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Blair M, Tweedlie L, Minnis H, Cronin I, Turner F. Online therapy with families - what can families tell us about how to do this well? A qualitative study assessing families' experience of remote Dyadic Developmental Psychotherapy compared to face-to-face therapy. PLoS One 2024; 19:e0301640. [PMID: 38626223 PMCID: PMC11020366 DOI: 10.1371/journal.pone.0301640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/19/2024] [Indexed: 04/18/2024] Open
Abstract
Dyadic Developmental Psychotherapy (DDP) is a family-based therapy for adopted children aiming to achieve secure attachment between the child and parent. Due to restrictions under the COVID-19 pandemic, delivery of DDP transitioned from face-to-face to online methods. This study aimed to explore families experience of online DDP compared to face-to-face DDP, looking at the advantages and disadvantages of remote delivery methods and the implications this has on future service delivery for clinicians. Semi-structured interviews with 6 families were conducted online. Analysis of transcripts using Interpretative Phenomenological Analysis (IPA) revealed four superordinate themes: environment and child engagement, non-verbal communication, travel and familiarity with remote interactions. Parents recognised the influence the physical and online environment had on their child's engagement levels, however, varied in their experience and hence preference of delivery method. All families emphasised the importance of non-verbal communication within DDP sessions and majority highlighted this may be lost online. For families who travelled to face-to-face DDP, car journeys provided a unique opportunity to decompress and reflect after sessions. For families where travel is unfeasible, online DDP was a lifeline, demonstrating the ability of remote therapy to widen access to specialist healthcare. Familiarity with online work emerged as a strong indicator of positive attitudes towards remote DDP, especially if the previous experience is positive and the child is confident using technology. Overall, families differed greatly in their experience of remote and face-to-face DDP indicating a new approach must be undertaken with each family beginning therapy, ensuring it is unique and individual to their needs.
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Affiliation(s)
- Monica Blair
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Leigh Tweedlie
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Helen Minnis
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Irene Cronin
- Academic Child and Mental Health Services, University of Glasgow, Glasgow, United Kingdom
| | - Fiona Turner
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
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2
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Chuah XJ, Aw CB, Ong PN, Samsuri KB, Dhaliwal SS. Receptivity towards Remote Service Delivery among Social Work Clients and Practitioners during COVID Times: A Systematic Review. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023; 20:800-839. [PMID: 37401444 DOI: 10.1080/26408066.2023.2228791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
PURPOSE This systematic review aims to identify and synthesize the available evidence on the receptivity toward, perceived advantages and challenges of remote service delivery among social work clients and practitioners during the context of COVID-19. METHOD Two electronic databases were searched from 2020 to 2022. Identified papers were screened against the established eligibility criteria, yielding 15 papers. Two additional papers were further identified through hand-search. As heterogeneity of studies was high, a narrative synthesis was performed to summarize the overall evidence. RESULTS Our review provides evidence that remote service delivery holds the potential to increase access to services among selected client populations as well as promote a sense of empowerment for clients and opportunities for practice enhancement for practitioners. DISCUSSION & CONCLUSION The findings from our study highlighted the need for innovative solutions and practical considerations for ongoing remote service, including the careful considerations of social work clients' and practitioners' suitability, the need for provision of training and ongoing support to optimize practitioners' well-being. As the delivery of services transition to face-to-face or remain remote, further research is needed to assess the promise of remote practice in optimizing overall service delivery, while maintaining client-reported satisfaction.
