The RENEW programme and telehealth transdiagnostic goal management training in outpatient neurology: A retrospective...

This clinical programme evaluation describes a telehealth, transdiagnostic Goal Management Training (GMT®) group adaptation delivered within RENEW (Resilience through Neurologic and Emotional Wellness), an academic outpatient neuropsychological rehabilitation programme. GMT® is an evidence-based cognitive rehabilitation intervention targeting goal neglect and goal-directed behaviour in acquired executive dysfunction. Using components of the RE-AIM framework, we characterize programme reach across 28 months (N = 371 completers), telehealth and transdiagnostic adaptations, and preliminary outcome data from a passive, platform-based monitoring system. Among survey completers (34% of programme completers), acceptability and satisfaction were high, and statistically significant pre-to-post improvements were observed across mood, anxiety, cognitive self-efficacy, quality of life, and mindful attention, with the largest effects for mood and anxiety. Implementing this monitoring infrastructure generated four lessons: (1) evaluation is limited by what is not collected at referral; (2) monitoring at the margins of clinical care is structurally unsustainable; (3) monitoring that does not return value to patients is a missed therapeutic opportunity; and (4) initiating data collection at referral enables evaluation and rigorous programme learning. These lessons help refine our monitoring design and offer a practical, generalizable account of what is required to deliver and evaluate neuropsychological rehabilitation at scale within routine clinical care.