A Randomized Trial of Teen Online Problem Solving: Efficacy in Improving Caregiver Outcomes After Brain Injury

Health Psychology (Impact Factor: 3.95). 07/2012; 31(6). DOI: 10.1037/a0028440
Source: PubMed

ABSTRACT Objective: To examine the results of a randomized clinical trial (RCT) of Teen Online Problem Solving (TOPS), an online problem solving therapy model, in increasing problem-solving skills and decreasing depressive symptoms and global distress for caregivers of adolescents with traumatic brain injury (TBI). Method: Families of adolescents aged 11-18 who sustained a moderate to severe TBI between 3 and 19 months earlier were recruited from hospital trauma registries. Participants were assigned to receive a web-based, problem-solving intervention (TOPS, n = 20), or access to online resources pertaining to TBI (Internet Resource Comparison; IRC; n = 21). Parent report of problem solving skills, depressive symptoms, global distress, utilization, and satisfaction were assessed pre- and posttreatment. Groups were compared on follow-up scores after controlling for pretreatment levels. Family income was examined as a potential moderator of treatment efficacy. Improvement in problem solving was examined as a mediator of reductions in depression and distress. Results: Forty-one participants provided consent and completed baseline assessments, with follow-up assessments completed on 35 participants (16 TOPS and 19 IRC). Parents in both groups reported a high level of satisfaction with both interventions. Improvements in problem solving skills and depression were moderated by family income, with caregivers of lower income in TOPS reporting greater improvements. Increases in problem solving partially mediated reductions in global distress. Conclusions: Findings suggest that TOPS may be effective in improving problem solving skills and reducing depressive symptoms for certain subsets of caregivers in families of adolescents with TBI. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

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    Journal of Pediatric Psychology 05/2014; DOI:10.1093/jpepsy/jsu032 · 2.91 Impact Factor
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    ABSTRACT: Background Parents caring for a child with Cystic Fibrosis (CF) are at high risk for psychological distress and have limited access to psychological care. Therefore, a web-based psychological support program for severely distressed parents of children with CF (WEP-CARE) was developed and evaluated for its feasibility and efficacy.MethodsA clinical expert panel developed WEP-CARE based on principles of cognitive-behavioral therapy. This web-based writing therapy comprises nine sessions, tailored for the specific needs of caregivers. The pilot study was conducted as a single-group intervention with pre-post-follow-up design. Out of 31 participants, 23 parents completed the intervention (21 female; mean age 37 years; SD¿=¿6.2 years, range 25 ¿ 48 years). Psychological symptoms and quality of life were assessed online by self-report measures at pre and post treatment and followed up 3 month later.ResultsOn average, the caregivers¿ symptoms of anxiety decreased statistically significant and clinical relevant about five points from an elevated (M¿=¿11.4; SD =2.6) to a normal level (M¿=¿6.7; SD¿=¿2.6; p¿<¿0.001) between pre and post treatment. Fear of disease progression (p¿<¿0.001) and symptoms of depression (p¿=¿0.02) significantly decreased as well. Quality of life significantly improved (p¿=¿0.01). The effects were maintained at the 3-months follow-up assessment.ConclusionsWEP-CARE is feasible and promising regarding its efficacy to improve parental mental health and quality of life.
    Health and Quality of Life Outcomes 02/2015; 13(1):11. DOI:10.1186/s12955-015-0211-y · 2.10 Impact Factor
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    ABSTRACT: Purpose: The purpose of the current study is to examine the efficacy of Counselor-Assisted Problem Solving (CAPS) in improving caregiver adaptation following traumatic brain injury (TBI). Research Method/Design: In a randomized clinical trial comparing CAPS (n = 65), an online problem-solving intervention with accompanying Web-based counseling sessions, with an information-based Internet Resource Comparison (IRC; n = 67) program, participants included families of 12- to17-year-olds who had sustained a TBI in the past 6 months. Linear regression analyses were used to identify main effects and to examine whether caregiver education, race, or prior computer use moderated treatment efficacy. Results: Computer experience moderated postintervention improvements in caregiving self-efficacy following CAPS, Specifically, parents in CAPS with low levels of prior use reporting the greatest improvements. CAPS participants who completed 5 or more sessions reported greater reductions in depression than did the IRC; however, the groups did not differ on global distress. Conclusions/Implications: Findings support the potential utility of counselor-supported Web-based interventions particularly for individuals with limited computer expertise following adolescent TBI. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Rehabilitation Psychology 02/2014; 59(1):1-9. DOI:10.1037/a0034911 · 1.91 Impact Factor


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Sep 10, 2014