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Affiliation(s)
- Xing Jun Chuah
- Learning & Development, AMKFSC Community Services Ltd, Ang Mo Kio, Singapore
| | - Chin Bee Aw
- Family & Community Support Division, AMKFSC Community Services Ltd, Seng Kang, Singapore
| | - Pei Ni Ong
- Specialist Division, AMKFSC Community Services Ltd, Ang Mo Kio, Singapore
| | - Khalisah Binte Samsuri
- Family & Community Support Division, AMKFSC Community Services Ltd, Seng Kang, Singapore
| | - Satvinder Singh Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western, Australia, Australia
- AMKFSC Community Services Ltd, Ang Mo Kio, Singapore
- Office of the Provost, University of Social Sciences, Clementi, Singapore
- DUKE-NUS Medical School, National University of Singapore, Queenstown, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia
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3
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Biddle L, Derges J, Cliffe B, Gooberman-Hill R, Linton MJ, Moran P, Bould H. "Pouring their heart out in Sainsbury's": qualitative study of young people's, parents' and mental health practitioners' experiences of adapting to remote online mental health appointments during COVID-19. BMC Psychiatry 2023; 23:641. [PMID: 37658298 PMCID: PMC10474770 DOI: 10.1186/s12888-023-05126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, technologies such as videoconferencing were used to deliver mental health appointments remotely online. For many people, this was a change from previous methods of mental healthcare receipt and delivery. We aimed to explore in-depth how practitioners, young people and parents in the UK experienced this transition. METHODS We used qualitative methods to collect data, triangulating between free-text online survey data (n = 38), focus groups (n = 5) (3 young adult groups (total n = 11); 2 practitioner groups (total n = 7)), and semi-structured interviews (practitioners n = 8; parents n = 4). Data were analysed using reflexive thematic analysis. RESULTS Participants held mixed views about remote appointments, which were encompassed within the five themes of: home as clinic; disrupted therapeutic relationships; difficulties with engagement; uncontained risk; and scope of care provision. While appointments at home could be regarded as more comfortable, naturalistic and accessible, it was also recognised that remoteness compromised practitioner control with consequences for their ability to monitor patient engagement, manage risk and ensure confidentiality when others were present in the home. This could create an additional burden for parents as they tried to facilitate appointments but felt unsupported in this role. Relatedly, remoteness was seen to hinder interpersonal communication, formation of trust, communication of empathy and opportunities to observe body language, all of which were deemed important to building and maintaining effective therapeutic relationships. Despite this, others thought the anonymity of a remote exchange may allow earlier disclosure. There was disagreement as to whether remote provision narrowed or expanded the scope of practice. CONCLUSIONS While some had positive views of remote mental health appointments, others found them challenging. Findings highlight key areas requiring attention and mitigation in future offerings of remote provision, namely: risk management, parental burden, and problematic engagement.
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Affiliation(s)
- Lucy Biddle
- Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK.
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
- Centre for Academic Mental Health, Bristol University Medical School, Oakfield House, Oakfield Road, Bristol, UK.
- Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
| | - Jane Derges
- Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK
| | - Bethany Cliffe
- Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rachael Gooberman-Hill
- Translational Health Sciences, Bristol University Medical School, Learning and Research Building, Southmead Hospital, Bristol, UK
- Elizabeth Blackwell Institute, University of Bristol, Royal Fort House, Bristol, UK
| | - Myles-Jay Linton
- Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK
| | - Paul Moran
- Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Centre for Academic Mental Health, Bristol University Medical School, Oakfield House, Oakfield Road, Bristol, UK
- Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Helen Bould
- Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK
- Centre for Academic Mental Health, Bristol University Medical School, Oakfield House, Oakfield Road, Bristol, UK
- Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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4
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Tajan N, Devès M, Potier R. Tele-psychotherapy during the COVID-19 pandemic: a mini-review. Front Psychiatry 2023; 14:1060961. [PMID: 37476543 PMCID: PMC10354254 DOI: 10.3389/fpsyt.2023.1060961] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
The COVID-19 pandemic has dramatically changed psychotherapy practices. Psychotherapy around the world has shifted from predominantly face-to-face settings to overwhelmingly online settings since the beginning of the pandemic. Many studies have been published on this topic, but there has been no review of the literature focused on the experience of psychotherapists. Our goal was to identify the challenging issues of teletherapy, including the efficiency of online consultations and the extent to which they are accepted by therapists and patients. A PubMed literature search using the [("Teletherapy" OR "Telebehavioral health" OR "telepsychotherapy") AND ("COVID-19")] search string retrieved 46 studies focused on mental health professionals, as detailed in a PRISMA flow diagram. Two reviewers independently screened the abstracts and excluded those that were outside the scope of the review. The selection of articles kept for review was discussed by all three authors. Overall, the review contributes to the description and evaluation of tele mental health services, including teletherapy, online counseling, digital mental health tools, and remote monitoring.
