Online problem-solving therapy after traumatic brain injury: a randomized controlled trial.

Area of Science:

• Neuroscience
• Pediatric Medicine
• Rehabilitation Psychology

Background:

• Pediatric traumatic brain injury (TBI) leads to significant functional impairments.
• Online family problem-solving therapy (FPST) shows promise in reducing adolescent behavioral issues.
• Counselor-Assisted Problem Solving (CAPS) is an online FPST intervention designed to improve outcomes for adolescents with TBI.

Purpose of the Study:

• To evaluate the long-term efficacy of CAPS compared to internet resources alone in improving functional outcomes for adolescents with TBI.
• To assess the impact of CAPS on child and family functioning over an 18-month period.

Main Methods:

• A multisite, assessor-blinded randomized controlled trial was conducted with children aged 12-17 hospitalized for TBI.
• Participants were randomized to either CAPS or an Internet Resource Comparison (IRC) group.
• Outcomes, including child and family functioning, were measured at baseline and at 6, 12, and 18 months post-injury.

Main Results:

• The CAPS group demonstrated significantly less impaired functioning compared to the IRC group at the 18-month follow-up.
• Parental education level moderated the treatment effect; CAPS showed an advantage over IRC primarily for participants with less-educated parents.
• No significant differences were found in family interaction ratings between the groups.

Conclusions:

• Brief, online interventions like CAPS initiated shortly after injury can yield sustained improvements in child functioning.
• CAPS may be particularly beneficial for improving outcomes in adolescents with TBI from lower socioeconomic status backgrounds.
• Clinical consideration should be given to implementing CAPS during the early post-injury period.