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Griffith K, O’Brien K, McGurty S, Miller P, Christino MA. The Efficacy of a Mental Skills Training Course for Collegiate Athletes. J Athl Train 2024; 59:772-778. [PMID: 38014800 PMCID: PMC11277272 DOI: 10.4085/1062-6050-0533.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
CONTEXT Psychological skills training improves performance in athletes. However, authors of few studies have looked at the efficacy and satisfaction of mental skills training programs for collegiate athletes. OBJECTIVE To evaluate the satisfaction of collegiate athletes with a 6-session mental skills course and to assess changes in mental toughness and coping skills before and after the course. DESIGN Cohort study. SETTING Division I collegiate athletic teams. PATIENTS OR OTHER PARTICIPANTS Fifty-four Division I female athletes (mean age = 19.8 years) participated in the program, and 42 (77.7%) completed precourse assessments, which subsequent evaluations were matched to. MAIN OUTCOME MEASURE(S) The Athletic Coping Skills Inventory (ACSI; range, 0-84) and Mental Toughness Index (MTI; range, 8-56) assessed coping skills and mental toughness precourse, immediately postcourse, and 4 months postcourse. Satisfaction was assessed on a 10-point scale. RESULTS For participants with paired precourse and immediately postcourse data (n = 37, 68.5%), MTI scores improved by a mean 2.6 points (95% CI = 1.1, 4.1; P = .001), and ACSI scores improved by a mean 4.0 points (95% CI = 0.6, 7.4; P = .02). At the 4-month follow-up (n = 25, 46.2%), no change was detected from precourse in mean MTI score (P = .72), but a significant increase of 3.4 points in mean ACSI (95% CI = 0.4, 6.4; P = .03) occurred. Overall satisfaction had a median score of 9/10 (interquartile range, 8-10) at postcourse, and 18 participants (48.6%) shared positive free-text comments regarding course delivery, content, and impact. No negative feedback was reported. CONCLUSIONS Mental toughness and coping skills scores significantly improved at postcourse assessment, with coping skills scores maintaining their effect at 4 months. The improvements identified spark the question of the potential impact of mental skills training programs when studied in larger athlete populations or over more sustained periods of time. Athletes reported being highly satisfied with course content and reported overall positive experiences.
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Affiliation(s)
- Kelsey Griffith
- Boston Children’s Hospital/The Micheli Center for Sports Injury Prevention, Norwood, MA
| | - Kimberly O’Brien
- Boston Children’s Hospital, MA. Dr O’Brien is now at Unlimited Resilience, LLC, Walpole, MA
| | - Shannon McGurty
- Boston Children’s Hospital, MA. Dr O’Brien is now at Unlimited Resilience, LLC, Walpole, MA
| | - Patricia Miller
- Boston Children’s Hospital, MA. Dr O’Brien is now at Unlimited Resilience, LLC, Walpole, MA
| | - Melissa A. Christino
- Boston Children’s Hospital, MA. Dr O’Brien is now at Unlimited Resilience, LLC, Walpole, MA
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2
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Aafjes-Van Doorn K, Békés V, Luo X, Hopwood CJ. Therapists' perception of the working alliance, real relationship and therapeutic presence in in-person therapy versus tele-therapy. Psychother Res 2024; 34:574-588. [PMID: 37011405 DOI: 10.1080/10503307.2023.2193299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
Objective: Although teletherapy is increasingly common, very little is known about its impact on therapeutic relationships. We aimed to examine differences between therapists' experiences of teletherapy and in-person therapy post-pandemic with regard to three variables pertinent to the therapeutic relationship: working alliance, real relationship, and therapeutic presence. METHODS In a sample of 826 practicing therapists, we examined these relationship variables, as well as potential moderators of these perceived differences including professional and patient characteristics and covid-related variables. RESULTS Therapists reported feeling significantly less present in teletherapy and their perceptions of the real relationship were somewhat impacted, but there were no average effects on their perceived quality of the working alliance. Perceived differences in the real relationship did not persist with clinical experience controlled. The relative reduction in therapeutic presence in teletherapy was driven by the ratings of process-oriented therapists and therapists conducting mostly individual therapy. Evidence for moderation by covid-related issues was also found, with larger perceived differences in the working alliance reported by therapists who used teletherapy because it was mandated and/or not by choice. CONCLUSION Our findings might have important implications for generating awareness around the therapists' lowered sense of presence in teletherapy compared to in-person teletherapy.
