A Survivor's Journey: Preliminary efficacy of an online problem-solving therapy for survivors of pediatric brain tumor.

BACKGROUND

Although pediatric brain tumor survivors are at high risk for a variety of psychosocial and neurocognitive late effects, there are few evidence-based interventions to address their needs. The purpose of this study was to test the efficacy of an online problem-solving intervention on improving the quality of life and executive dysfunction among adolescent and young adult brain tumor survivors.

PROCEDURE: A Survivor's Journey was adapted from a similar intervention for survivors of traumatic brain injuries, and involved self-guided web modules providing training in problem-solving as a tool for coping with everyday challenges, as well as weekly teleconferences with a trained therapist. Survivors (n = 19) between the ages of 13 and 25, and their caregivers, completed standardized measures of their emotional and behavioral functioning, executive functioning, and quality of life before and after the 12- to 16-week intervention.

RESULTS

Participation in the intervention led to significant improvements in self-reported overall (Mpre  = 62.03, SDpre  = 17.67, Mpost  = 71.97, SDpost  = 16.75; d = 0.58, P = 0.01) and physical quality of life (Mpre  = 63.13, SDpre  = 21.88, Mpost  = 75.00, SDpost  = 21.33; d = 0.55, P < 0.01) as well as parent-reported emotional quality of life (Mpre  = 65.00, SDpre  = 28.72, Mpost  = 76.15, SDpost  = 23.47; d = 0.43, P = 0.03). Greater improvement was noted in those who were diagnosed before the age of seven and those with average or above average estimated IQs. Current age did not moderate outcomes.

CONCLUSIONS

Online problem-solving therapy may be efficacious in improving pediatric brain tumor survivors' quality of life; however, further research with a comparison group is needed. Online interventions such as Survivor's Journey may decrease barriers to evidence-based psychosocial care for brain tumor survivors.