Sessions include
standard concussion education, motivational interviewing and goal-setting, compensatory cognitive strategies,
relaxation training, and training in planful problem-solving. Assessments will include standard self-report and
cognitive measures that will be administered at baseline, post-treatment, and three-month follow-up. The
primary objective of this study will be to evaluate the effectiveness of PST-Concussion in reducing
psychological distress compared to TAU. Secondary and tertiary objectives will be to evaluate whether PST-
Concussion is associated with appreciable change in subjective neurocognitive functioning, objective
neurocognitive functioning, psychosocial functioning, and disability and quality of life. Multi-level modeling will
be used to eval...

## Key facts

- **NIH application ID:** 10750847
- **Project number:** 1I01RX004778-01
- **Recipient organization:** VA WESTERN NEW YORK HEALTHCARE SYSTEM
- **Principal Investigator:** Paul R. King
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-10-01 → 2027-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10750847

## Citation

> US National Institutes of Health, RePORTER application 10750847, Problem-Solving Training for Concussion (PST-Concussion):  A Brief, Skills-Focused Intervention to Improve Functional Outcomes in Veterans with mTBI and Co-occurring Mental Health Symptoms (1I01RX004778-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10750847. Licensed CC0.

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