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Affiliation(s)
| | - Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Xiaochen Luo
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
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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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Kucer A, Derella OJ, Kilbride A, Zayde A. Therapeutic Alliance and Group Cohesion Across Telehealth Delivery of Mentalizing-focused Parenting Groups. Int J Group Psychother 2024; 74:122-148. [PMID: 38513156 PMCID: PMC11088874 DOI: 10.1080/00207284.2024.2319627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
This study assessed changes in therapeutic alliance and group cohesion among parents/primary caregivers enrolled in Connecting and Reflecting Experience (CARE), a short-term, group-based, mentalizing-focused parenting program designed to support a diverse community facing socioeconomic and health disparities. Caregivers (N = 44) experiencing parenting stress or parent-child relational challenges were recruited from their children's outpatient psychiatry clinic to participate in one of nine 12-session telehealth CARE groups. Caregivers completed the Working Alliance Inventory-Short Revised and the Therapeutic Factors Inventory Cohesiveness subscale after CARE Sessions 1 and 12. Ratings of group cohesion and therapeutic bond with facilitators increased significantly across treatment. Findings indicate that caregivers from underserved families with high levels of parenting stress experienced an increase in group cohesion and therapeutic alliance throughout a telehealth adaptation of CARE.
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Affiliation(s)
| | - Olivia J. Derella
- Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY
| | - Anna Kilbride
- Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY
| | - Amanda Zayde
- Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, NY
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5
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Garcini LM, Vázquez AL, Abraham C, Abraham C, Sarabu V, Cruz PL. Implications of Undocumented Status for Latinx Families During the COVID-19 Pandemic: A Call to Action. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:10-23. [PMID: 36689639 PMCID: PMC10710880 DOI: 10.1080/15374416.2022.2158837] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND A disproportionate number of COVID-19 cases and deaths have been reported among Latinxs in the U.S. Among those most affected by the pandemic are marginalized families, including those that are undocumented and mixed-status, in which some, but not all members are undocumented. Undocumented and mixed-status families face multiple and chronic daily stressors that compromised their health and wellbeing. Salient stressors faced by undocumented Latinx families include poverty, social disadvantage, discrimination, dangerous living and working conditions, and limited access to healthcare. These stressors are frequently compounded with trauma, fear of detention, deportation, and family separation. PURPOSE Informed by the literature and insights from our community-based work to address the health needs of undocumented and mixed status Latinx families during the pandemic, this paper uses a social determinants of health lens to present a narrative summary that highlights four primary psychosocial stressors faced by these families and their implications for mental health. DISCUSSION These include stressors pertaining to (a) anti-immigrant rhetoric and actions; (b) family stressors and disruptions in family dynamics; (c) economic changes and financial losses; and (c) limited access to healthcare. Implications of the aforesaid stressors on the mental health of undocumented families and youth are also discussed. In addition, recommendations are provided for the provision of mental health services, best practices, and resources from a strengths-based approach.
