The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury.

Wade, Shari L.; Carey, Joanne; Wolfe, Christopher R.

doi:10.1037/0090-5550.51.3.179

Cited by 156 publications

(178 citation statements)

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“…problem-solving and emotional dysregulation) noted minimal behavioural changes immediately post-intervention [58, 93,98,100,104,105,107]. However there was high participant satisfaction with using tele-practice [93] and greater changes observed in outcome at follow-up [58, 98,100,104,105,107].…”

Section: Telerehabilitationmentioning

confidence: 99%

“…Indeed, telerehabilitation for MANUSCRIPT ACCEPTED -BRAIN INJURY: 02 FEBRUARY 2017 17 people with TBI featured in 38 of the included papers (see Table 2), comprising 2 systematic reviews [39,79], 22 group comparison trials [23][24][25]30,35,52,58,74,77,82,84,[98][99][100][104][105][106][108][109][110][111]113], 9 case series [28,50,80,83,93,97,101,102,107] Importantly, no statistically significant differences were found between the tele-practice and face-to-face intervention delivery methods [39,79].…”

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confidence: 99%

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Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

et al. 2017

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distinct from motor speech impairments or primary language impairments (e.g. aphasia), in that the impairments arise from the diffuse axonal injuries which occur in frontal and prefrontal areas of the brain [6]. These impairments can be defined as any aspect of communication that result from underlying deficits in cognition [4,5,7].Communication difficulties after a TBI can affect how a person hears, listens, understands, speaks, reads, writes, and how they engage in conversation and social communication [5]. The underlying deficits of cognition that affect these communicative functions can include slowed information processing; impaired working memory and attention; disorientation and disorganisation; executive function problems including rigidity, poor conceptualization, planning, and problem solving; and poor self-control or selfregulation of cognition or behaviour [4,5]. As a result of these changes in cognitivecommunicative processes, people with TBI have been described as 'overtalkative, inefficient, tangential or drifting from topic to topic, or lacking in language output. ' [4] (p.354). These cognitive-communication impairments can restrict a person's ability to communicate, live independently, return to work or education, participate in society, and build or maintain relationships after their TBI [8].The International Cognitive (INCOG) guidelines for the management of a person's cognitive rehabilitation following TBI highlight that assessment of cognitive-communication skills should incorporate performance in everyday social activities [4]. Adolescents and young adults, the group most at risk of TBI, use digital and online communication MANUSCRIPT ACCEPTED -BRAIN INJURY: 02 FEBRUARY 2017 4 technologies from a young age [9] and, following TBI, involvement in social, academic, and societal situations may be reduced with difficulties using technology and social media [5]. As a result, people with cognitive-communication impairments resulting from a TBI face challenges in accessing information independently and engaging effectively in social networks [8]. However, little is known about how people with cognitive-communication impairments after TBI use and experience digital communication and the internet.Furthermore, clinical guidelines for the assessment of cognitive-communication skills following a TBI do not provide guidance on the use of social media, or of assistive technologies (AT) to support cognitive-communication rehabilitation [4,5].In order to review the existing literature on technology it is essential to consider which types of technology appear in relation to TBI and cognitive-communication. In this study, we considered three major categories of technology: (i) Assistive Technology (AT), being 'any item, piece of equipment, or product, whether it is acquired commercially, includes technology such as email, the internet, and mobile phones [13] which enable users to access, store, transmit, and manipulate information [14]. The multiple purposes of the different types of technology selected ...

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Section: Telerehabilitationmentioning

confidence: 99%

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confidence: 99%

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

et al. 2017

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“…25 PST has also been used in internet-based sessions to lower parental distress and improve social functioning of children with TBI. 26,27 In the present study, we report the results of a randomized controlled trial (RCT) of PST for family caregivers of persons with TBI. Building on a prior demonstration of PST for caregivers of stroke survivors, 24 we developed an intervention that would train caregivers in problemsolving principles in their home, circumventing problems with mobility, isolation, and lack of access that typically limit services to caregivers.…”

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confidence: 99%

Problem-Solving Training for Family Caregivers of Persons With Traumatic Brain Injuries: A Randomized Controlled Trial

