Hackensack Meridian JFK Johnson Rehabilitation Institute Leads Nationwide Study Using Teletherapy to Improve Emotional Health After Brain Injury Among Military Members and Civilians

Hackensack Meridian JFK Johnson Rehabilitation Institute is leading a nationwide, multi-site study funded by the U.S. Department of Defense that uses teletherapy to improve the lives of service members and civilians who have experienced a traumatic brain injury.

The $4.3 million study will test an intervention — called Building Emotional Self-Awareness Teletherapy (BEST) — that is designed to strengthen emotional health and resiliency in people with mild traumatic brain injury who experience alexithymia, a condition marked by difficulty recognizing and expressing emotions. The goal is to improve emotional regulation and resilience and lessen post-traumatic stress, anxiety, depression, and anger.

The research builds on a study, published today, that found that 83% of participants in BEST reported a noticeable improvement in their functioning. Researchers called for a larger trial with more rigorous designs to test the true impact of BEST.

“People must be able to recognize their emotions in order to manage and effectively work through them,” said Dawn Neumann, PhD, FACRM, Principal Investigator and Manager of Brain Injury Research at JFK Johnson Rehabilitation Institute. “Individuals with alexithymia often struggle with anxiety, anger, depression, and post-traumatic stress. This treatment aims to help them regain emotional self-awareness, a key step toward psychological health and resilience.”

The research into mild traumatic brain injury, such as concussion, has the potential to enhance readiness and recovery on the battlefield, during training, or in resource-limited environments.

The Department of Defense’s Congressionally Directed Medical Research Programs is funding the study through its Traumatic Brain Injury and Psychological Health Research Program. JFK Johnson Rehabilitation Institute serves as the lead site, collaborating with Indiana University School of Medicine; National Intrepid Center of Excellence (NICoE); Naval Medical Center Camp Lejeune; Minneapolis Veterans Affairs Hospital; and University of South Florida.

The study will enroll 152 adults — both civilians and military service members — who have experienced a concussion or mild traumatic brain injury and continue to experience emotional dysregulation. The BEST program is provided through teletherapy, expanding access for individuals facing transportation, distance, or other barriers.

Sara Cuccurullo, MD, Medical Director and Vice President at JFK Johnson Rehabilitation Institute, said the study reflects the institute’s commitment to advancing brain injury science through its nationally recognized Center for Brain Injury.

“At JFK Johnson Rehabilitation Institute, we see the profound and lasting emotional challenges that can follow brain injury,” Dr. Cuccurullo said. “Our Center for Brain Injury has long been dedicated to helping patients rebuild their lives. This research is essential because it seeks to understand and treat these invisible wounds.”

If successful, researchers believe BEST could become a new evidence-based standard of care for individuals with mild TBI, including service members recovering from combat-related or training-related brain injuries. By improving emotional awareness and regulation, the therapy could enhance recovery, readiness, and reintegration into both civilian and military life.

For Lieutenant Michael Diamond, USN, a 21-year U.S. Navy officer and combat veteran, emotional regulation challenges followed multiple traumatic brain injuries from combat deployments, training exercises, and exposure to blasts.

“My wife began noticing I was developing a ‘quick fuse’ with external influences and reacting in a different fashion, such as clenched jaws and grinding of teeth. She equated it to me turning into the ‘Hulk’ when I would get emotionally overstimulated,” Lt. Diamond said. “For happy or joyous events, I would have very muted emotional reactions — limited smiling or lack of excitement or joy. In her eyes it seemed like I was always mad or on the brink of an emotional outburst.”

Lt. Diamond said that before the program, he viewed therapy as a “check-the-box” exercise. But the structured approach of BEST changed his perspective.

“The biggest help the BEST program provided me was tapping into emotional intelligence and understanding the impact emotions had on external responses. Too often my instinctive response was anger. I didn’t realize the buildup of compounding emotions,” said Lt. Diamond. “After completing the program, I can now quantify and apply a name to the emotion I’m feeling and triage my response. It also allows me to communicate to others where I am emotionally.”

He added that the program gave him tools he will carry into civilian life: “It allowed me to identify my emotions and coordinate my response rather than just be angry. It also provided me with the time and space to ‘checklist’ emotions and use mitigating steps to prevent outbursts.”

In addition to Dr. Neumann at JFK Johnson, the research leaders at the other sites are:

• Devan Parrott, Ph.D., Indiana University
• Treven Pickett, Psy.D., National Intrepid Center of Excellence (NICoE)
• Lieutenant Commander Jessica Forde, Ph.D., Navy Medical Center Camp Lejeune (NMCCL)
• Jacob Finn, Ph.D., Minneapolis Veterans Affairs Hospital
• Jason Wilson, M.D., Ph.D., University of South Florida

This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, the Defense Health Agency J9, Research and Development Directorate, and the U.S. Army Medical Research Acquisition Activity at the U.S. Army Medical Research and Development Command, through the Traumatic Brain Injury and Psychological Health Research Program under Award No. W81XWH-22-2-0064 and HT9425-25-1-0889. Opinions, interpretations, conclusions, and recommendations are those of the author and are not endorsed by the Department of Defense.