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Affiliation(s)
- Luz M. Garcini
- Department of Psychological Sciences, Rice University
- Center for the United States and Mexico, Baker Institute for Public Policy, Rice University
| | | | | | - Ciciya Abraham
- Department of Sciences, University of Texas at San Antonio
| | - Vyas Sarabu
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio
| | - Pamela Lizette Cruz
- Center for the United States and Mexico, Baker Institute for Public Policy, Rice University
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6
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Lebow JL. Another editor's farewell. FAMILY PROCESS 2023; 62:1273-1280. [PMID: 38055997 DOI: 10.1111/famp.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Jay L Lebow
- Family Process and Family Institute at Northwestern, Evanston, Illinois, USA
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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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Leung DKY, Wong FHC, Wong ELY, Sze L, Chan M, Liu T, Fong APC, Kwok WW, Shum AKY, Wong GHY, Lum TYS. Technology Affordance in an Information and Communication Technology Delivered Group Psychotherapy and Exercise Program for Older People With Depressive Symptoms: A Multiple Triangulation Qualitative Study. Innov Aging 2023; 7:igad063. [PMID: 37593232 PMCID: PMC10430789 DOI: 10.1093/geroni/igad063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 08/19/2023] Open
Abstract
Background and Objectives Health and mental health interventions, such as psychotherapy and exercise programs, delivered via information and communication technology (ICT) may improve service access. However, adjustment among older people and in synchronous group interventions is more challenging. Technology affordance concerns the possibilities engendered by technology for various users and purposes and can help understand challenges in ICT-delivered groups and identify possible solutions. Research Design and Methods Adopting a multiple triangulation approach, we observed ICT-delivered groups of acceptance and commitment therapy and exercise for older people with depressive symptoms, conducted focus groups with older people who had received group psychotherapy with or without an exercise component, and obtained clinical notes from interventionists. We conducted a thematic analysis of the observation notes, focus group transcriptions, and clinical notes. Results Four focus groups were conducted with 22 participants (mean age = 72.6 years, standard deviation = 7.2, 86% female). We identified 3 challenges: (1) seeing-be seen dilemma, (2) speaking-hearing dilemma, and (3) blurred therapy-home boundary, and 2 solutions: (1) maneuvering layouts and collaborative tools, and (2) cross-platform mediated strategies. Participants struggled to observe the interventionist while simultaneously demonstrating their posture in front of a camera. Remaining silent and moderated turn-taking allowed for clearer hearing but limited interactions. Interruptions from the background environment and intersections of family living spaces disrupted audio-visual communication and jeopardized the sense of security. As a solution, interventionists maneuvered layouts and collaborative tools on teleconferencing applications to achieve intervention goals and provided support through different media. Discussion and Implications The identified challenges and potential solutions can be understood from interactivity, portability, temporality, persistence, and multimediality. Technology affordance can guide ICT-delivered group design by matching the affordance of various technologies and communication media with the characteristics of the intervention and users to enhance efficacy and avoid an unnecessary digital divide.
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Affiliation(s)
- Dara Kiu Yi Leung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Frankie Ho Chun Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Philip Merrill College of Journalism, University of Maryland, College Park, College Park, Maryland, USA
| | - Edwin Lok Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Lesley Sze
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Melissa Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Tianyin Liu
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Annabelle Pui Chi Fong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Wai Wai Kwok
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Angie Kwan Yu Shum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Gloria Hoi Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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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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Shaikh AN, Westcott JB, Franck Love S, Flynn L, Chang CY, Mize MC. Examining Help-Seeking Intentions Among Generation Z College Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2023. [DOI: 10.1080/87568225.2023.2198155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Afroze N. Shaikh
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia
| | - Jordan B. Westcott
- Counselor Education Department, Virginia Tech, Blacksburg, Virginia, USA
| | - Sebastian Franck Love
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia
| | - Lauren Flynn
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia
| | - Catherine Y. Chang
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia
| | - Mary Chase Mize
- Clinical Mental Health Counseling and Psychology Department, Agnes Scott College, Decatur, Georgia
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Hoss L, Richardson LS, Axelrod AD, Cravens Pickens J. Clinical Guidelines When Addressing Abuse over Telemental Health. CONTEMPORARY FAMILY THERAPY 2023; 45:1-11. [PMID: 37361258 PMCID: PMC10050821 DOI: 10.1007/s10591-023-09665-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 03/31/2023]
Abstract
Providing therapy services via Telemental Health (TMH), or teletherapy, has exponentially increased since the COVID-19 pandemic. Although previous research demonstrates that TMH is as effective as in-person therapy, there is a dearth of research on how therapists should address technology-perpetrated abuse and intimate partner violence (IPV) over TMH. This is extremely problematic given the frequency in which violence occurs in romantic relationships. This manuscript aims to address this gap by providing concrete clinical guidelines based on existing literature and professional experience with engaging in TMH services. The authors review literature on technology-perpetrated abuse and discuss innovative ways to assess and treat IPV over TMH by adapting protocols from Domestic Violence-Focused Couple's Therapy. Within this, the authors integrate research on high-conflict couples to provide new suggestions on how to manage couples who escalate quickly and who are prone to violence. The manuscript will conclude with future directions for research.