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Affiliation(s)
- Nicolas Tajan
- Laboratory of Psychopathology and Psychoanalysis, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Maud Devès
- Institut de Physique du Globe de Paris, CNRS, Université Paris Cité, Paris, France
- Centre de Recherche Psychanalyse Médecine et Société, CNRS, Université Paris Cité, Paris, France
| | - Rémy Potier
- Centre de Recherche en Psychopathologie et Psychologie Clinique, Institut de Psychologie, Université Lumière Lyon 2, Lyon, France
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5
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Cassity-Caywood W, Griffiths A, Woodward M, Hatfield A. The Benefits and Challenges of Shifting to Telehealth During COVID-19: Qualitative Feedback from Kentucky's Sexual Violence Resource Centers and Children's Advocacy Centers. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 8:87-99. [PMID: 36597503 PMCID: PMC9801142 DOI: 10.1007/s41347-022-00296-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
The onset of the COVID-19 pandemic presented novel challenges for service providers addressing mental health issues with a large shift to the utilization of telehealth. While previous research has examined the benefits and challenges of providing mental health and crisis services remotely through telehealth, little research exists examining the use of telehealth in children's advocacy centers (CACs) and sexual violence resource centers (SVRCs). CACs and SVRCs are multi-disciplinary agencies taking a holistic approach to addressing interpersonal violence, making them unique in that they provide a range of direct services beyond mental health counseling (e.g., legal advocacy, medical exams, and prevention education) but all geared toward public health and safety. The current study explored the experiences of direct service providers in Kentucky CACs and SVRCs and their opinions about the most significant challenges and benefits of adapting their practices at the onset of the COVID-19 pandemic. A total of 118 providers participated in the study, and 88 reported using telehealth (defined as communicating with clients via technology such as videoconferencing, phone calls, or email) since the onset of COVID-19. Qualitative data from those 88 respondents regarding the challenges and benefits of using telehealth were collected and coded using a thematic content analysis. 78.6% of the sample indicated that they served primarily rural areas. Benefits noted included increasing treatment access, increasing treatment flexibility, and advancing continuity of care, while challenges included difficulties with technology, client engagement, privacy, and logistical challenges. Responses highlighted that telehealth presented both a number of advantages and difficulties and that more formal guidance for providers at CACs and SVRCs was desired.
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Affiliation(s)
- Whitney Cassity-Caywood
- Department of Community Leadership and Human Services, Murray State University, Murray, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA.,Paducah Regional Campus, Murray State University, 4430 Sunset Ave, Paducah, KY 42001 USA
| | - Austin Griffiths
- The Department of Social Work Program, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| | - Matthew Woodward
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| | - Alecia Hatfield
- Department of Psychology, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
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6
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Aviram A, Nadan Y. Online clinical supervision in couple and family therapy: A scoping review. FAMILY PROCESS 2022; 61:1417-1436. [PMID: 36000250 PMCID: PMC10086939 DOI: 10.1111/famp.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
Online clinical supervision, or telesupervision, is a growing practice in couple and family therapy. This scoping review aims to identify and synthesize the existing body of knowledge regarding the utilization, experiences, and perceptions of telesupervision among the couple and family therapists and to highlight gaps in the literature. The review followed the five-step approach proposed by Arksey et al. (2005). Fifteen articles were included and their analysis yielded four themes: 1. telesupervision competence; 2. setting and boundary management; 3. advantages of telesupervision; and 4. challenges of telesupervision. Our review clearly demonstrates the dearth of available conceptual and empirical work. The rapidly growing use of online therapy and telesupervision in couple and family therapy has created a critical need to expand this body of knowledge by collecting evidence that can later be translated into practice. Moreover, we identified several gaps in the existing body of knowledge, including a lack of reports on the efficacy of telesupervision and on the experiences, processes, and ascribed meanings of the supervisors and supervisees. We also noted a lack of practice and ethical guidelines for telesupervision. We conclude our analysis by suggesting areas and directions for further investigation.
