Background:   
Patients who sustain mild and moderate traumatic brain injury (TBI) may experience long-lasting somatic, cognitive, and emotional symptoms affecting the ability to perform in activities of daily life and return-to-work (RTW). Despite a growing body of research on treatment options after TBI, there is limited knowledge regarding patients´ lived experiences,  particularly regarding experiences with treatment efforts offered in the early phase after injury (1). Objectives: The main aim was to explore how persons with mild and moderate TBI describe and make sense of their injury and their “recovery” process. In particular, we focus on the rehabilitation process; how treatment approaches, including Compensatory Cognitive Training (CCT) (2), have influenced how they make sense of their “recovery” process. The patients’ “recovery” process in relation to their everyday lives, including RTW, is addressed, as well.

Methods:
This study is part of an ongoing randomized controlled trial (RCT) examining the efficacy of a complex intervention after mild and moderate TBI on RTW, work stability and productivity (3). The intervention consists of group-based cognitive training (CCT) and supported employment (SE). This qualitative sub-study consists of in-depth interviews with 8 participants recruited from the RCT. Three women and five men, 27-55 years old were interviewed immediately after completing 10 weekly sessions of CCT, 4-6 months after injury. At this early stage of the RTW-process experience with SE is not yet a topic. The interviews lasted from 50 to 90 minutes. 

Results:
The participants expressed the importance of gaining increased knowledge by own reflections, within family, employer’s and health professionals, and information shared in group sessions. Several participants searched advice from many sources. They described receiving conflicting and sometimes confusing advice, such as to do as little as possible, but also to stay as active as possible. They described feeling left alone having to navigate a field where little evidence-based knowledge was available. The participants experienced the strategies they acquired in the CCT intervention as useful, but also challenging. They expressed that increasing the duration of the CCT intervention, to have more time to integrate new strategies into daily life, would be helpful. There was much ambivalence as to whether time alone would result in healing, and if the learned strategies were helpful in the RTW-process. Most participants felt that meeting others in a similar situation had been helpful. Some missed more help with physical symptoms like balance problems, vestibular symptoms and visual impairments. 

Conclusion: 
As this study is ongoing, these results are preliminary. A thematic analysis is conducted and final results will be presented at the IBIA congress.


1.	Mah et al. Disabil Rehabil 2018;40(8):960-973.

2.	Twamley et al. J Rehabil Res Dev 2014;51(1):59-70.

3. 	Howe et al.  Trials 2017 Oct 17;18(1):483.

«There are ups and downs while slowly moving forward, in a way» - Stories of improvement and treatment after mild and moderate traumatic brain injury