AUTHOR=Wade Shari L. , Walsh Kathleen , Slomine Beth S. , Davis Kimberly C. , Heard Cherish , Maggard Brianna , Sutcliffe Melissa , Van Tubbergen Marie , McNally Kelly , Deidrick Kathleen , Kirkwood Michael W. , Lantagne Ann , Ashman Sharon , Scratch Shannon , Chesley Gayle , Johnson-Kerner Bethany , Johnson Abigail , Cirincione Lindsay , Austin Cynthia TITLE=Widespread clinical implementation of the teen online problem-solving program: Progress, barriers, and lessons learned JOURNAL=Frontiers in Rehabilitation Sciences VOLUME=3 YEAR=2023 URL=https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2022.1089079 DOI=10.3389/fresc.2022.1089079 ISSN=2673-6861 ABSTRACT=Objective

We describe the clinical implementation in North America of Teen Online Problem Solving (TOPS), a 10+ session, evidence-based telehealth intervention providing training in problem-solving, emotion regulation, and communication skills.

Methods

Twelve children's hospitals and three rehabilitation hospitals participated, agreeing to train a minimum of five therapists to deliver the program and to enroll two patients with traumatic brain injuries (TBI) per month. Barriers to reach and adoption were addressed during monthly calls, resulting in expansion of the program to other neurological conditions and extending training to speech therapists.

Results

Over 26 months, 381 patients were enrolled (199 TBI, 182 other brain conditions), and 101 completed the program. A total of 307 therapists were trained, and 58 went on to deliver the program. Institutional, provider, and patient barriers and strategies to address them are discussed.

Conclusions

The TOPS implementation process highlights the challenges of implementing complex pediatric neurorehabilitation programs while underscoring potential avenues for improving reach and adoption.