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Affiliation(s)
- Alon Aviram
- The Paul Baerwald School of Social Work and Social WelfareThe Hebrew University of JerusalemJerusalemIsrael
| | - Yochay Nadan
- The Paul Baerwald School of Social Work and Social WelfareThe Hebrew University of JerusalemJerusalemIsrael
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Williamson V, Larkin M, Reardon T, Pearcey S, Button R, Green I, Hill C, Stallard P, Spence SH, Breen M, Mcdonald I, Ukoumunne O, Ford T, Violato M, Sniehotta F, Stainer J, Gray A, Brown P, Sancho M, Morgan F, Jasper B, Creswell C. School-based screening for childhood anxiety problems and intervention delivery: a codesign approach. BMJ Open 2022; 12:e058089. [PMID: 35728898 PMCID: PMC9214411 DOI: 10.1136/bmjopen-2021-058089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES A very small proportion of children with anxiety problems receive evidence-based treatment. Barriers to access include difficulties with problem identification, concerns about stigma and a lack of clarity about how to access specialist services and their limited availability. A school-based programme that integrates screening to identify those children who are most likely to be experiencing anxiety problems with the offer of intervention has the potential to overcome many of these barriers. This article is a process-based account of how we used codesign to develop a primary school-based screening and intervention programme for child anxiety problems. DESIGN Codesign. SETTING UK primary schools. PARTICIPANTS Data were collected from year 4 children (aged 8-9 years), parents, school staff and mental health practitioners. RESULTS We report how the developed programme was experienced and perceived by a range of users, including parents, children, school staff and mental health practitioners, as well as how the programme was adapted following user feedback. CONCLUSIONS We reflect on the mitigation techniques we employed, the lessons learnt from the codesign process and give recommendations that may inform the development and implementation of future school-based screening and intervention programmes.
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Affiliation(s)
- Victoria Williamson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Michael Larkin
- Institute for Neurodevelopment and Health, Department of Psychology, Aston University, Birmingham, UK
| | - Tessa Reardon
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Samantha Pearcey
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
| | - Roberta Button
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Iheoma Green
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Susan H Spence
- Australian Institute of Suicide Research and Prevention and School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Maria Breen
- Thames Valley Clinical Trials Unit, University of Reading, Reading, UK
| | | | - Obioha Ukoumunne
- NIHR ARC South West Peninsula, University of Exeter, Heavitree Rd, Exeter, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Mara Violato
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Falko Sniehotta
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Alastair Gray
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Brown
- Bransgore C Of E Primary School, Bransgore, UK
| | | | - Fran Morgan
- Square Peg (Team Square Peg CIC), London, UK
| | - Bec Jasper
- Square Peg (Team Square Peg CIC), London, UK
| | - Cathy Creswell
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
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The effective delivery of digital CBT: a service evaluation exploring the outcomes of young people who completed video conferencing therapy in 2020. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Despite its impressive evidence base, there is a widening access gap to receiving cognitive behavioural therapy (CBT). Video conferencing therapy (VCT) offers an effective solution for logistical barriers to treatment, which has been salient throughout the Coronavirus pandemic. However, research concerning the delivery of CBT via VCT for children and young people (CYP) is in its infancy, and clinical outcome data are limited. The aim of this service evaluation was to explore the effectiveness of a VCT CBT intervention for CYP referred from Child and Adolescent Mental Health Services (CAMHS) in the UK. A total of 989 records of CYP who had completed CBT via VCT in 2020 with Healios, a digital mental health company commissioned by the National Health Service (NHS), were examined to determine changes in anxiety, depression and progress towards personalised goals. Routine outcome measures (ROMs) were completed at baseline and endpoint, as well as session by session. Feedback was collected from CYP and their families at the end of treatment. There was a significant reduction in symptoms of anxiety and depression and significant progress towards goals, with pre- to post-effect sizes (Cohen’s d) demonstrating medium to large effects (d=.45 to d=−1.39). Reliable improvement ranged from 31 to 80%, clinical improvement ranged from 33 to 50%, and 25% clinically and reliably improved on at least one measure; 92% reported that they would recommend Healios. This service evaluation demonstrates that Healios’ CBT delivered via VCT is effective for CYP receiving it as part of routine mental health care.
