Comparative effectiveness of family problem-solving therapy (F-PST) for adolescents after traumatic brain injury: Protocol for a randomized, multicenter, clinical trial

Abstract

IntroductionThe objective of this manuscript is to describe the methodology that will be used to test the comparative effectiveness, feasibility, and acceptability of three formats of family problem solving therapy (F-PST) for improving functional outcomes of complicated mild to severe adolescent TBI.MethodsThree-arm comparative effectiveness, randomized clinical trial (RCT) design. We describe the protocol of a three-arm RCT comparing the effectiveness of three modalities of F-PST to reduce executive dysfunction and behavior problems following TBI in adolescence. The RCT will compare the relative effectiveness among face-to-face; online and self-directed; and therapist-supported online modes of treatment.Ethics and disseminationIt is anticipated that findings from this work will inform future clinical care practices, with implications for treatment of other patient populations of youth with psychological symptoms arising from neurological conditions. Institutional review board approval will be obtained from all sites prior to commencement of the study.

Adolescent quality of life following family problem-solving treatment for brain injury.

“…We recruited adolescents hospitalized at least overnight for a moderate to severe TBI, age 14–19 years, who were experiencing some degree of current behavioral impairment (B. G. Kurowski et al, 2018).…”

“…L. Wade, Kurowski, et al, 2015; improvements in HR QoL have not previously been evaluated. Given that QoL provides an important indicator of disease burden and a primary target for public health initiatives, we sought to address this deficiency by examining changes in parent-and youth-reported QoL as part of a larger comparative effectiveness study of three modalities of family problem-solving treatment to reduce behavioral morbidity in adolescence following childhood TBI (B. G. Kurowski et al, 2018). Two separate reports examined comparative efficacy in improving child externalizing and executive function behaviors (B.…”

Diagnosis and management of cerebral palsy and other types of pediatric brain injury.

“…Intensive training of memory and cognitive skills, plus training of parents in the ability to optimally assist their children, has also shown efficacy (Kurowski et al, 2014(Kurowski et al, , 2018Wade, Kurowski, et al, 2015;Wade et al, 2006Wade et al, , 2010.…”

Executive Functioning and Problem Solving: A Bidirectional Relation

“…Zelazo et al [30] aimed to improve preschool children's executive function skills, such as cognitive flexibility, working memory and inhibitory control through goaldirected problem solving. As it is already known executive function skills can be fostered through reflection training as individuals acknowledge and are able to manipulate their cognition and emotions.…”