TY - JOUR PY - 2019// TI - Adolescent quality of life following family problem-solving treatment for brain injury JO - Journal of consulting and clinical psychology A1 - Wade, Shari L. A1 - Cassedy, Amy E. A1 - Taylor, H. Gerry A1 - McNally, Kelly A. A1 - Kirkwood, Michael W. A1 - Stancin, Terry A1 - Horn, Paul S. A1 - Kurowski, Brad G. SP - ePub EP - ePub VL - ePub IS - ePub N2 - OBJECTIVE: To examine changes in quality of life (QoL) in adolescents receiving family problem-solving therapy (F-PST) following traumatic brain injury (TBI).

METHOD: Adolescents hospitalized for moderate-to-severe TBI were randomized to 1 of 3 ten-session, 6-month long treatments: face-to-face F-PST (n = 34), therapist-guided online F-PST (n = 56), and self-guided online F-PST (n = 60). Participants included 96 boys and 54 girls, of whom 124 were White and 6 were Hispanic. Outcomes were assessed pretreatment and 6 and 9 months later. Adolescents and parents rated adolescent QoL and TBI-related symptoms on the PedsQL and Health and Behavior Inventory (HBI), respectively. We used mixed modeling to examine changes over time and moderators of treatment efficacy.

RESULTS: Therapist- and self-guided online groups demonstrated improvements in parent-proxy QoL from baseline to 9 months, Cohen's d = 0.75; p =.004 and Cohen's d = 1.30; p <.001, respectively. The face-to-face group had poorer parent-proxy QoL at 6 months (M = 62, SE = 3.4) than either the therapist- (M = 70.9, SE = 2.8) or self-guided online group (M = 71.1, SE = 2.6). There were no changes or group differences in self-reported QoL over time. Similar findings were observed on the HBI. Differential treatment effects on parent-proxy outcomes were found in boys versus girls and in those from single versus 2-parent households. Improvements in parent-proxy HBI ratings mediated QoL improvements.

CONCLUSIONS: Both online treatments, but not face-to-face F-PST, were associated with clinical improvements, raising questions about our current delivery paradigm. Individual and family moderators of treatment efficacy underscore the potential of personalized treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Language: en

LA - en SN - 0022-006X UR - http://dx.doi.org/10.1037/ccp0000440 ID - ref1 ER -