Key learning aims
(1)
To consider whether CBT can be effectively delivered in routine care via VCT.
(2)
To explore whether CBT delivered in routine care via VCT is acceptable to children, young people and their families.
(3)
To reflect on the benefits of VCT and the collection of a variety of ROMs via digital platforms.
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9
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Lange AMC, Humayun S, Jefford T. The Feasibility of Providing Remote Functional Family Therapy with Adolescents During the COVID-19 Pandemic: A Mixed-Method Study. CHILD & YOUTH CARE FORUM 2022; 52:441-466. [PMID: 35531310 PMCID: PMC9060401 DOI: 10.1007/s10566-022-09692-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/03/2022]
Abstract
Background Due to the recent COVID-19 pandemic, mental health care has largely transferred its services to online platforms, using videoconferencing (VC) or teletherapy. Within the field of family therapy, however, there is little evidence on the feasibility of using VC, especially when working with whole families at the edge of care. Objective This study investigated the feasibility of remote Functional Family Therapy (FFT), using a mixed-method approach. Method Study 1 consisted of semi-structured interviews with 23 FFT professionals (18 female) about their experience of providing remote FFT during the COVID-19 pandemic. Study 2 included monitoring data of 209 FFT clients (46% female, M age = 14.00) who participated in FFT during the pandemic. We compared families who received mainly in-person, mainly remote or a mix of remote and in-person on client-reported alliance, drop-out, therapist-rated outcomes, and treatment intensity using MANCOVA's and chi-square tests. Results In Study 1 two themes emerged around experienced challenges, namely 'Feeling in control' and 'Engagement and alliance'. Two other themes emerged around adaptations, namely 'Being more on top' and 'Connecting in different ways'. In Study 2, we found that the therapeutic alliance was not related to using VC. Also, families had less between-session contact during the Engagement and Motivation Phase when receiving mainly VC, but had more sessions and longer therapy when receiving a mix of in-person and remote therapy. Conclusions The current study suggests that providing systemic family teletherapy to families on the edge of care is feasible. Further development of systemic family teletherapy is warranted. Supplementary Information The online version contains supplementary material available at 10.1007/s10566-022-09692-y.
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Affiliation(s)
- Aurelie M. C. Lange
- Family Psychology Mutual CIC, Huntingdon, UK
- School of Human Science, University of Greenwich, London, UK
| | - Sajid Humayun
- School of Human Science, University of Greenwich, London, UK
| | - Tom Jefford
- Family Psychology Mutual CIC, Huntingdon, UK
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10
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McCoyd JLM, Curran L, Candelario E, Findley P. "There is Just a Different Energy": Changes in the Therapeutic Relationship with the Telehealth Transition. CLINICAL SOCIAL WORK JOURNAL 2022; 50:325-336. [PMID: 35493775 PMCID: PMC9035977 DOI: 10.1007/s10615-022-00844-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
The therapeutic relationship (TR), including its therapeutic frame, is the foundation of the therapeutic endeavor. In response to the COVID-19 pandemic and the rapid transition to videoconferencing for therapeutic encounters, we employed a cross-sectional exploratory survey with 1490 respondents to understand how practitioners adapted to the changes. In this secondary analysis focused on the TR, we analyze the clinicians' (N = 448) spontaneous narratives about facets of the TR. Temporally, we focused on how these adaptations occurred during the initial part of the pandemic before vaccination was available and while the TR was still adapting to teletherapy videoconferencing under the duress of pandemic crises. We find three broad themes: (1) It is a "much more remote relationship"; (2) The "connection…remains surprisingly strong"; and (3) It is "energetically taxing." Each reflects clinicians' views of the TR as altered, but surprisingly resilient. Although grateful for the safety of virtual therapeutic encounters, clinicians mourned the loss of an embodied encounter, experienced depletion of energy beyond Zoom fatigue, and nonetheless recognized their clients' and their own abilities to adapt.
