T-ScEmo4ALL Plus+: Treatment for social cognition disorders in patients with acquired brain injury and neuropsychiatric problems – A single case experimental design (SCED) study protocol

INTRODUCTION: Many patients with acquired brain injury (ABI) suffer from impaired social cognition, which may result in reduced social participation, quality of life and quality and stability of partner relationships. Social cognition problems often co-occur with, and in some cases contribute to, neuropsychiatric symptoms such as emotional dysregulation, disinhibition, and irritability, which may further complicate social functioning. Effective interventions targeting social cognition are therefore of particular importance for ABI patients with comorbid neuropsychiatric symptoms. The Treatment Social cognition and Emotion regulation (T-ScEmo) has shown promising effects on social cognition and emotion regulation in patients with traumatic brain injury (TBI), but has not yet been studied in ABI patients with comorbid neuropsychiatric problems. Therefore, the main aim of the current study is to examine the effect of T-ScEmo on social functioning in patients with ABI and comorbid neuropsychiatric problems. METHODS AND ANALYSIS: A non-concurrent, randomized, multiple-baseline single-case experimental design (SCED) will be employed to investigate the effectiveness of T-ScEmo in this study. At least 8 participants and a significant other will be randomly assigned to one of three baseline lengths. The primary outcome measures (social functioning, neuropsychiatric problems, relationship quality) will be assessed daily during baseline and twice a week during the treatment and maintenance phases. Secondary outcomes will be assessed at T0 (pre-treatment), T1 (post-treatment), and T2 (1-year follow-up). Both patients and the significant other will complete all outcome measures. DISCUSSION: T-ScEmo may offer a valuable addition to neurorehabilitation practices for this specific target group of patients. Forthcoming results may contribute to more personalized and effective treatment strategies for the growing number of patients with ABI and comorbid neuropsychiatric problems. TRIAL REGISTRATION: The study is registered in the database of clinicaltrials.gov (Treatment for Social Cognition Disorders (T-ScEmo) in Patients With Acquired Brain Injury and Comorbid Neuropsychiatric Problems | ClinicalTrials.gov) under identifier NCT06923683. Date registered: 04/17/2025.