• Shari L Wade, Terry Stancin, Michael Kirkwood, Tanya Maines Brown, Kendra M McMullen, and H Gerry Taylor.
• 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).
• J Head Trauma Rehabil. 2014 May 1;29(3):198-207.

ObjectiveTo 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).DesignRandomized clinical trial with interviewers naive to treatment condition.SettingThree large tertiary children's hospitals and 2 general hospitals with pediatric commitment.ParticipantsA total of 132 children and adolescents aged 12 to 17 years hospitalized during the previous 6 months for moderate to severe TBI.InterventionsParticipants 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.Main Outcome MeasuresChild Behavior Checklist administered before and after completion of treatment (ie, approximately 6 months after treatment initiation).ResultsPost 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.ConclusionOnline problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI.

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