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Rehabilitation Research and Training Center for Traumatic Brain Injury Interventions--Teen Online Problem Solving Study

Not Applicable
Completed
Conditions
Traumatic Brain Injury
Interventions
Behavioral: Teen Online Problem Solving (TOPS)
Behavioral: Internet Resources Comparison (IRC)
Behavioral: Teen Online Problem Solving--Teen Only (TOPS-TO)
Registration Number
NCT01042899
Lead Sponsor
Children's Hospital Medical Center, Cincinnati
Brief Summary

This study will evaluate the effectiveness of an Internet-based psychosocial treatment in improving problem-solving, communication skills, stress management strategies, and coping among teens who have had a traumatic brain injury and their families.

Detailed Description

Traumatic brain injury (TBI) in adolescents is a significant stressor for both the teen and his or her family. Existing interventions are rare and access to treatment can be restricted by distance and finances. Based on previous findings and participant feedback, we propose to expand the previously developed TOPS intervention by conducting a multi-site study comparing the efficacy of TOPS to that of TOPS-Teen Only (TOPS-TO) in improving child behavior and functioning, parental depression and distress and family functioning. The efficacy of both active treatments would be examined in relation to an internet resource comparison group (IRC). During years 1-3, we will recruit 165 children between the ages of 11 and 18 with moderate to severe TBI and randomly assign them to receive TOPS, TOPS-TO, or IRC. We anticipate that TOPS will result in improvements in child, caregiver, and family functioning relative to IRC; but that TOPS-TO will only result in improvements in child behavior and adjustment. Based on prior research, we anticipate that the family-level treatment model of TOPS may be more effective than TOPS-TO in improving child behavior for children/adolescents with fewer social resources. Given these expectations, we will test the following hypotheses: 1) Children with TBI receiving either TOPS or TOPS-TO will have fewer behavior problems, greater social competence, and better functioning than those receiving IRC at both post-treatment and at a 6-month follow-up assessment. 2) Caregivers of children receiving TOPS will report less depression and psychological distress, less parent-child conflict, and better family functioning than those receiving TOPS-TO or IRC at both post-treatment and at a 6-month follow-up assessment. 3) Social resources will moderate treatment efficacy, such that children with limited social and economic resources will show greater improvements in the more comprehensive TOPS intervention. We hypothesize better teen problem solving and communication skills, fewer teen emotional/behavioral problems, less parental burden and distress, and less parent-teen conflict at follow-up among the TOPS group compared to the IRC group. TOPS makes use of emerging technology to address the multifaceted needs of teens following TBI with the goal of improving the teen's social and emotional functioning, thereby enabling him or her to better negotiate the complex transition to adulthood and independent functioning.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
153
Inclusion Criteria
  • Moderate to severe TBI that occurred within the last 18 months
  • Overnight hospital stay
  • English-speaking
  • Parent must be willing to provide informed consent
Exclusion Criteria
  • Child does not live with parents or guardian
  • Child or parent has history of hospitalization for psychiatric problem
  • TBI is a result of child abuse
  • Child suffered a non-blunt injury (e.g., projectile wound, stroke, drowning, or other form of asphyxiation)
  • Diagnosed with moderate or severe mental retardation, autism, or a significant developmental disability

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Teen Online Problem Solving (TOPS)Teen Online Problem Solving (TOPS)Web intervention
Internet Resources ComparisonInternet Resources Comparison (IRC)Web Intervention
Teen Online Problem Solving (TOPS)Teen Online Problem Solving--Teen Only (TOPS-TO)Web intervention
Teen Online Problem Solving (TOPS)Internet Resources Comparison (IRC)Web intervention
Teen Online Problem Solving---Teen OnlyTeen Online Problem Solving--Teen Only (TOPS-TO)Web Intervention
Primary Outcome Measures
NameTimeMethod
Parent Report Measures5 years
Secondary Outcome Measures
NameTimeMethod
Teen Self-Report Measures5 years
Neuropsychological Testing5 years

Trial Locations

Locations (5)

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Rainbow Babies' and Children's Hospital

🇺🇸

Cleveland, Ohio, United States

MetroHealth Medical Center

🇺🇸

Cleveland, Ohio, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

The Children's Hospital

🇺🇸

Denver, Colorado, United States

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