Teen Online Problem Solving Therapy for Adolescents with TBI: Training and International Applications


“Adolescents with traumatic brain injury (TBI) experience a range of cognitive, behavioral, and social-emotional challenges following their injuries and families often struggle with how to best support their child during the challenging transition from adolescence to adulthood. The Teen Online Problem Solving program (TOPS) was developed to provide an accessible treatment approach to address child behavior problems and family distress post TBI. TOPS is a 10-14 session, telepsychology program integrating a website with videoconference sessions with a trained therapist to address child behavioral challenges and family distress through training in problem solving, self-regulation, and communication skills. Across five randomized controlled trials, a comparative effectiveness study, and an individual participant data meta-analysis, TOPS has established efficacy in improving child behavior problems and executive dysfunction in adolescents who experienced TBI of varying severities and etiologies, including abusive head trauma. Additionally, TOPS has been used successfully with children with acquired brain injuries due to tumors or infection. TOPS has also been shown to reduce caregiver depression and distress. TOPS is currently being clinically implemented at ten sites across the United States and has been adapted for trials in the United Kingdom, New Zealand, and Italy.

This day-long workshop is aimed to provide attendees with a comprehensive understanding of the TOPS program and how it can be used with diverse teens and families. Specifically, we will: 1) describe the TOPS program and its theoretical and conceptual underpinnings, 2) review the evidence supporting TOPS including the optimal application and who is most likely to benefit, 3) provide hands-on training on using the TOPS program clinically with families, and 4) describe how TOPS has been adapted for use with various etiologies as well as other countries and cultures. Discussion will focus on how the problem-solving process can be used to address common TBI-related challenges and serve as an executive-function heuristic for adolescents following TBI. Participants will have the opportunity to learn and practice skills with one another and obtain feedback from the team of instructors. Lead by Dr. Shari Wade, the developer of TOPS, our international team including Drs. Anna Adlam and Jenny Limond, University of Exeter, UK, Kelly Jones, Auckland University of Technology, NZ, Claudia Corti and Alessandra Bardoni, Institute Eugenio Media, IT, Jessica Aguilar, Cincinnati Children’s Hospital, US, and Tricia Williams, Sick Kids Hospital, CA, will discuss challenges and strategies for implementing TOPS and related evidence-based programs with diverse diagnoses, populations, and cultures. We will also discuss therapist qualifications and the potential for implementation by speech language pathologists and occupational therapists.

Learning Objectives:

  • Identify the optimal timing and age range for the Teen Online Problem Solving program.
  • Identify the 5 steps of problem solving.
  • Describe two considerations when implementing in new cultures or settings.


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