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Affiliation(s)
- Judith L. M. McCoyd
- School of Social Work, Rutgers University, 120 Albany St., Tower 1, Suite 200, New Brunswick, NJ 08901 USA
| | - Laura Curran
- School of Social Work, Rutgers University, 120 Albany St., Tower 1, Suite 200, New Brunswick, NJ 08901 USA
| | - Elsa Candelario
- School of Social Work, Rutgers University, 120 Albany St., Tower 1, Suite 200, New Brunswick, NJ 08901 USA
| | - Patricia Findley
- School of Social Work, Rutgers University, 120 Albany St., Tower 1, Suite 200, New Brunswick, NJ 08901 USA
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11
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Simons A, Noordegraaf M, Van Regenmortel T. 'When it comes to relational trauma, you need people at the table': Therapist experiences of online therapy for families with a prior disclosure of sibling sexual abuse during Covid-19 pandemic lockdowns. JOURNAL OF FAMILY THERAPY 2022; 44:JOFT12397. [PMID: 35602926 PMCID: PMC9111092 DOI: 10.1111/1467-6427.12397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 06/15/2023]
Abstract
This study aims to contribute to the evaluation of online therapy during Covid-19 pandemic lockdowns, by exploring family therapists' experiences of therapy for twelve Sibling Sexual Abuse (SSA) families in the Netherlands. Seven transcripts of interviews with highly specialised Dutch family therapists were analysed using thematic analysis (TA). Two main findings emerged from this study. First, the Dutch therapists reported no acute worries about their clients' sexual safety during the pandemic lockdowns. Nonetheless, the switch to online therapy for the SSA families created concern regarding victim safety in speaking out freely at home. Second, while the sudden switch to online therapy enabled SSA therapists to stay connected with their SSA families, therapists experienced a decline in therapy quality and in their own well-being. In the therapists' experience, it was almost impossible to conduct their most fundamental interventions online, such as intervening in family relationships.
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Affiliation(s)
- Aletta Simons
- Ede Christian University of Applied Sciences, Social WorkEdethe Netherlands
- Tilburg School of Social and Behavioral Sciences, TranzoTilburg UniversityTilburgthe Netherlands
| | | | - Tine Van Regenmortel
- Tilburg School of Social and Behavioral Sciences, TranzoTilburg UniversityTilburgthe Netherlands
- Faculty of Social SciencesHIVA, University of LeuvenLeuvenBelgium
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12
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Adams J, Baxter M. A systemic supervisory methodology and approach used during COVID times: Collective cut-outs - a gift from the left hand. JOURNAL OF FAMILY THERAPY 2022; 44:JOFT12391. [PMID: 35602925 PMCID: PMC9111272 DOI: 10.1111/1467-6427.12391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 06/15/2023]
Abstract
This paper sets out to explore the use of a systemic reflexive exercise called "Collective Cut-Outs", detailing its methodology and usefulness with "frontline" mental health practitioners within supervision and teaching contexts. We draw on the use of storytelling, image, creativity and the usefulness of the left hand (right brain) in clinical mental health contexts and focus on its value in reflexive supervisory groups. We also aim to give voice to the experiences of "frontline" Black Asian Minority Ethnic (BAME) clinicians in an inner-city mental health team during the COVID-19 pandemic. The Collective Cut-Out exercise and its methodology provide a framework to help facilitate reflexive spaces that promote mindful group exercise and the subsequent expression of personal and professional resonance. The subjects of clinical challenge and collective resilience are also brought forth. We offer a case study in the second part of the paper, outlining the use of the exercise in a reflexive group supervisory context. The team in focus have kindly given us, the authors, permission to use their experiences and "cut-outs". We have either adapted or removed identifiable information from the writing to protect and respect the identity of the team and individuals involved.