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Affiliation(s)
- Lara Hoss
- Department of Community, Family, and Addiction Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79415 USA
| | - Lauren S. Richardson
- Department of Community, Family, and Addiction Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79415 USA
| | - Amanda D. Axelrod
- Department of Community, Family, and Addiction Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79415 USA
| | - Jaclyn Cravens Pickens
- Department of Community, Family, and Addiction Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79415 USA
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Baker AJL, Konigsberg M, Brown E, Adkins KL. Successes, challenges, and opportunities in providing evidence-based teletherapy to children who have experienced trauma as a response to Covid-19: A national survey of clinicians. CHILDREN AND YOUTH SERVICES REVIEW 2023; 146:106819. [PMID: 36714194 PMCID: PMC9872563 DOI: 10.1016/j.childyouth.2023.106819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/28/2022] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
While teletherapy is not a new phenomenon, most clinicians have not been trained and do not routinely practice it. The current study was designed to ascertain challenges and opportunities presented by the widescale usage of teletherapy especially for traumatized children, which was necessitated by the COVID-19 pandemic. Two hundred and fifty clinicians across the United States providing teletherapy to traumatized children completed an online survey. Results revealed that many logistical aspects of treatment were perceived to be easier when implemented remotely. Some clinical aspects of care were also perceived to be easier, notably engagement with caregivers. Developing rapport, assessing emotions, and keeping children's attention, however, were perceived as more challenging. Child characteristics such as age, attention span, and screen fatigue were viewed as creating challenges. Most clinicians had not received training in relevant topics for teletherapy and were eager to receive such training. These results suggest many avenues for refining and fine-tuning remote mental health services especially for children.
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Affiliation(s)
- Amy J L Baker
- Vincent J. Fontana Center for Child Protection of the New York Foundling, 590 Avenue of the Americas, NY, NY 10011, United States
| | - Melinda Konigsberg
- Little Flower Children and Families Services of New York, 630 Flushing Avenue, Brooklyn, NY, United States
| | - Elissa Brown
- St. John's University, 8000 Utopia Parkway, Jamaica, NY 11349, United States
| | - Kevin Lee Adkins
- Vincent J. Fontana Center for Child Protection of the New York Foundling, 590 Avenue of the Americas, NY, NY 10011, United States
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Lebow JL. Welcoming Melanie M. Domenech Rodríguez. FAMILY PROCESS 2023; 62:1-5. [PMID: 36914426 DOI: 10.1111/famp.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Jay L Lebow
- Family Process and Family Institute at Northwestern, Evanston, Illinois, USA
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Clemmons NG, Coates E, McLeod A. Understanding the benefits of child-parent psychotherapy delivered via telehealth during the COVID-19 pandemic. CHILDRENS HEALTH CARE 2023. [DOI: 10.1080/02739615.2023.2179489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
| | - Erica Coates
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC, USA
| | - Alison McLeod
- Department of Psychology, Georgetown University, Washington, DC, USA
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Doherty WJ, Harris SM, Hall EL, Hubbard AK. Hoe lang wachten mensen voordat zij hulp zoeken voor relatieproblemen? Een onderzoeksnotitie. GEZINSTHERAPIE WERELDWIJD 2023. [PMCID: PMC9912228 DOI: 10.1007/s12440-023-00190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Een vaak aangehaalde, maar slecht onderbouwde opvatting over relatietherapie is dat koppels gemiddeld zes jaar wachten voordat zij met relatietherapie beginnen voor ernstige relatieproblemen. Deze opvatting gaat vaak hand in hand met het idee dat veel koppels “te laat” komen en dat de vooruitzichten op herstel niet goed zijn. Dit is de eerste studie met een grote steekproef naar de tijd tussen het begin van de relatieproblemen en de start van relatietherapie (N = 270) of individuele therapie (N = 101). We hebben hierin een gemiddelde interval geconstateerd van 2,68 jaar; vanaf het begin van de problemen tot de start van de relatietherapie. De meeste koppels starten binnen twee jaar met de therapie. De bevindingen voor individuele therapie voor relatieproblemen zijn vergelijkbaar. De belangrijkste klinische implicatie is dat therapeuten zich geen zorgen hoeven te maken over het aantal koppels dat zo lang wacht met therapie dat hun problemen niet meer op te lossen zijn.
