OUR STORY

The Quebec City OSI clinic has been running GMT™ groups since 2019, when our collaborators at the Clinic, Edouard Auger and Vicky Lavoie, along with their team of clinicians, received training from Margaret McKinnon and Charlene O'Connor. Since initially trialing GMT™ among their clientele, it has quickly become the most in-demand group offered, even during the Covid-19 Pandemic, when groups were shifted to an online format. While initially offered as a pandemic response, the online groups provided accessibility for clients living in more rural locations, and as a result the clinic has since been offering groups both online and in-person, typically twice per year during the fall and winter.

 

EVALUATING GMT™

In 2022, our team received support from the Military Casualty Support Foundation, the Cowan Foundation, and RBJ Schlegel to conduct an evaluation of virtual GMT™ implementation at the clinic. We conducted two virtual focus groups with clinicians who either facilitated GMT™, or who referred their clients to the GMT™ groups (11 participants in total, who included 7 psychiatrists, 2 psychologists, 1 nurse, and 1 social worker), asking them to share:

• client feedback

• their clinical observations on symptom improvement among clients who attended the groups

• the strategies used and adaptations made to facilitate GMT™ online

• the perceived pros and cons of delivering GMT™ online, and

• the optimal therapeutic timepoint at which to refer clients to the groups.

   

Results found that both clients and clinicians found GMT™ to be helpful in regulating symptoms of PTSD, and GMT™ was felt to help clients manage their cognitive challenges. The group format was also found to be helpful in reducing isolation and improving motivation and morale. We concluded that GMT™ should be considered as a beneficial part of a treatment package for OSI clients seeking treatment for PTSD with cognitive dysfunction.

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EVALUATING TIGMT

Building on these findings, the Trauma and Recovery Research Unit subsequently developed a trauma-informed adaptation of Goal Management Training™ (TIGMT). This adaptation was informed by a pilot study funded by the Workplace Safety and Insurance Board (WSIB). Importantly, TIGMT acknowledges that OSI presentations are heterogeneous and may include conditions such as major depressive disorder, traumatic brain injury, and other trauma-related difficulties, in addition to PTSD.

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In parallel, clinicians at the Quebec City OSI Clinic shared valuable feedback on adaptations they had already made to the standard GMT™ protocol to improve relevance for their client population and feasibility for online delivery. In particular, they emphasized the need for modifications that accounted for the unique cultural context of Canadian military members and Veterans with trauma-related conditions.

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In 2023, the research team met with Edouard Auger and Vicky Lavoie to formally integrate these insights into a modified, trauma-specific version of GMT™—TIGMT—tailored specifically to the needs of Veterans with PTSD and other OSI presentations. Key adaptations included revising language to be explicitly trauma-informed, updating examples to better align with Veterans’ lived experiences, and replacing work-focused scenarios with situations more relevant to individuals who are not currently employed (e.g., meeting with a case worker). Importantly, TIGMT also acknowledges that OSI presentations are heterogeneous and may include conditions such as major depressive disorder, traumatic brain injury, and other trauma-related difficulties, in addition to PTSD. TIGMT materials were also translated into French to ensure accessibility for francophone clients.

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TIGMT began being trialed at the Quebec City OSI Clinic in Fall 2025, with additional funding secured to support a formal evaluation of this adapted intervention. The Clinic will deliver TIGMT across multiple cycles over 2025–2026 in both online and in-person formats. Following the completion of three full intervention cycles, the Trauma and Recovery Research Unit will conduct clinician focus groups to evaluate implementation, clinical utility, and perceived differences between TIGMT and standard GMT™. These focus groups will examine clinicians’ experiences facilitating or referring to TIGMT, the types of clinical questions that arise during delivery, and the extent to which TIGMT better addresses the needs of OSI clients.

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This ongoing evaluation will inform further refinement of TIGMT and support its potential scale-up across OSI clinical settings.

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NEXT STEPS

Following the completion of TIGMT delivery cycles, the Trauma and Recovery Research Unit will undertake the following next steps:

• Clinician Focus Groups: Focus groups will be conducted at the OSI Clinic to gather in-depth feedback on the implementation, clinical utility, and perceived impact of TIGMT from clinicians involved in facilitation and referral.

• Research Publications: Findings from the TIGMT evaluation will be disseminated through peer-reviewed research publications to contribute to the evidence base on trauma-informed cognitive rehabilitation for OSI populations.

• Knowledge Translation Webinar: A free, publicly accessible webinar will be offered to share key findings, clinical insights, and practical considerations for implementing TIGMT in applied clinical settings.

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