Moving from research to clinical care: Building therapist capacity to deliver the teen online problem-solving program for acquired brain injuries in adolescence.

Abstract

Objective: To describe the training process for teen online problem solving (TOPS) for acquired brain injury (ABI) in adolescence. We evaluated feedback from training participants and therapists delivering the intervention to assess facilitators and barriers to adoption into clinical practice. Method: Therapist trainings took place between February 2020 and December 2021 and were primarily virtual due to the COVID-19 pandemic. We surveyed 190 trainees and 27 active therapists regarding their experiences with the training process and with delivering the intervention to families, respectively. Descriptive statistics were reported for Likert scale items. Open-ended survey responses were summarized using inductive thematic analysis by two independent coders, and themes were compared by profession. Results: The majority of trainees reported that they felt comfortable or very confident using the TOPS intervention with patients following the training. Trainees reported that they benefited from clinician-centered and applied training components. Active therapists identified facilitators to TOPS implementation including the family-based therapeutic approach, virtual format, and the broad generalizability of the problem-solving framework. Barriers to implementation included low family engagement, comorbid mental health or language difficulties, and external family stressors. Conclusions: The implementation process for TOPS highlights the importance of and challenges to the dissemination of psychosocial interventions. As pediatric ABI remains an underserved population within behavioral health, future implementation work should address barriers in integrating evidence-based therapies within clinical practice. Impact and ImplicationsThis article documents the implementation process of an evidence-based psychological intervention across 15 sites in North America using the RE-AIM (Reach Efficacy Adoption Implementation and Maintenance) implementation framework. Findings highlight the need for hands-on, practical training and implementation support to build therapist capacity for improving psychosocial well-being for families of adolescents with acquired brain injuries.