Abstract
We developed a Web-based intervention for pediatric traumatic brain injury (TBI) and examined its feasibility for participants with limited computer experience. Six families, including parents, siblings, and children with TBI, were given computers, Web cameras, and high-speed Internet access. Weekly videoconferences with the therapist were conducted after participants completed on-line interactive experiences on problem solving, communication, and TBI-specific behavior management. Families were assigned to videoconference with NetMeeting (iBOT cameras) or ViaVideo. Participants ranked the Web site and videoconferences as moderately to very easy to use. ViaVideo participants rated videoconferencing significantly more favorably relative to face-to-face meetings than did NetMeeting participants. Both the Web site and videoconferencing were rated as very helpful. All families demonstrated improved outcomes on one or more target behaviors, including increased understanding of the injury and improved parent-child relationships. All parents and siblings and all but 1 child with TBI said they would recommend the program to others. We conclude that a face-to-face intervention can be successfully adapted to the Web for families with varied computer experience.
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Agnew-Davies, R., Stiles, W. B., Hardy, G. E., Barkham, M., &Shapiro, D. A. (1998). Alliance structure assessed by the Agnew Relationship Measure (ARM).British Journal of Clinical Psychology,37,155–172.
Brooks, D. (1991). The head-injury family.Journal of Clinical & Experimental Neuropsychology,13,155–188.
Brown, G., Chadwick, O., Shaffer, D., Rutter, M., &Traub, M. (1981). A prospective study of children with head injuries: III. Psychiatric sequelae.Psychological Medicine,11,63–78.
Farmer, J. E., &Muhlenbruck, L. (2001). Telehealth for children with special health care needs: Promoting comprehensive systems of care.Clinical Pediatrics,40, 93–98.
Fay, G. C., Jaffe, K. M., Polissar, N. L., Liao, S., Rivara, J. B., &Martin, K. M. (1994). Outcome of pediatric traumatic brain injury at three years: A cohort study.Archives of Physical Medicine & Rehabilitation,75,733–741.
Fletcher, J., Ewing-Cobbs, L., Miner, M., Levin, H., &Eisenberg, H. (1990). Behavioral changes after closed head injury in children.Journal of Consulting & Clinical Psychology,58,93–98.
Gega, L., Marks, I., &Mataix-Cols, D. (2004). Computer-aided CBT self-help for anxiety and depressive disorders: Experience of a London clinic and future directions.Journal of Clinical Psychology,60,147–157.
Glueckauf, R. L., Fritz, S. P., Ecklund-Johnson, E. P., Liss, H. J., Dages, P., &Carney, P. (2002). Videoconferencing-based family counseling for rural teenagers with epilepsy: Phase 1 findings.Rehabilitation Psychology,47,49–72.
Greist, J. H. (1998). Treatment for all: The computer as patient assistant.Psychiatric Services,49,887–889.
Greist, J. H., Gustafson, D. H., Stauss, F. F., Rowse, G. L., Laughren, T. P., &Chiles, J. A. (1973). Computer interview for suicide-risk prediction.American Journal of Psychiatry,130,1327–1332.
Hawley, C. A., Ward, A. B., Magnay, A. R., &Long, J. (2002). Children’s brain injury: A postal follow-up of 525 children from one health region in the UK.Brain Injury,16,969–985.
Hewson, C. M., Laurent, D., &Vogel, C. M. (1996). Proper methodologies for psychological and sociological studies conducted via the Internet.Behavior Research Methods, Instruments, & Computers,28,186–191.
Joinson, A. N. (1998). Causes and implications of disinhibited behavior on the Net. In J. Gackenbach (Ed.),Psychology of the Internet (pp. 43–60). New York: Academic Press.
Kinsella, G., Ong, B., Murtaugh, D., Prior, M., &Sawyer, M. (1999). The role of the family for behavioral outcome in children and adolescents following traumatic brain injury.Journal of Consulting & Clinical Psychology,67,116–123.
Kleiner, K. D., Akers, R., Burke, B. L., &Werner, E. J. (2002). Parent and physician attitudes regarding electronic communication in pediatric practices.Pediatrics,109,740–744.
Maheu, M. M. (2000). Delivering behavioral telehealth via the Internet: E-health.TelehealthNet. http://telehealth.net/articles/.
Maheu, M. M. (2003). The online clinical practice management model.Psychotherapy: Theory, Research, Practice, Training,40, 20–32.
Marks, I., Shaw, S., &Parkin, R. (1998). Computer-aided treatments of mental health problems.Clinical Psychology: Science & Practice,5, 151–170.
Marks, M., Sliwinski, M., &Gordon, W. A. (1993). An examination of the needs of families with a brain injured child.NeuroRehabilitation,3, 1–12.
Max, J. E., Castillo, C. S., Robin, D. A., Lindgren, S. D., Smith, W. L., Jr.,Sato, Y., Mattheis, P. J., &Stierwalt, J. A. G. (1998). Predictors of family functioning after traumatic brain injury in children and adolescents.Journal of the American Academy of Child & Adolescent Psychiatry,37,83–90.
Max, J. E., Koele, S. L., Smith, W. L., Jr.,Sato, Y., Lindgren, S. D., Robin, D. A., &Arndt, S. (1998). Psychiatric disorders in children and adolescents after severe traumatic brain injury: A controlled study.Journal of the American Academy of Child & Adolescent Psychiatry,37,832–840.