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Affiliation(s)
- Joanne Adams
- Visiting LecturerSystemic PsychotherapyDETTavistock and Portman Foundation TrustLondonUnited Kingdom
| | - Melissa Baxter
- Senior Systemic Psychotherapist, City and Hackney CAMHSEast London Foundation TrustLondonUnited Kingdom
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Mishna F, Milne B, Sanders J, Greenblatt A. Social Work Practice During COVID-19: Client Needs and Boundary Challenges. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2021; 9:113-120. [PMID: 34754722 PMCID: PMC8569291 DOI: 10.1007/s40609-021-00219-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
While information and communication technologies (ICTs) permeated social work practice long before the onset of COVID-19, the abrupt need to close non-essential workplaces resulted in an unparalleled incorporation of digital technology into practice across the globe. The onset of COVID-19 occurred during phase two of research in which we were investigating social workers' informal use of ICT with clients. Prior to COVID-19, we were conducting interviews with practitioners and clients from four agencies serving diverse client populations in a large city in Canada. With the onset of COVID-19, we adapted to the COVID-19 context and amended the questions to investigate ICT use during the pandemic. In addition, with ethics approval, we conducted second interviews with practitioners interviewed prior to COVID-19 with a revised guide to address the pandemic context; and we continued to recruit and interview practitioners and clients using an amended interview guide incorporating pandemic-related questions. The sample comprised 27 practitioners and 22 clients. Eleven practitioners participated in interviews prior to and during COVID-19. Analysis of transcribed interviews revealed that the COVID-19 context had led to a paradigm shift in practitioners' ICT use, with two key themes identified: (1) boundary challenges and (2) clients' diverging ICT needs. We discuss these themes and present implications for policy and practice in a post-COVID-19 world.
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Affiliation(s)
- Faye Mishna
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4 Canada
| | - Betsy Milne
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4 Canada
| | - Jane Sanders
- Present Address: School of Social Work, King’s University College at Western University, London, ON Canada
| | - Andrea Greenblatt
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4 Canada
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Lange AMC, Delsing MJMH, van Geffen M, Scholte RHJ. Alliance Between Therapist and Multi-stressed Families During the COVID-19 Pandemic: The Effect of Family-Based Videoconferencing. CHILD & YOUTH CARE FORUM 2021; 51:593-611. [PMID: 34421286 PMCID: PMC8370056 DOI: 10.1007/s10566-021-09644-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
Background A strong therapeutic alliance or working relationship is essential for effective face-to-face family-based psychotherapy. However, little is known about the use of VC on alliance in family-based therapy. The recent COVID-19 pandemic led to a national lockdown during which most family-based therapy transferred to VC. Objective The current study analyzed the development and strength of alliance prior and during lockdown for multi-stressed families participating in Multisystemic Therapy (MST). Method Alliance with the therapist was reported monthly by 846 caregivers (81% female). Using latent growth curve models (longitudinal approach), the development of alliance was estimated for families participating in MST prior to the lockdown, transferring to VC early in treatment or late in treatment. Using regression analyses (cross-sectional approach), lockdown (yes/no) was included as predictor of alliance. In these analyses, type of family (regular; intellectual disability; concerns regarding child abuse or neglect) and gender of caregiver were included as moderators. Results Both analytical approaches showed that alliance was not affected by VC, except for families with concerns of child abuse, who reported lower alliances during lockdown. However, these results where no longer significant when controlling for multiple testing. Conclusions Strong alliances can be developed and maintained during family-based VC sessions with multi-stressed families. However, for some subgroups, such as families with concerns of child abuse, VC might not be suitable or sufficient. Future research needs to investigate the potential and limitations of using VC with families.