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Affiliation(s)
- William J. Doherty
- Department of Family Social Science, University of Minnesota, St. Paul, MN Verenigde Staten
| | - Steven M. Harris
- Department of Family Social Science, University of Minnesota, St. Paul, MN Verenigde Staten
| | - Eugene L. Hall
- Postdoctoral Research Associate at the Danielsen Institute, Boston University, Boston, MA Verenigde Staten
| | - Aimee K. Hubbard
- Department of Family Social Science, University of Minnesota, St. Paul, MN Verenigde Staten
- Postdoctoral Research Associate at the Danielsen Institute, Boston University, Boston, MA Verenigde Staten
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Békés V, Aafjes-van Doorn K, Roberts KE, Stukenberg K, Prout T, Hoffman L. Adjusting to a new reality: Consensual qualitative research on therapists' experiences with teletherapy. J Clin Psychol 2023; 79:1293-1313. [PMID: 36704974 DOI: 10.1002/jclp.23477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/26/2022] [Accepted: 12/27/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE In the wake of the COVID-19 pandemic, the use of teletherapy has become more pervasive than ever. Many therapists faced this move to a remote setting with little experience or training. We aimed to qualitatively examine therapists' subjective experience of providing teletherapy, including changes in technique, the therapeutic relationship, and the therapeutic process. METHODS Thirty-one psychotherapists participated in semistructured interviews. Interviews were recorded, then transcribed and analyzed using the Consensual Qualitative Research method. RESULTS Therapists typically reported a change in the therapeutic relationship in terms of an increased sense of disconnection as well as shifts in various aspects of the relational dynamics, and they also typically experienced differences in the therapy process due to changes in patient and therapist engagement in the therapeutic work. Additionally, some therapists also reported that they became more active and directive in sessions, took a more informal, personal, or relaxed approach to interacting with patients, and while the emotional connection changed and they missed the energy and intimacy of in-person sessions, the relationship in telesessions felt more authentic and human for some, and teletherapy also provided a way to discuss new dimensions in the process. CONCLUSION Overall, these results suggest great variability in therapists' subjective experiences with teletherapy, and present teletherapy as a distinct therapy format in many aspects. Further process-level research and subsequent training is needed to better equip therapists to navigate teletherapy's challenges and harness its unique opportunities.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York, USA
| | | | - Kailey E Roberts
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York, USA
| | - Karl Stukenberg
- School of Psychology, Xavier University, Cincinnati, Ohio, USA
| | - Tracy Prout
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York, USA
| | - Leon Hoffman
- New York Psychoanalytic Institute, New York, New York, USA
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17
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Hellstern RB, Robinson WD. The Impact of COVID-19 and Telehealth Services on Attrition Rates in Psychotherapy. CONTEMPORARY FAMILY THERAPY 2023; 45:1-12. [PMID: 36711078 PMCID: PMC9873205 DOI: 10.1007/s10591-023-09661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
Attrition in psychotherapy has been identified as a significant obstacle in the productive delivery of mental health services. Defined generally as the ending of a treatment prior to proper optimal benefit, attrition both hinders treatment efficacy and costeffectiveness in therapy. With the demands for quality mental health services increasing, resources must be identified to reduce barriers to such services. The COVID-19 pandemic has resulted in the emergence of one potential resources: telehealth services. The current study aims to identify how COVID-19 and telehealth services have influenced attrition by analyzing attrition rates from both before and during the pandemic in a community health center where a transition to telehealth was made at the start of the pandemic. In addition, the variables of age, gender, socioeconomic status, and insurance coverage were also tested as potential predictors of attrition. Using de-identified patient information, clients who had participated in therapy services within a six-month period at a community health center (N = 329) were selected. A survival analysis was used to assess the time taken from initial appointment to the point of attrition. Results indicated that those who attended therapy via telehealth were less likely to stop attending treatment than those who participated in therapy in person. Individuals who used both in-person and telehealth visits were the least likely to terminate treatment prematurely. Clinical implications include the need for therapists to offer both telehealth and in-person services in order to give clients more resources to reduce a large barrier to needed mental healthcare treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s10591-023-09661-0.
