Internet-Based Treatment for Children With Traumatic Brain Injuries & Their Families: Counselor Assisted Problem Solving

A traumatic brain injury (TBI) is caused by a strong blow, jolt, or penetration to the head
that disrupts normal brain functioning. A TBI can range from a mild concussion to severe
brain damage. Falls, assaults, and motor vehicle accidents account for more than 50% of
TBIs. Physical symptoms of a TBI can be subtle to severe and can include nausea, memory
loss, mood swings, blurred vision, and light-headedness. This type of injury can be very
stressful for families and can result in feelings of anxiety, burden, and depression among
family members. A child who experiences a TBI will often display new social and behavioral
problems, leading to further parental distress and increased family dysfunction. Recent
studies have shown that problem-solving interventions can reduce caregiver distress and
improve child adjustment following a TBI. However, access to skilled therapists and
specialized care for this kind of psychosocial treatment is often limited in many
communities. In such communities, the Internet offers a new way to meet the mental and other
health needs of individuals with TBIs. 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 TBI and their families.

Families participating in this study will be randomly assigned to either an Internet-based
counselor-assisted problem-solving (CAPS) group or an Internet resource comparison group
(IRC). Participants assigned to CAPS will work with a trained counselor who will guide them
through a 6-month structured online problem-solving and skill-building program via
one-on-one videoconference sessions. Families assigned to IRC will receive computers, high
speed Internet access, and links to brain injury information and resources, but no access to
the CAPS Web site content. The effectiveness of CAPS will be assessed after treatment and at
6- and 12-month follow-up evaluations.