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Affiliation(s)
- Aurelie. M. C. Lange
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | | | - Marieke van Geffen
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Ron. H. J. Scholte
- Praktikon, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Tranzo, Tilburg University, Tilburg, The Netherlands
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Burbach FR, Stiles KM. Digital mental health and neurodevelopmental services: a case-based realist evaluation. JMIR Form Res 2021; 5:e29845. [PMID: 34369382 PMCID: PMC8486993 DOI: 10.2196/29845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/25/2021] [Accepted: 08/08/2021] [Indexed: 11/27/2022] Open
Abstract
Background The rapid movement of mental health services on the internet following the onset of the COVID-19 pandemic has demonstrated the potential advantages of digital delivery and has highlighted the need to learn from prepandemic digital services. Objective The aim of this study is to explore the different elements of interconnected digital mental health and neurodevelopmental services of a well-established provider to the UK National Health Service and how web-based delivery enables young people and their families to access high-quality assessments and interventions in a more timely, flexible, and person-centered manner than in-person delivery. Methods A realist evaluation multiple case–study design was used, with 9 pediatric cases (aged 8-15 years) identified as representative of the services provided by Healios. Presenting concerns included autism and ADHD, anxiety and panic attacks, low self-esteem, anger and self-harm. The research literature was used to define the program theory and six context-mechanism-outcome (CMO) statements. The CMOs formed the basis for the initial data extraction, with novel elements added via an iterative process. Results We identified 10 key elements of web-based services: flexible delivery and timely response, personalized care to the individual, comprehensive care enabled by multiple interconnected services, effective client engagement and productive therapeutic alliances, use of multiple communication tools, client satisfaction with the service, good clinical outcomes, ease of family involvement throughout sessions or from different locations, facilitation of multi-agency working and integration with National Health Services, and management of risk and safeguarding. These elements supported the six CMOs; there was clear evidence that young people and their families valued the responsiveness and flexibility of the web-based mental health service and, in particular, how quickly they were seen. There was also clear evidence of individual needs being met, good therapeutic alliances, and client satisfaction. Multiple communication tools appeared to maximize engagement and working digitally facilitated multi-agency communication and delivery of safe care. The abovementioned factors may be related to the finding of good clinical outcomes, but the methodology of this study does not allow any conclusions to be drawn regarding causality. Conclusions This study demonstrates the effectiveness of interconnected digital mental health and neurodevelopmental services as well as how web-based delivery enables young people and their families to access assessments and interventions in a more timely, flexible, and person-centered manner than in-person delivery. The 10 key elements of web-based service delivery identified through the 9 case studies suggest the potential advantages of web-based work. These elements can inform future research and aid in the delivery of high-quality digital services.
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Affiliation(s)
- Frank R Burbach
- Healios Ltd., 4a Tileyard Studios, Kings Cross, London, GB.,University of Exeter, Stocker Rd, Exeter, GB
| | - Katie M Stiles
- Healios Ltd., 4a Tileyard Studios, Kings Cross, London, GB
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Smith K, Moller N, Cooper M, Gabriel L, Roddy J, Sheehy R. Video counselling and psychotherapy: A critical commentary on the evidence base. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kate Smith
- Division of Health Sciences Abertay University Dundee UK
| | - Naomi Moller
- Department of Psychology University of the West of England Bristol UK
| | - Mick Cooper
- Department of Psychology Roehampton University London UK
| | - Lynne Gabriel
- Faculty of Health and Life Sciences York St John University York UK
| | - Jeannette Roddy
- University of Salford School of Nursing Midwifery and Social Work Manchester UK
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