Brief report: Description of feasibility and satisfaction findings from an innovative online family problem-solving intervention for adolescents following traumatic brain injury.

OBJECTIVE: To describe feasibility and satisfaction findings from an innovative online family problem-solving intervention for adolescents with traumatic brain injury (TBI). METHODS: Nine adolescents who sustained a moderate to severe TBI in the previous 24 months and their families participated in a novel, online, manualized treatment program (Teen Online Problem Solving, TOPS) consisting of 10 web-based sessions providing information and interactive exercises on cognitive, social, and behavioral skills typically affected by TBI. Web-based sessions were followed by synchronous video conferences with a therapist to review target skills and apply the problem-solving process to family goals. RESULTS: All teens and consenting parents completed at least 10 sessions. The website and videoconferences received moderate to high ratings on helpfulness and ease of use. Parents and teens reported increased knowledge regarding targeted knowledge and skills. CONCLUSIONS: Findings support the acceptability of TOPS for adolescent TBI.

Preliminary efficacy of a Web-based family problem-solving treatment program for adolescents with traumatic brain injury.

OBJECTIVE: Preliminary report of the efficacy of a Web-based treatment program to improve adolescent and family psychosocial functioning following traumatic brain injury (TBI). PARTICIPANTS: Families of 9 adolescents with TBI (2 severe and 7 moderate) injured less than 24 months ago participated in this study. INTERVENTION: A Web-based family treatment program designed to enhance family problem solving and adjustment, as well as reduce adolescent behavioral and social problems that are common sequelae of moderate-to-severe TBI was used as intervention. The program consisted of 10 core sessions and up to 4 supplemental sessions, each consisting of self-guided Web exercises followed by a videoconference therapy session. RESULTS: Significant improvements were found in parent-reported adolescent internalizing behaviors, self-reported adolescent depressive symptoms, parental depression, and parent-adolescent conflict. Effect sizes were in the medium-to-high range for these same contrasts. Exploratory analyses suggested that providing audio with the Web site may enhance some outcomes. CONCLUSIONS: This study provides preliminary evidence of the feasibility and efficacy of family-centered online intervention for improving adolescent and family adaptation following pediatric TBI.

Lessons learned: the effect of prior technology use on Web-based interventions.

This study examined the role of regular prior technology use in treatment response to an online family problem-solving (OFPS) intervention and an Internet resource intervention (IRI) for pediatric traumatic brain injury (TBI). Participants were 150 individuals in 40 families of children with TBI randomly assigned to OFPS intervention or an IRI. All families received free computers and Internet access to TBI resources. OFPS families received Web-based sessions and therapist-guided synchronous videoconferences focusing on problem solving, communication skills, and behavior management. All participants completed measures of depression, anxiety, and computer usage. OFPS participants rated treatment satisfaction, therapeutic alliance, and Web site and technology comfort. With the OFPS intervention, depression and anxiety improved significantly more among technology using parents (n = 14) than nontechnology users (n = 6). Technology users reported increasing comfort with technology over time, and this change was predictive of depression at followup. Satisfaction and ease-of-use ratings did not differ by technology usage. Lack of regular prior home computer usage and nonadherence were predictive of anxiety at followup. The IRI was not globally effective. However, controlling for prior depression, age, and technology at work, there was a significant effect of technology at home for depression. Families with technology experience at home (n = 11) reported significantly greater improvements in depression than families without prior technology experience at home (n = 8). Although Web-based OFPS was effective in improving caregiver functioning, individuals with limited computer experience may benefit less from an online intervention due to increased nonadherence.

Can devices facilitate a hypnotic induction?

Historically, many devices were believed to have the ability to facilitate a hypnotic induction, but in time such devices proved to have no inherent facilitating properties other than a general placebo effect. To test the efficacy of a device called a "plasma ball" that may facilitate an induction by combining two sensory modalities simultaneously (visual and auditory), 42 college students who scored 6 and below on the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) and completed a scale rating the realness of items, were selected for a second session. Participants were matched on hypnotizability scores and randomly assigned to experimental or standard eye fixation induction control condition. Although hypnotizability scores and realness ratings increased significantly from the initial session, use of the device did not produce higher hypnotizability scores or realness ratings in the experimental compared with the control condition. Results indicate that there is still no evidence that one fixation device works better as a target than any other.