title: Counselor-assisted problem solving (CAPS) improves behavioral outcomes in older adolescents with complicated mild to severe TBI.
abstract: OBJECTIVE
  To test the efficacy of Counselor-Assisted Problem Solving (CAPS) versus an Internet resource comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI).
  
  
  METHODS
  Randomized clinical trial with interviewers naive to treatment condition.
  
  
  METHODS
  Three large tertiary children's hospitals and 2 general hospitals with pediatric commitment.
  
  
  METHODS
  A total of 132 children and adolescents aged 12 to 17 years hospitalized during the previous 6 months for moderate to severe TBI.
  
  
  METHODS
  Participants in CAPS (n = 65) completed 8 to 12 online modules providing training in problem solving, communication skills, and self-regulation and subsequent synchronous videoconferencing with a therapist. Participants in the IRC group (n = 67) received links to Internet resources about pediatric TBI.
  
  
  METHODS
  Child Behavior Checklist administered before and after completion of treatment (ie, approximately 6 months after treatment initiation).
  
  
  RESULTS
  Post hoc analysis of covariance, controlling for pretreatment scores, was used to examine group differences in behavior problems in the entire sample and among older (n = 59) and younger adolescents (n = 53). Among older but not younger adolescents, CAPS resulted in greater improvements on multiple dimensions of externalizing behavior problems than IRC.
  
  
  CONCLUSIONS
  Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI.
authors: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (Dr Wade and Ms McMullen), Cincinnati, Ohio; MetroHealth Medical Center (Dr Stancin) and Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center (Dr Taylor), Case Western Reserve University, Cleveland, Ohio; Children's Hospital Colorado and University of Colorado School of Medicine, Aurora (Dr Kirkwood); and Mayo Clinic, Rochester, Minnesota (Dr Brown).
authors: Shari L
authors: SL
authors: Wade
authors: Terry
authors: T
authors: Stancin
authors: Michael
authors: M
authors: Kirkwood
authors: Tanya Maines
authors: TM
authors: Brown
authors: Kendra M
authors: KM
authors: McMullen
authors: H Gerry
authors: HG
authors: Taylor
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D003194:Computer-Assisted Instruction; D003376:Counseling; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D011340:Problem Solving
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