The world of pediatric neurorehabilitation is evolving rapidly, with innovative programs like Teen Online Problem-Solving (TOPS) leading the charge. This evidence-based telehealth intervention is designed to address cognitive reframing, metacognitive strategies, self-regulation, and communication skills in adolescents with traumatic brain injuries (TBI) and other neurological conditions. As a practitioner in this field, understanding the implementation and outcomes of the TOPS program can significantly enhance your practice and patient outcomes.
The Genesis of TOPS
The TOPS program was developed to bridge the gap between evidence-based practices (EBP) and clinical care. Despite substantial research validating EBPs through randomized controlled trials, many never transition into everyday practice. The TOPS program seeks to change this by providing a structured, telehealth-based approach to problem-solving and emotional regulation for adolescents.
Implementation Challenges and Strategies
The implementation of TOPS across various institutions highlighted several challenges, including institutional, provider, and patient/family barriers. Understanding these challenges can help practitioners anticipate potential obstacles and develop strategies for successful implementation.
- Institutional Barriers: Lack of established follow-up clinics and communication among subspecialties often hinder patient identification. Strategies such as integrating TOPS into existing clinical care workflows and engaging leadership for broader marketing initiatives can help overcome these barriers.
- Provider Barriers: Many trained providers do not deliver the program due to workflow incompatibility or reluctance to try new methods. Developing brief presentations and fliers to educate providers about the program's benefits can increase buy-in.
- Patient/Family Barriers: Stigma around mental health treatment and logistical issues like broadband access can deter participation. Directly enrolling families during clinic visits and tailoring program delivery to address specific patient concerns can enhance engagement.
The Role of Telehealth in Expanding Reach
The COVID-19 pandemic accelerated the adoption of telehealth services, providing a unique opportunity for programs like TOPS to expand their reach. The flexibility of telehealth allows practitioners to offer both therapist-guided and self-guided options, catering to diverse patient needs and preferences.
Encouraging Further Research
The successful implementation of TOPS underscores the importance of ongoing research in pediatric neurorehabilitation. Practitioners are encouraged to explore further research opportunities to refine telehealth interventions and expand their application to other neurological conditions.
To read the original research paper, please follow this link: Widespread clinical implementation of the teen online problem-solving program: Progress, barriers, and lessons learned.
