Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is helping hospitals and rehab centers deliver family problem-solving therapy to improve quality of life and behavior for teens with traumatic brain injury, or TBI.

More than 150,000 children in the United States have ongoing problems due to TBI. Less than half of these children receive treatment. Connecting families with treatment can improve quality of life and behavior for teens with TBI.

Implementation Project Summary

What is the goal of this implementation project?

Violent bumps or blows to the head, such as from car crashes or sports accidents, can cause TBI. People with TBI may have headaches, nausea, dizziness, confusion, or mood changes. Some TBIs cause physical, emotional, and behavioral problems that last a long time and are stressful for families.

Family problem-solving therapy, or F-PST, teaches families how to communicate and manage anger. It also helps families to adjust to changes in daily life. A PCORI-funded study found that online F-PST with or without a therapist was similar to in-person F-PST in improving quality of life and behavior for teens with TBI. Both types also improved parents’ depression and distress.

This project will expand the use of F-PST for teens with TBI to 15 children’s hospitals and rehab centers across 10 US states and Toronto.

What will this project do?

The project team will work with the children’s hospitals and rehab centers to develop ways to enroll teens and match them to the type of F-PST they prefer. Based on what works best for each family, they can choose

  • In-person F-PST, where teens and families have hour-long meetings with a therapist and receive printed materials.
  • Online F-PST with a therapist, where teens and families have hour-long video calls with a therapist. They also have access to online materials, such as videos and ways to practice skills learned during the calls.
  • Online F-PST without a therapist, where teens and families have access to online materials that they can review on their own.

The project team will train providers at each site to deliver F-PST in person and online. The trainings will include in-person and video education, webinars, and continuing education credits. Providers will receive support, supervision, and training in F-PST.

The project team will also develop F-PST materials for families who speak Spanish.

What is the expected impact of this project?

In this project, more than 800 teens will receive F-PST. In addition to training therapists to deliver F-PST, the project will certify trainers. These trainers can continue to train and supervise therapists to deliver the therapy after the project ends. The project team will look at whether F-PST is working as planned to improve teen quality of life and behavior and depression in parents.

This project will demonstrate what’s required to offer F-PST at children’s hospitals and rehab centers in ways that work best for families—either online or in person.

More about this implementation project:

Stakeholders Involved in This Project

  • National Association of State Head Injury Administrators
  • Center on Brain Injury Research and Training
  • Brain Injury Association of Pennsylvania
  • Colorado Department of Human Services (MINDSOURCE Brain Injury Network)
  • International Pediatric Brain Injury Society

Implementation Strategies

  • Adapt F-PST to work with sites’ existing resources and workflows.
  • Adapt F-PST for use by children with other brain injuries, such as tumors or strokes, and by translating into Spanish.
  • Provide sites with tools to support implementation, including algorithms for matching families to F-PST.
  • Provide educational materials to families through website.
  • Develop and use online therapist education modules.
  • Train therapists and staff, in person and online, to use F-PST.
  • Provide technical assistance to sites, including supervision and consultation.
  • Certify trainers who will supervise and train future therapists to deliver F-PST.
  • Offer continuing education credits.

Evaluation Outcomes

To document implementation:

  • Number of patients receiving F-PST
  • Number of therapists trained to deliver F-PST per site
  • Other measures that assess acceptability, fidelity of program delivery, sustainability
  • Implementation barriers and facilitators

To assess healthcare and health outcomes:

  • Teen quality of life
  • Teen behavior problems
  • Teen and parent satisfaction
  • Parental depression

Project Information

Shari L. Wade, PhD
Cincinnati Children's Hospital Medical Center

Key Dates

July 2019
September 2023

Study Registration Information

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Comparing Online and In-Person Family Therapy for Teens with Traumatic Brain Injury and Their Parents


Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
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Last updated: May 23, 2022