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A new study, published in the latest issue of the Journal of Occupational and Environmental Medicine, Improving Outcomes for Work-Related Concussions: A Mental Health Screening and Brief Therapy Model, assessed the efficacy of a neurocognitive screening evaluation and brief therapy model to improve RTW outcomes for workers who experienced mild head injuries.

There has been increased interest in both the immediate and long-term consequences of mild head injuries in basic and applied health sciences for the past few decades. To some extent, this interest has been fueled by the very public debate about the dangerousness of sports-related repeated mild head trauma in both children and adults.

There has also been media interest in non-sports-related head trauma in adults especially the elderly due to falls, in military populations, and after motor vehicle accidents.

The increased public attention to these issues has also increased awareness and concern regarding mild head injuries in the workplace. Many patients with work-related mild head trauma show delayed recovery resulting in significant increases in both medical services utilization and work leave.

Neuropsychological assessment to clarify the extent of cognitive features and psychosocial factors can be used effectively to rule out symptom magnification and secondary gain issues, as well as to provide additional objective data to clients about their subjective distress and cognitive complaints.

The current study is a multiple time-line design within an integrated care model combining outpatient medical and mental health services to address delayed recovery from mild Traumatic Brain Injury (mTBI) and Postconcussional Syndrome (PCS ) for 157 injured employees receiving workers compensation benefits.

Based on the outcome of the assessment, clients were either determined to be at MMI and discharged, or treatment recommendations were made for either mental health or Health and Behavior Assessment and Intervention (HBAI services). There were also several clients where biopsychosocial factors were identified which appeared to be affecting the individual’s recovery, that is, poor sleep patterns, inactivity, or other health behaviors, or anxiety, depressed mood, psychosomatic or post-traumatic symptoms which did not rise to the level of warranting a mental health diagnosis.

Overall, 155 of the 157 patients (98.7%) returned to work at full duty without further restrictions or accommodations. The findings of this study support the view that prolonged mTBI and PCS are strongly influenced by psychological factors. Conducting a brief and readily accessible neurocognitive assessment to reassure injured workers that their concerns about mTBI/concussion were being carefully considered and thoroughly addressed appeared to have dramatic effects on decreasing chronicity in this study.