title: Long-Term Caregiver Mental Health Outcomes Following a Predominately Online Intervention for Adolescents With Complicated Mild to Severe Traumatic Brain Injury.
abstract: OBJECTIVE
  To examine the efficacy of counselor-assisted problem solving (CAPS) in improving long-term caregiver psychological functioning following traumatic brain injury (TBI) in adolescents.
  
  
  METHODS
  This randomized clinical trial compared CAPS (n = 65), a predominantly online problem-solving intervention, with an Internet resource comparison (n = 67) program. Families of adolescents with TBI completed a baseline assessment and follow-up assessments 6, 12, and 18 months later. General linear mixed models were used to examine longitudinal changes in caregiver global psychological distress, depressive symptoms, and caregiving self-efficacy. Family income and injury severity were examined as moderators of treatment efficacy.
  
  
  RESULTS
  Family income moderated long-term changes in caregiver psychological distress. For lower-income caregivers, the CAPS intervention was associated with lower levels of psychological distress at 6, 12, and 18 months post baseline.
  
  
  CONCLUSIONS
  These findings support the utility of Web-based interventions in improving long-term caregiver psychological distress, particularly for lower-income families.
authors: Department of Psychology, University of Cincinnati, Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, karvercl@mail.uc.edu.
authors: Christine L
authors: CL
authors: Petranovich
authors: Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati.
authors: Shari L
authors: SL
authors: Wade
authors: Case Western Reserve University, Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center.
authors: H Gerry
authors: HG
authors: Taylor
authors: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
authors: Amy
authors: A
authors: Cassedy
authors: Case Western Reserve University, MetroHealth Medical Center.
authors: Terry
authors: T
authors: Stancin
authors: Children's Hospital Colorado and University of Colorado School of Medicine, and.
authors: Michael W
authors: MW
authors: Kirkwood
authors: Department of Psychiatry and Psychology, Mayo Clinic, and Mayo Medical School.
authors: Tanya
authors: T
authors: Maines Brown
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000451:nursing*; D017028:Caregivers / Q000523:psychology*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007182:Income; D020407:Internet; D008297:Male; D011340:Problem Solving / Q000502:physiology; D011613:Psychotherapy / Q000379:methods*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome
keywords: caregiver outcomes; psychopathology; traumatic brain injury