Connection During COVID-19: Pilot Study of a Telehealth Group Parenting Intervention

Overview

Journal Am J Psychother

Specialties Pharmacology
Psychiatry

Date 2021 Sep 16

PMID 34525847

Citations 5

Authors

Amanda Zayde

Anna Kilbride

Audrey Kucer

Henry A Willis

Adella Nikitiades

Jonathan Alpert

Vilma Gabbay

Affiliations

Soon will be listed here.

Abstract

Objective: The COVID-19 pandemic has resulted in considerable stress for families, placing parents at risk for heightened psychological distress, while prompting widespread changes in mental health service delivery. This study evaluated treatment engagement, acceptability, and psychiatric distress among participants in the telehealth adaptation of the Connecting and Reflecting Experience (CARE) program after the onset of COVID-19.

Methods: CARE is a transdiagnostic, bigenerational, mentalizing-focused group parenting intervention based out of an outpatient child mental health clinic in an underserved urban community. Individuals participating in CARE during the clinic's transition to telehealth services were recruited for participation in this pre-post design pilot study. Participants (N=12) completed self-report surveys before and after their first telehealth group session and at their 20-week follow-up. Quantitative and qualitative measures were used to evaluate psychiatric symptoms, treatment engagement, and preliminary acceptability of the adaptation.

Results: Self-reported mood and anxiety symptoms decreased significantly after 20 weeks of telehealth therapy. Participants reported high levels of therapeutic alliance and group cohesion in the telehealth format. Results also showed minimal participant-reported privacy concerns and a trend toward increased treatment engagement.

Conclusions: These findings have implications regarding the acceptability of teletherapy interventions for caregivers of children during this period of heightened vulnerability and limited access to social support and health services. They also are relevant to establishing the preliminary acceptability of mentalizing-focused parenting inventions delivered via telehealth.

Citing Articles

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Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review.

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Therapeutic Alliance and Group Cohesion Across Telehealth Delivery of Mentalizing-focused Parenting Groups.

Kucer A, Derella O, Kilbride A, Zayde A Int J Group Psychother. 2024; 74(2):122-148.

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Privacy and Security Risk Factors Related to Telehealth Services - A Systematic Review.

Houser S, Flite C, Foster S Perspect Health Inf Manag. 2023; 20(1):1f.

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References

Hilty D, Ferrer D, Burke Parish M, Johnston B, Callahan E, Yellowlees P . The effectiveness of telemental health: a 2013 review. Telemed J E Health. 2013; 19(6):444-54. PMC: 3662387. DOI: 10.1089/tmj.2013.0075. View

Galea S, Merchant R, Lurie N . The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention. JAMA Intern Med. 2020; 180(6):817-818. DOI: 10.1001/jamainternmed.2020.1562. View

Jacobson N, Truax P . Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991; 59(1):12-9. DOI: 10.1037//0022-006x.59.1.12. View

Backhaus A, Agha Z, Maglione M, Repp A, Ross B, Zuest D . Videoconferencing psychotherapy: a systematic review. Psychol Serv. 2012; 9(2):111-131. DOI: 10.1037/a0027924. View

Patrick S, Henkhaus L, Zickafoose J, Lovell K, Halvorson A, Loch S . Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey. Pediatrics. 2020; 146(4). DOI: 10.1542/peds.2020-016824. View

Lowe B, Kroenke K, Herzog W, Grafe K . Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord. 2004; 81(1):61-6. DOI: 10.1016/S0165-0327(03)00198-8. View

Lopez A, Rothberg B, Reaser E, Schwenk S, Griffin R . Therapeutic groups via video teleconferencing and the impact on group cohesion. Mhealth. 2020; 6:13. PMC: 7136655. DOI: 10.21037/mhealth.2019.11.04. View

Wind T, Rijkeboer M, Andersson G, Riper H . The COVID-19 pandemic: The 'black swan' for mental health care and a turning point for e-health. Internet Interv. 2020; 20:100317. PMC: 7104190. DOI: 10.1016/j.invent.2020.100317. View

Morland L, Mackintosh M, Greene C, Rosen C, Chard K, Resick P . Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial. J Clin Psychiatry. 2014; 75(5):470-6. DOI: 10.4088/JCP.13m08842. View

10.

Martin A, Rief W, Klaiberg A, Braehler E . Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2005; 28(1):71-7. DOI: 10.1016/j.genhosppsych.2005.07.003. View

11.

Fontanesi L, Marchetti D, Mazza C, Di Giandomenico S, Roma P, Verrocchio M . The effect of the COVID-19 lockdown on parents: A call to adopt urgent measures. Psychol Trauma. 2020; 12(S1):S79-S81. DOI: 10.1037/tra0000672. View

12.

Zhou X, Snoswell C, Harding L, Bambling M, Edirippulige S, Bai X . The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemed J E Health. 2020; 26(4):377-379. DOI: 10.1089/tmj.2020.0068. View

13.

Spinelli M, Lionetti F, Pastore M, Fasolo M . Parents' Stress and Children's Psychological Problems in Families Facing the COVID-19 Outbreak in Italy. Front Psychol. 2020; 11:1713. PMC: 7350926. DOI: 10.3389/fpsyg.2020.01713. View

14.

Griffith A . Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. J Fam Violence. 2020; 37(5):725-731. PMC: 7311181. DOI: 10.1007/s10896-020-00172-2. View

15.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

16.

Russell B, Hutchison M, Tambling R, Tomkunas A, Horton A . Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent-Child Relationship. Child Psychiatry Hum Dev. 2020; 51(5):671-682. PMC: 7398861. DOI: 10.1007/s10578-020-01037-x. View

17.

Burgoyne N, Cohn A . Lessons from the Transition to Relational Teletherapy During COVID-19. Fam Process. 2020; 59(3):974-988. PMC: 7404738. DOI: 10.1111/famp.12589. View

18.

Gentry M, Lapid M, Clark M, Rummans T . Evidence for telehealth group-based treatment: A systematic review. J Telemed Telecare. 2018; 25(6):327-342. DOI: 10.1177/1357633X18775855. View

19.

Fonagy P, Campbell C, Truscott A, Fuggle P . Debate: Mentalising remotely - The AFNCCF's adaptations to the coronavirus crisis. Child Adolesc Ment Health. 2020; 25(3):178-179. PMC: 7362025. DOI: 10.1111/camh.12404. View

20.

Kazdin A, Holland L, Crowley M . Family experience of barriers to treatment and premature termination from child therapy. J Consult Clin Psychol. 1997; 65(3):453-63. DOI: 10.1037//0022-006x.65.3.453. View