Journal of the International Neuropsychological Society



Rehabilitation of executive functioning: An experimental–clinical validation of Goal Management Training


BRIAN  LEVINE a1a2, IAN H.  ROBERTSON a3a4c1, LINDA  CLARE a3, GINA  CARTER a3, JULIA  HONG a1, BARBARA A.  WILSON a3, JOHN  DUNCAN a3 and DONALD T.  STUSS a1a2
a1 Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto
a2 Departments of Psychology and Medicine (Neurology), University of Toronto
a3 Medical Research Council Applied Psychology Unit, Cambridge, U.K.
a4 Department of Psychology, Trinity College Dublin, Ireland

Abstract

Two studies assessed the effects of a training procedure (Goal Management Training, GMT), derived from Duncan's theory of goal neglect, on disorganized behavior following TBI. In Study 1, patients with traumatic brain injury (TBI) were randomly assigned to brief trials of GMT or motor skills training. GMT, but not motor skills training, was associated with significant gains on everyday paper-and-pencil tasks designed to mimic tasks that are problematic for patients with goal neglect. In Study 2, GMT was applied in a postencephalitic patient seeking to improve her meal-preparation abilities. Both naturalistic observation and self-report measures revealed improved meal preparation performance following GMT. These studies provide both experimental and clinical support for the efficacy of GMT toward the treatment of executive functioning deficits that compromise independence in patients with brain damage. (JINS, 2000, 6, 299–312.)

(Received October 7 1998)
(Revised April 20 1999)
(Accepted June 15 1999)


Key Words: Traumatic brain injury; Frontal lobes; Strategy application; Goal neglect.

Correspondence:
c1 Reprint requests to: Ian H. Robertson, Department of Psychology, Trinity College Dublin, Dublin, Ireland. E-mail: irobertson@tcd.ie