Rivera

Elliott

Berry

et al. 2008

Archives of Physical Medicine and Rehabilitation

134

128

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Objective-To test the hypothesis that a problem-solving training program would lower depression, health complaints, and burden, and increase well-being reported by community-residing family caregivers of persons with traumatic brain injuries (TBIs). Design-Randomized controlled trial. Setting-General community.Participants-Of the 180 people who expressed interest in the study, 113 did not meet eligibility criteria. A consenting sample of family caregivers were randomized into a problem-solving training group (4 men, 29 women; average age, 51.3y) or an education-only control group (34 women; average age, 50.8y). Care recipients included 26 men and 7 women in the intervention group (average age, 36.5y) and 24 men and 10 women in the control group (average age, 37.2y).Intervention-Problem-solving training based on the D'Zurilla and Nezu social problem-solving model was provided to caregivers in the intervention group in 4 in-home sessions and 8 telephone follow-up calls over the course of their year-long participation. Control group participants received written educational materials and telephone calls at set intervals throughout their 12 months of participation.Main Outcome Measures-Caregiver depression, health complaints, well-being, and social problem-solving abilities.Results-Hierarchical linear models revealed caregivers receiving problem-solving training reported significant decreases in depression, health complaints, and in dysfunctional problem-solving styles over time. No effects were observed on caregiver well-being, burden, or constructive problemsolving styles.Conclusions-Problem-solving training provided in the home appears to be effective in alleviating distress and in decreasing dysfunctional problem-solving styles among family caregivers of persons Reprint requests to Patricia A. Rivera, PhD, Birmingham VAMC, 700 19th St S, Birmingham, AL 35233, No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. NIH Public Access KeywordsBrain injuries; Caregivers; Problem-solving; Randomized controlled trials; RehabilitationEvidence accumulating from decades of empirical research substantiates that many family caregivers of persons with traumatic brain injury (TBI) experience considerable distress and compromised quality of life, generally, in the wake of the neurobehavioral changes imposed by TBI. 1 To a great extent, this research has been content to describe the various demographic, social, and psychologic correlates of distress, depression, and burden reported by caregivers. Despite this evidence, a recent critical review identified only 4 published studies to date of interventions to alleviate caregiver distress, and it concluded that there is currently no evidence supporting the usefulness of any single psychosocial intervention for family caregivers of persons with TBI. 2Much of the available research on caregiver distress after TBI...

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“…9 In the current investigation we examined the efficacy of teen online problem-solving (TOPS) relative to access to Internet resources regarding TBI (Internet resource comparison [IRC]). We hypothesized that teens and families who participated in TOPS would show greater reductions in adolescent behavior problems and parent-teen conflict than teens who participated in IRC.…”

Section: (Continued On Last Page)mentioning

confidence: 99%

“…9 During the initial in-home session, the therapist identified goals that the teen and family wanted to address and trained the family on navigating the TOPS Web site and using the videoconferencing software. All subsequent sessions were conducted remotely by using online videoconferencing or, in rare instances when videoconferencing was not possible, over the telephone.…”

Section: Description Of the Tops Interventionmentioning

confidence: 99%

Effect on Behavior Problems of Teen Online Problem-Solving for Adolescent Traumatic Brain Injury

2011

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Traumatic brain injury in teenagers may lead to increased behavior problems and corresponding deterioration in family relationships. Familycentered training in problem-solving skills may facilitate improvements in behavior and self-management after traumatic brain injury, but this strategy has not been tested with teens. WHAT THIS STUDY ADDS:A comparison of teen online problemsolving (TOPS) with access to Internet resources for treatment of teenagers after traumatic brain injury revealed lower family conflict after TOPS and improvements in behavior among teens with severe injury or lower socioeconomic status. abstract PURPOSE: To report the results of a randomized clinical trial of teen online problem-solving (TOPS) meant to improve behavioral outcomes of adolescents with traumatic brain injury (TBI). METHODS: A randomized clinical trial was conducted to compare the efficacy of TOPS with access to Internet resources in teenagers with TBI in improving parent and self-reported behavior problems and parentteen conflicts. Participants included 41 adolescents aged 11 to 18 years (range: 11.47-17.90 years) who had sustained a moderate-to-severe TBI between 3 and 19 months earlier. Teens in the TOPS group received 10 to 14 online sessions that provided training in problem-solving, communication skills, and self-regulation. Outcomes were assessed before treatment and at a follow-up assessment an average of 8 months later. Groups were compared on follow-up scores after we controlled for pretreatment levels. Injury severity and socioeconomic status were examined as potential moderators of treatment efficacy. RESULTS: Forty-one participants provided consent and completed baseline assessments, and follow-up assessments were completed for 35 participants (16 TOPS, 19 Internet resource comparison). The TOPS group reported significantly less parent-teen conflict at follow-up than did the Internet-resource-comparison group. Improvements in teen behavior after TOPS were moderated by injury severity; there were greater improvements in the teens' internalizing symptoms after TOPS among adolescents with severe TBI. Family socioeconomic status also moderated the efficacy of TOPS in improving behavior problems reported by both parents and teens, although the nature of the moderation effects varied. CONCLUSION: Our findings suggest that TOPS contributes to improvements in parent-teen conflict generally and parent and self-reported teen behavior problems for certain subsets of participants. Pediatrics 2011;128:e947-e953 AUTHORS:

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The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury.

Cited by 156 publications

References 36 publications

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

Problem-Solving Training for Family Caregivers of Persons With Traumatic Brain Injuries: A Randomized Controlled Trial

Effect on Behavior Problems of Teen Online Problem-Solving for Adolescent Traumatic Brain Injury

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