Randomized Controlled Trial of an Online Problem-Solving Intervention Following Adolescent Traumatic Brain Injury: Family Outcomes.

The study recruited families regardless of parent or family functioning, and most participants reported functioning within normal limits, which may have masked larger intervention effects in more distressed families. The interventions were designed to target adolescent executive and behavioral outcomes, not directly to improve parent or family functioning, which may explain the mixed results. Data were collected only from primary caregivers, who were nearly all mothers, so the findings do not reflect fathers' perspectives. The sample was heterogeneous, and white participants were more likely to complete follow-up than nonwhite participants, limiting generalizability. The study did not measure whether families in the control group actually accessed the internet resources, nor did it assess parental problem-solving skills to see if they mediated outcomes.

The study was supported by the U.S. Government (Non-P.H.S.). No specific commercial conflicts of interest were declared in the provided text.

Do not assume that family-based interventions are universally superior for reducing parental burden. The data indicate that for single parents, involving the parent in the intervention (TOPS-F) was less effective than a teen-only approach (TOPS-TO) for improving family cohesion and reducing conflict, suggesting that adding parental tasks may increase stress in single-parent households.