A randomized trial of teen online problem solving: Efficacy in improving caregiver outcomes after brain injury.
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.
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Participants appreciated content that helped them learn specific techniques such as problem solving and anger control, or challenging negative thoughts.
“Appreciation was expressed for content that helped participants to learn specific techniques such as problem solving and anger control (71), or challenging negative thoughts (37).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [71]
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Self-citationJenkin, T., D’Cruz, K., Botchway-Commey, E. N., Muscara, F., Anderson, V. A., Scheinberg, A. M., & Knight, S. (2024) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2024.2330141 · Cited by 4 · see citing works
Karns, C. M., Wade, S. L., Slocumb, J., Keating, T., Gau, J. M., Slomine, B. S., Suskauer, S. J., & Glang, A. E. (2023) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2023.03.013 · Cited by 4 · see citing works
Self-citationPsychological Support Using Narrative Psychotherapy for Children with Brain Injury
Perkins, A. (2015) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137388223_11 · Cited by 2 · see citing works
Helping Children with Brain Injury and Behavioural Problems: The Importance of Antecedent Regulation
Watson, S., Reed, J., & Byard, K. (2015) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137388223_6 · Cited by 2 · see citing works
Limond, J., Wade, S. L., Vickery, J., Jeffery, A., Warren, F. C., Hawton, A., Smithson, J., Ford, T. J., Haworth, S., & Adlam, A. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-029349 · Cited by 1 · see citing works
Self-citationZabel, T. A., Bernat, D. J., Costello, R., Edgar, V. B., Heffelfinger, A. K., Jordan, L. L., Koop, J. I., Leiser, K., MacDonald, B., Stanford, L. D., et al. (2025) · The Clinical Neuropsychologist · doi:10.1080/13854046.2025.2566208 · Cited by 1 · see citing works
Combs, A. B., Wagner, J. L., Huszti, H. C., Wade, S. L., Schmidt, M., Buschhaus, S., Scherra, J., Wetter, S. E., Ogundairo, D. A., Coffey, C. S., et al. (2026) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2026.101605 · Cited by 1 · see citing works
Self-citationA Contextual, Systemic Perspective in Child Neuropsychological Rehabilitation
Byard, K. (2015) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137388223_9 · Cited by 1 · see citing works
Chevignard, M., & Chevignard, M. (2018) · De Boeck Supérieur eBooks · doi:10.3917/dbu.roy.2018.01.0323 · Cited by 1 · see citing works
Online Family Problem Solving for Adolescent Traumatic Brain Injury
Wade, S. L., & Hung, A. H. (2015) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137388223_3 · Cited by 1 · see citing works
Self-citationMcCusker, C. G. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-801640-4.00012-3
McCusker, C. G. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-801640-4.00010-x
PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE AMONG YOUTH WITH SPINAL CORD INJURY
McAuliff, K. E. (2017) · Digital Commons-DePaul (DePaul University)
Hinton, S. (2017) · The University of Queensland · doi:10.14264/uql.2018.68
Traumatic Brain Injury/Concussions
Davies, S. C., & Kolber-Jamieson, A. (2018) · Springer eBooks · doi:10.1007/978-3-030-00791-1_8
Herrera, J. (2018) · D-Scholarship@Pitt (University of Pittsburgh)
Winning, A. M., & Holmbeck, G. N. (2021) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsab036
Normalizing perinatal neurological development via intervention
DeMaster, D., Vaughn, K. A., & Moore, B. D. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817988-8.00043-9
Linden, M., Leonard, R., Ewing‐Cobbs, L., Davis, K. C., & Schrieff-Brown, L. (2024) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2024.1405674
Talent Management Factors Influencing Employee Retention
Khan, A. H., & Bhagat, M. (2025) · IGI Global eBooks · doi:10.4018/979-8-3373-4485-0.ch011
Empowering Independence in Spina Bifida: A Scoping Review of Interventions
Wilson, C. S., Bradstreet, L. E., Ludwig, N. N., Gehred, A. P., Stephan, C. T., Zabel, T. A., & Koterba, C. (2026) · Topics in Spinal Cord Injury Rehabilitation · doi:10.46292/sci25-00046
Rohrer-Baumgartner, N., Holthe, I. L., Svendsen, E. J., Dahl, H. M., Borgen, I. M. H., Hauger, S. L., Brunborg, C., Ponsford, J. L., Wade, S. L., Egeland, J., et al. (2026) · BMC Pediatrics · doi:10.1186/s12887-026-06997-y
Self-citationTechnology-Based Interventions for Children with Neurological Conditions
Wade, S. L., Adlam, A., Viola, N., Hemming, F., Jones, K., Corti, C., & Williams, T. S. (2026) · doi:10.1093/9780197814116.003.0015
Self-citation
- Authors
- Wade, S. L., Walz, N. C., Carey, J., McMullen, K. M., Cass, J., Mark, E., & Yeates, K. O.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- The Ohio State University (US)
- Venue
- Health Psychology
- Published
- 2012
- Volume
- 31
- Issue
- 6
- Pages
- 767-776
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2111742199
- Cited by
- 94
- References
- 27
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 6 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 7 · 2019: 15 · 2018: 16 · 2017: 6 · 2016: 6 · 2015: 10 · 2014: 7 · 2013: 3 · 2012: 1
- FWCI
- 5.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- US Department of Education (H133G050239)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- problem-solving therapy, traumatic brain injury, adolescents, caregiver depression, caregiver distress, problem-solving skills, online intervention, household income, mediation, parental satisfaction
- MeSH terms
- Adolescent, Adult, Brain Injuries, Child, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Parent-Child Relations, Parents, Problem Solving, Socioeconomic Factors, Stress, Psychological, Trauma Severity Indices, Treatment Outcome, Internet
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