Evaluating the Therapist-assisted Online Parenting Strategies (TOPS) program on anxiety, depression and sleep in adolescents aged 12 to 18 years.

This individualized intervention is comprised of two parts: 1) a web-based component drawn from the Partners in Parenting intervention (refer to ACTRN12615000247572) which includes a once-off individually-tailored feedback report on the parent's parenting practices and up to nine weekly web-based modules (each taking 15-25 minutes to complete); and, 2) a coaching component delivered via web-conference or telephone, henceforth known as Therapist-assisted Online Parenting Strategies (TOPS) sessions, one session accompanying each web-based module, each taking 30-45 minutes. The web-based component will be composed of 9-modules, covering areas of 1) the parent’s relationship with their teen, 2) parental involvement, 3) encouraging their teen to develop supportive relationships with friends, 4) establishing family rules, 5) minimising conflict in the home environment, 6) health habits covering diet, physical activity, sleep habits and abstinence from alcohol and drugs, 7) strategies for parents to help deal with their teen’s problems, 8) strategies for parents to help their teen manage their anxiety, and 9) seeking additional professional help. Supplemented TOPS sessions will be run in the trial, aligned with material from the Partners in Parenting program. The TOPS sessions contain more expansive content for parents to reinforce learning and allow them the opportunity to clarify the material provided on the website. Discussions around goal setting and enabling goal attainment are also a focus of these sessions. The material developed to enhance the online-content is visually presented through online teleconferencing during the TOPS coaching session. Annotated copies of the presentation will be provided as soft-copy and emailed to the parent at the end of the TOPS session. TOPS sessions are manualised so that coaches standardize delivery of the protocol. TOPS coaches are at minimum post-graduate psychology students undertaking training in a Doctorate or Masters in Psychology (Clinical or Educational and Developmental). Parents will first complete two baseline surveys of the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS; Cardamone-Breen, Jorm, Lawrence, Mackinnon, & Yap, 2017) that assesses their current parenting practices against the recommendations in the Guidelines 'How to reduce your child's risk of depression and clinical anxiety in your teenager' (Yap, Martin, & Jorm, 2017; henceforth the Guidelines). Based on their responses to the second baseline survey that is completed approximately 1 month after registration, parents in the intervention group will then (1) receive an individually-tailored feedback report that highlights areas where they are doing well (i.e., concordant with the Guidelines) and areas where they can improve (i.e., not concordant with the Guidelines), and (2) be given access to the web-based parenting intervention (up to 9 modules) to support them in making changes to the identified areas of weakness in their parenting. Specific modules are recommended to parents based on their responses to the Parent Survey. Feedback messages will be brief, with practical strategies provided in dot point form, and are designed to motivate behaviour change. All participating parents will view their feedback report online and will also be emailed a copy of their feedback report. The participating parent will be invited to attend an orientation session within 1 month of registering but prior to completion of the second baseline survey. This session is aimed at enabling the parent participant to log-in to the intervention website, to engage with the online modules and to become familiarised with the web-conference coaching process. No intervention material or psychoeducation content will be presented to participants at this stage. Immediately after the parent participant completes the second baseline survey, he/she will be emailed instructions for accessing the interactive parenting program. When parents log in to their parenting program, he/she will see their recommended modules as well as the remaining modules that have not been allocated. Parents can further tailor their parenting program at this stage by deselecting recommended modules and/or selecting additional modules. They then confirm their selection and can commence their personalised program. The 9 modules comprising the intervention are derived from topics covered in the Guidelines. Modules include illustrations, vignettes, interactive activities, goal-setting exercises, and an end-of-module quiz with immediate feedback to consolidate learning. The module topics include: 1) Establishing and maintaining a good relationship with your teenager 2) Being involved and supporting increasing autonomy 3) Encouraging supportive relationships 4) Establishing family rules and consequences 5) Minimising conflict in the home 6) Encouraging good health habits (diet, physical activity, sleep and abstinence from alcohol or drugs) 7) Helping your teenager to deal with problems 8) Helping your teenager to deal with anxiety 9) Professional help-seeking when needed Trained coaches will unlock online modules progressively for parents after they have completed the previous module and received a follow-up TOPS coaching session at a time appointed by the parent. Online modules will take approximately 15 to 25 minutes to complete while the conference call-coaching sessions are anticipated to take between 30 and 45 minutes. TOPS-coaches will review goal setting or the successful application of new skills, respond to questions, and provide encouragement. Adolescents will not participate in coaching calls or access the website. The intervention period is anticipated to run for 4 months while the adolescent continues to receive standard psychological care externally. Although the online component consists of only 9-modules, up to 13 telephone coaching sessions will be offered to parents through an expanded "Encouraging good health habits" module, covering each health habit of diet, physical activity, sleep and abstinence from alcohol or drugs, over 4 weeks. Parents are encouraged to complete one module per week. Once parents have completed all the modules in their personalised program, they have ongoing access to all 12 modules in the program. Their access to their parenting program will remain open indefinitely. Retention of participants will be aided by follow-up phone calls to parents who have not booked in their TOPS session within a 2-week period. Trained research assistants with currently enrolment status in an undergraduate degree majoring in Psychology will follow-up calls using a standardised script. Outcomes will be assessed through parent and adolescent online surveys completed at the two baseline timepoints (at enrolment, Day 0; and on Day 30), at post-intervention (4 months from the parent commencing the intervention) and at follow-up (12 months from the parent commencing the intervention). Consent for adolescent participation will be provided by parents during registration or if adolescents turn 18 during the trial, consent will be obtained from the teen separately prior to their continued participation in the trial. Research assistants will then contact adolescents by phone to initiate completion of the adolescent-version surveys where they will be provided with separate logins and passwords. Adolescents will be guided through using Qualtrics to complete the survey and encouraged to complete this survey (except for the sleep diary component) in one sitting. Where they are unable to do so in one sitting, reminder emails or SMS will be sent to the adolescent, if required follow-up by another phone call within a 7-day period. At all time points, adolescents will be requested to complete the survey (or opt out of doing so if they do not wish to participate) before the parents are asked to do the same, with a maximum period of a one-week difference allowed between parent and adolescent survey completion. References: Cardamone-Breen, M. C., Jorm, A. F., Lawrence, K. A., Mackinnon, A. J., & Yap, M. B. (2017). The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders. PeerJ, 5, e3825. Yap, M. B. H., Martin, P. D., & Jorm, A. F. (2017). Online parenting guidelines to prevent adolescent depression and anxiety: Evaluating user characteristics and usefulness. Early Intervention in Psychiatry.