Christine L Petranovich1, Shari L Wade2, H Gerry Taylor3, Amy Cassedy4, Terry Stancin5, Michael W Kirkwood6, Tanya Maines Brown7. 1. Department of Psychology, University of Cincinnati, Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, karvercl@mail.uc.edu. 2. Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati. 3. Case Western Reserve University, Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center. 4. Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center. 5. Case Western Reserve University, MetroHealth Medical Center. 6. Children's Hospital Colorado and University of Colorado School of Medicine, and. 7. Department of Psychiatry and Psychology, Mayo Clinic, and Mayo Medical School.
Abstract
OBJECTIVE: To examine the efficacy of counselor-assisted problem solving (CAPS) in improving long-term caregiver psychological functioning following traumatic brain injury (TBI) in adolescents. METHODS: This randomized clinical trial compared CAPS (n = 65), a predominantly online problem-solving intervention, with an Internet resource comparison (n = 67) program. Families of adolescents with TBI completed a baseline assessment and follow-up assessments 6, 12, and 18 months later. General linear mixed models were used to examine longitudinal changes in caregiver global psychological distress, depressive symptoms, and caregiving self-efficacy. Family income and injury severity were examined as moderators of treatment efficacy. RESULTS: Family income moderated long-term changes in caregiver psychological distress. For lower-income caregivers, the CAPS intervention was associated with lower levels of psychological distress at 6, 12, and 18 months post baseline. CONCLUSIONS: These findings support the utility of Web-based interventions in improving long-term caregiver psychological distress, particularly for lower-income families.
RCT Entities:
OBJECTIVE: To examine the efficacy of counselor-assisted problem solving (CAPS) in improving long-term caregiver psychological functioning following traumatic brain injury (TBI) in adolescents. METHODS: This randomized clinical trial compared CAPS (n = 65), a predominantly online problem-solving intervention, with an Internet resource comparison (n = 67) program. Families of adolescents with TBI completed a baseline assessment and follow-up assessments 6, 12, and 18 months later. General linear mixed models were used to examine longitudinal changes in caregiver global psychological distress, depressive symptoms, and caregiving self-efficacy. Family income and injury severity were examined as moderators of treatment efficacy. RESULTS: Family income moderated long-term changes in caregiver psychological distress. For lower-income caregivers, the CAPS intervention was associated with lower levels of psychological distress at 6, 12, and 18 months post baseline. CONCLUSIONS: These findings support the utility of Web-based interventions in improving long-term caregiver psychological distress, particularly for lower-income families.
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