recovery after stress toolkit (reset): pilot study

Conditions: Post-traumatic Stress Disorder

Summary: experiencing an accident and staying in the hospital can be scary and traumatic for children. the goal of this project is to develop an online resource to help children and their parents develop effective coping skills to manage their stress. children ages 8-17 who exhibit signs of posttraumatic stress will view 8 online modules and attend weekly videoconferencing sessions with a therapist. parents will have 4 modules to assist them in supporting their child after the injury.

the overarching goal of this project is to provide a research and treatment resource for the management of psychological distress in children who have been hospitalized for a physical trauma. the investigators will pilot an innovative, brief e-health approach to treatment of ptss designed to be delivered through the trauma system. the investigators will create interactive web-based psychoeducational modules that are developmentally tailored for school age children (8 to 17 years) for use with synchronous e-health therapy sessions with a trained therapist. companion modules for parents will help parents to understand and respond to their child's ptss. the investigators will perform a single-arm pilot trial of a brief e-health approach to treatment of ptss (i.e., recovery after stress toolkit; reset). ( delete with usual care.)

Eligibility criteria:
inclusion criteria: * ages of 8 to 17 years at time of enrollment * hospitalized for trauma at one of the following sites: picu, ward or rapid treatment/observation unit (less than 23 hours stay) * both the parent and the child participating have the ability to read and speak english * have broadband internet availability at their home address * elevated post-traumatic stress symptoms (if the child exhibits clinically significant ptss determined with the cpss \[foa et al., 2001\] with a score greater than or equal to 11 on the sum of the highest item by item score of parent/child report, they will be invited to participate in the pilot intervention. this methodology for using a joint score on the cpss was informed by previous work indicating that both parents and children tend to underreport ptss symptoms. thus, implementing a multi-informant approach yields a more valid estimation of a child's psychopathology.) exclusion criteria: * has sustained a moderate or severe tbi, as defined by a glasgow coma score of less than 13 * has been diagnosed with moderate or severe intellectual disability , low functioning autism spectrum disorder, or a developmental disability (this will be determined by medical chart review and confirmed with parent report: has the child ever been diagnosed with an intellectual or developmental disability? i.e., child must be able to talk; the rationale for this is that they may have difficulty mastering the course content) * has a pre-existing severe psychiatric disorder that required prior psychiatric hospitalization (e.g., bipolar disorder, schizophrenia) * the mechanism of the injury was abuse or interpersonal violence * they are currently receiving psychotherapy * has been hospitalized for their injury for over 30 days * no attempt will be made to recruit caregivers while their child is unstable, e.g. vitals are abnormal, there are major complications, or death may be imminent. children with multiple injuries are eligible to participate but their caregivers will not be approached until any interventions (surgery, casting, etc.) are completed.

Keywords: post-traumatic stress medical stress e-health