Shari L Wade1, Terry Stancin, Michael Kirkwood, Tanya Maines Brown, Kendra M McMullen, H Gerry Taylor. 1. Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (Dr Wade and Ms McMullen), Cincinnati, Ohio; MetroHealth Medical Center (Dr Stancin) and Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center (Dr Taylor), Case Western Reserve University, Cleveland, Ohio; Children's Hospital Colorado and University of Colorado School of Medicine, Aurora (Dr Kirkwood); and Mayo Clinic, Rochester, Minnesota (Dr Brown).
Abstract
OBJECTIVE: To test the efficacy of Counselor-Assisted ProblemSolving (CAPS) versus an Internet resource comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI). DESIGN: Randomized clinical trial with interviewers naive to treatment condition. SETTING:Three large tertiary children's hospitals and 2 general hospitals with pediatric commitment. PARTICIPANTS: A total of 132 children and adolescents aged 12 to 17 years hospitalized during the previous 6 months for moderate to severe TBI. INTERVENTIONS:Participants in CAPS (n = 65) completed 8 to 12online modules providing training in problem solving, communication skills, and self-regulation and subsequent synchronous videoconferencing with a therapist. Participants in the IRC group (n = 67) receivedlinks to Internet resources about pediatric TBI. MAIN OUTCOME MEASURES: Child Behavior Checklist administered before and after completion of treatment (ie, approximately 6 months after treatment initiation). RESULTS: Post hoc analysis of covariance, controlling for pretreatment scores, was used to examine group differences in behavior problems in the entire sample and among older (n = 59) and younger adolescents (n = 53). Among older but not younger adolescents, CAPS resulted in greater improvements on multiple dimensions of externalizing behavior problems than IRC. CONCLUSION:Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI.
RCT Entities:
OBJECTIVE: To test the efficacy of Counselor-Assisted Problem Solving (CAPS) versus an Internet resource comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI). DESIGN: Randomized clinical trial with interviewers naive to treatment condition. SETTING: Three large tertiary children's hospitals and 2 general hospitals with pediatric commitment. PARTICIPANTS: A total of 132 children and adolescents aged 12 to 17 years hospitalized during the previous 6 months for moderate to severe TBI. INTERVENTIONS:Participants in CAPS (n = 65) completed 8 to 12 online modules providing training in problem solving, communication skills, and self-regulation and subsequent synchronous videoconferencing with a therapist. Participants in the IRC group (n = 67) received links to Internet resources about pediatric TBI. MAIN OUTCOME MEASURES: Child Behavior Checklist administered before and after completion of treatment (ie, approximately 6 months after treatment initiation). RESULTS: Post hoc analysis of covariance, controlling for pretreatment scores, was used to examine group differences in behavior problems in the entire sample and among older (n = 59) and younger adolescents (n = 53). Among older but not younger adolescents, CAPS resulted in greater improvements on multiple dimensions of externalizing behavior problems than IRC. CONCLUSION: Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI.
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