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Tools for rehabilitation and cognitive care (On-TRACC): Development of a brief intervention for chronic cognitive
Kathleen F Pagulayan1, Holly K Rau1, Orli M Shulein2
1Seattle Division, VA Puget Sound Health Care System.
Abstract:
[Correction Notice: An Erratum for this article was reported online in Rehabilitation Psychology on Jul 20 2026 (see record 2027-92628-001). Due to an editorial production error, the title was originally incorrectly published as "On-Tools for Rehabilitation and Cognitive Care: Development of a Brief Intervention for Chronic Cognitive Difficulties After Mild Traumatic Brain Injury." All versions of this article have been corrected.] Purpose/Objective: To describe the development of a novel rehabilitation intervention (Tools for Rehabilitation and Cognitive Care [On-TRACC]) for individuals reporting cognitive persistent postconcussive symptoms (PPCSs) after mild traumatic brain injury (mTBI) as a bridge to care for modifiable conditions that can impact cognition.
Research Method/Design:
Intervention development via four methods: literature review, veteran survey, clinician survey, and a beta test with three participants/three clinicians. A total of 53 veterans with a history of mTBI and cognitive PPCSs participated in the veteran survey, while seven clinicians, including speech pathologists, psychologists, and a psychology postdoctoral fellow, completed the clinician survey. Three veterans and three clinicians participated in a beta test of the intervention to assess usability, identify any content issues, and gather specific feedback.
Results:
The new intervention is a five-session, patient-centered rehabilitation program for individuals reporting persistent cognitive difficulties after mTBI. On-TRACC provides tailored psychoeducation about modifiable factors contributing to cognitive difficulties, self-management skills, and compensatory cognitive rehabilitation strategies. On-TRACC is based on personalized values and is designed to support short- and long-term management of factors contributing to current symptoms that are currently untreated or undertreated.
Conclusion/Implications:
Through a multistep process that incorporated stakeholder input and a review of the empirical literature, we developed an evidence-informed intervention that fills a gap in current care for cognitive PPCSs. Future studies are needed to evaluate the efficacy of this intervention for individuals with chronic cognitive difficulties after mTBI. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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