Online Program Helps Reduce Distress After Brain Injury
Families of children with traumatic brain injuries often suffer great burden and distress after the injury. But how do you make it easy for them to access therapy? In a new study, Shari Wade, PhD, suggests that families participate in therapy when it's convenient for them – from their home computers.
Brain injuries in children have been shown to have a profound impact on the entire family. After seeing success with face-to-face family therapy, Dr. Wade speculated the possibility of reaching even more families with online resources.
"We had a hard time getting parents to come back to the hospital for weekly sessions," says Dr. Wade, a staff psychologist in Pediatric Rehabilitation at Cincinnati Children's. "The logical next step was to create an online intervention to equip families with strategies to help facilitate problem-solving."
Two groups took part in the study. In one, families were given access to internet resources, including links to brain injury web sites. In the other, families received the same web resources, plus access to interactive sessions and a web cam that allowed biweekly videoconference sessions with a therapist. With the latter group, Dr. Wade says, "Families could be specific about their problems and brainstorm solutions. The family would vote on what solution they wanted to implement and then keep track of the results together."
Tracking the Results
Aiding Dr. Wade and her colleagues in this study was a system originally developed for the General Clinical Research Center (GCRC) at Cincinnati Children's. The Division of Biomedical Informatics created a Study Tracking System for the GCRC, which served as the platform for the tracking system Dr. Wade used in her study. (Dr. Wade also is performing another brain injury study using the GCRC for rating, assessment and coding of parent/child interaction videos.)
Upon analyzing the study's results recorded in this tracking system, the researchers found the two groups did not differ significantly in overall problemsolving skills when the treatment was complete. But the research did uncover other telling results. The group participating in the interactive sessions and video conferences reported less parental depression and distress after treatment. The children with brain injury were better able to manage their own behavior after the interactive intervention. And these families also reported a high acceptance of the program; they all indicated they would recommend it to others. Furthermore, the investigators found that individuals with varied education backgrounds can benefit from this intervention regardless of computer skill level.
Eliminating Barriers
Access to computers and highspeed internet connection is becoming less of a concern as users power up everywhere from bagel shops to the beach. "Even in families where parents are fairly computer-illiterate, the kids are very savvy since they're using computers in schools," Dr. Wade says. In fact, the researchers report that "interventions delivered via computer…eliminate common barriers to treatment such as time, distance and the unavailability of knowledgeable providers."
Expanding on this research, Dr. Wade is working with another Cincinnati Children's researcher on adapting the program for use with families who have internationally adopted. A study at the University of Pittsburgh is comparing her intervention to an online support group. And she has received a National Institutes of Health grant to target this intervention to teens.
Having researched brain injuries in children for nearly 15 years now, Dr. Wade sees how critical it is to aid not just the child, but the entire family. She also stresses the importance of focusing on families of children with moderate brain injuries. "The kids with severe injuries tend to get more resources," she says. "Kids with moderate injuries may fall through the cracks a bit more." At a time when computers are bringing the world to our desktops, this online program is one way families may be able to avoid those cracks.