Rabasca, L. (2000). Self-help sites: A blessing or a bane?Monitor on Psychology,31, 28–30.
Ritterband, L. M., Cox, D. J., Walker, L. S., Kovatchev, B., McKnight, L., Patel, K., Borowitz, S., &Sutphen, J. (2003). An Internet intervention as adjunctive therapy for pediatric encopresis.Journal of Consulting & Clinical Psychology,71,910–917.
Rivara, J. B., Fay, G. C., Jaffe, K. M., Polissar, N. L., Shurtleff, H. A., &Martin, K. M. (1992). Predictors of family functioning one year following traumatic brain injury in children.Archives of Physical Medicine & Rehabilitation,73,899–910.
Rivara, J. B., Jaffe, K. M., Polissar, N. L., Fay, G. C., Liao, S., &Martin, K. M. (1996). Predictors of family functioning and change 3 years after traumatic brain injury in children.Archives of Physical Medicine & Rehabilitation,77,754–764.
Rotondi, A. J., Sinkule, J., & Spring, M. (in press). An interactive Web-based intervention for persons with TBI and their families: Use and evaluation by female significant others.Journal of Head Trauma Rehabilitation.
Rutter, M. (1981). Psychological sequelae of brain damage in children.American Journal of Psychiatry,138,1533–1543.
Schopp, L. H., Johnstone, B. J., &Merrell, D. (2000). Telehealth and neuropsychological assessment: New opportunities for psychologists.Professional Psychology: Research & Practice,31,179–183.
Schwartz, L., Taylor, H. G., Drotar, D., Yeates, K. O., Wade, S. L., &Stancin, T. (2003). Long-term behavior problems following pediatric traumatic brain injury: Prevalence, predictors, and correlates.Journal of Pediatric Psychology,28,251 -263.
Singer, G. H. S., Glang, A., Nixon, C., Cooley, E., Kerns, K. A., Williams, D., &Powers, L. E. (1994). A comparison of two psychosocial interventions for parents of children with acquired brain injury: An exploratory study.Journal of Head Trauma Rehabilitation,9, 38–49.
Singer, G. H. S., &Powers, L. E. (1997). Stress management training to help parents adapt to a child’s ABI. In G. H. S. Singer, A. Glang, & J. M. Williams (Eds.),Children with acquired brain injury: Educating and supporting families (pp. 235–251). Baltimore: Brookes.
Sturges, J. W. (1998). Practical use of technology in professional practice.Professional Psychology: Research & Practice,29,183–188.
Taylor, H. G., Yeates, K. O., Wade, S. L., Drotar, D., Klein, S., &Stancin, T. (1999). Influences on first-year recovery from traumatic brain injury in children.Neuropsychology,13,76–89.
Taylor, H. G., Yeates, K. O., Wade, S. L., Drotar, D., Stancin, T., Taylor, H. G., Yeates, K. O., Wade, S. L., Drotar, D., Stancin, T., &Minich, N. (2002). A prospective study of short- and long-term outcomes after traumatic brain injury in children: Behavior and achievement.Neuropsychology,16,15–27.
Wade, S. L. (2004). Commentary: Computer-based interventions in pediatric psychology.Journal of Pediatric Psychology,29,269–272.
Wade, S. L., Drotar, D., Taylor, H. G., &Stancin, T. (1995). Assessing the effects of traumatic brain injury (TBI) on family functioning: Conceptual and methodological issues.Journal of Pediatric Psychology,20,737–752.
Wade, S. L., Michaud, L., & Brown, T. M. (2004).A family intervention to improve child outcomes following traumatic brain injury (TBI). Manuscript submitted for publication.
Wade, S. L., Taylor, H. G., Drotar, D., Stancin, T., &Yeates, K. O. (1996). Childhood traumatic brain injury: Initial impact on the family.Journal of Learning Disabilities,29,652–661.
Wade, S. L., Taylor, H. G., Drotar, D., Stancin, T., &Yeates, K. O. (1998). Family burden and adaptation following traumatic brain injury (TBI) in children.Pediatrics,102,110–116.
Wade, S. L., Taylor, H. G., Drotar, D., Stancin, T., Yeates, K. O., &Minich, N. M. (2002). A prospective study of long-term caregiver and family adaptation following brain injury in children.Journal of Head Trauma Rehabilitation,17,96–111.
Wolfe, C. R. (2001).Learning and teaching on the World Wide Web. San Diego: Academic Press.
Yeates, K. O., Taylor, H. G., Drotar, D., Wade, S. L., Klein, S., Stancin, T., &Schatschneider, C. (1997). Pre-injury family environment as a determinant of recovery from traumatic brain injuries in school-age children.Journal of the International Neuropsychological Society,3,617–630.
Yeates, K. O., Taylor, H. G., Wade, S. L., Drotar, D., Stancin, T., &Minich, N. (2002). A prospective study of short- and long-term neuropsychological outcomes after traumatic brain injury in children.Neuropsychology,16,514–523.
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This work was supported by Grant HD40942-02, NCMKR, National Institutes of Health.
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Wade, S.L., Wolfe, C.R. & Pestian, J.P. A Web-based family problem-solving intervention for families of children with traumatic brain injury. Behavior Research Methods, Instruments, & Computers 36, 261–269 (2004). https://doi.org/10.3758/BF03195572
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DOI: https://doi.org/10.3758/BF03195572