4. Discussion
TBI, brain injury
Results of this pilot feasibility study suggest SwapMyMood may be an acceptable addition to the use of paper manuals to support SM/Vs with mTBI and co-occurring psychological conditions in using the executive functioning strategies taught in the Executive Plus/STEP Program and should be studied in an adequately powered, randomized controlled trial. The groups were statistically comparable on all outcome measures, both with and without adjustments for group difference in demographic, injury, and treatment characteristics, and both groups demonstrated post-intervention gains in goal attainment, executive function, problem-solving, emotion regulation, and knowledge of how to use the strategies targeted. Furthermore, all participants in both groups demonstrated meaningful change in executive function as measured by GAS. The present study does not control for or consider the impact of other rehabilitation services and interventions participants received during the study period, and thus, gains in executive function cannot be interpreted as resultant of the study intervention. However, the equivalent gains demonstrated by the groups provide preliminary support for use of SwapMyMoood as an adjunct option to conventional care, adding evidence for the feasibility of use of computerized technology for cognitive and behavioral interventions for people with brain injury [These findings suggest feasibility by demonstrating effective implementation of the SwapMyMood app in a clinical setting in this sample. This intervention was implemented during the COVID-19 pandemic when in-person clinical interventions were not available for every client. This study suggests that SwapMyMood may be an acceptable intervention which can be utilized for remote use for people with brain injury who are unable to obtain in-person care (e.g., due to financial or transportation limitations or disruptions such those caused by the COVID-19 pandemic). Limited access to rehabilitation services after TBI for individuals in underserved groups is well documented in the literature [