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brain injury, problem solving, acquired brain injury, executive function, executive functioning, intervention, traumatic brain injuries, head injury, problem solving skills, therapy, treatment


Background and Objective(s): Individuals with acquired brain injury (ABI) often demonstrate executive functioning (EF) impairments that impact their ability to identify and solve problems within their daily lives. This systematic review attempts to consolidate available research supporting problem-solving interventions as effective, evidence-based practice for addressing EF deficits in individuals with ABI.

Methods: A systematic review was conducted using the databases Ovid Medline, CINAHL, and PsycINFO. Studies met the following inclusion criteria: 1) problem-solving intervention, 2) EF outcomes, 3) individuals with acquired brain injuries. Studies were excluded based on the following criteria: 1) single case study design, 2) family-centered interventions and outcomes. All studies were then quality assessed using components of the Assessment of the Quality and Applicability of Systematic Reviews.

Results: A total of 531 studies were identified and 14 met inclusion criteria. The overall quality of the studies was ‘moderate.’ Interventions identified include problem-solving skills training, analogical problem-solving approach, explicit problem-solving training, Attention and Problem Solving, Interactive Strategy Modelling Training, Short-Term Executive Plus, Counselor Assisted Problem-Solving Training, Teen Online Problem Solving-Teen Only, and Teen Online Problem Solving-Family.

Conclusions: Problem-solving interventions are effective for use as management strategies for individuals with problem-solving deficits following ABI. The available evidence does not support the use of these interventions as remediation for EF deficits. Explicit teaching of problem-solving frameworks has been found to improve individuals’ abilities to recognize solutions to daily problems and determine a plan to reach an appropriate solution. Variables such as age, injury severity, and cognitive reserve may contribute to the level of success of the problem-solving interventions. More research is warranted to support the use and generalization of explicit problem-solving interventions to improve EF in individuals with ABI.


Nancy Gauvin, EdD, CCC-SLP

Efficacy of Problem-Solving Interventions for Improving Executive Functioning  Outcomes in Patients with Acquired Brain Injuries:  A Systematic Review