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Affiliation(s)
- Rylan B. Hellstern
- Department of Human Development and Family Studies, Utah State University, Logan, UT USA
| | - W. David Robinson
- Department of Human Development and Family Studies, Utah State University, Logan, UT USA
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18
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Voth Schrag RJ, Leat S, Backes B, Childress S, Wood L. "So many extra safety layers:" Virtual service provision and implementing social distancing in interpersonal violence service agencies during COVID-19. JOURNAL OF FAMILY VIOLENCE 2023; 38:227-239. [PMID: 35106021 PMCID: PMC8794597 DOI: 10.1007/s10896-021-00350-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 05/07/2023]
Abstract
The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured interviews were conducted from July to December 2020 with 33 interpersonal violence service providers from across the United States, and data were analyzed via conventional content analysis with additional steps for data credibility. Findings fall within two primary categories: 1) Technology and Virtual Service Provision; and 2) Social Distancing for In-person Services. Within each category, a number of themes emerged illustrating strengths and challenges of each approach, and the complex web of technological, safety, and public health considerations being balanced in interpersonal violence service agencies. These results provide guidance for the implementation of virtual services in an on-going manner, as well as underscoring the importance of future planning to facilitate effective in-person but physically distant services. There is also a clear need for agencies to support the interpersonal violence workforce to reduce occupational stress and enhance skills and capacities with new forms of services.
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Affiliation(s)
- Rachel J. Voth Schrag
- University of Texas at Arlington School of Social Work, 211 S. Cooper, Arlington, TX 76016 USA
| | | | | | | | - Leila Wood
- University of Texas Medical Branch, Galveston, TX USA
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19
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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 2023; 52:441-466. [PMID: 35531310 PMCID: PMC9060401 DOI: 10.1007/s10566-022-09692-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [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 ,grid.36316.310000 0001 0806 5472School of Human Science, University of Greenwich, London, UK
| | - Sajid Humayun
- grid.36316.310000 0001 0806 5472School of Human Science, University of Greenwich, London, UK
| | - Tom Jefford
- Family Psychology Mutual CIC, Huntingdon, UK
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20
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Lebow J, Snyder DK. Couple therapy in the 2020s: Current status and emerging developments. FAMILY PROCESS 2022; 61:1359-1385. [PMID: 36175119 PMCID: PMC10087549 DOI: 10.1111/famp.12824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the evolution of couple therapy into a prominent intervention modality and coherent body of practice. The review begins with the consideration of the field's strong empirical underpinnings derived from research on couple therapy and basic relational science. Couple therapy comprises the widely accepted method for reducing relationship distress and enhancing relationship quality. Moreover, both as a stand-alone intervention and in conjunction with other treatment formats, couple-based interventions have garnered considerable empirical support for their effectiveness in addressing a broad spectrum of specific relational dysfunctions as well as individual emotional and physical health problems. We highlight the convergence of methods through common factors, shared strategies, and remarkably similar arrangements across approaches. Our review also points to key differences among approaches, the importance of recognizing respective strengths and limitations linked to these differences, and building on differences across models when selecting and tailoring interventions for a given couple. The discussion concludes with a consideration of recent trends in the field including the impact of telehealth and related digital technologies, the expansion of specific treatments for specific problems and diverse populations, the interface of couple therapy with relationship education, and enduring challenges as well as new opportunities addressing broader systemic and global dynamics.
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Affiliation(s)
- Jay Lebow
- Family Institute of NorthwesternNorthwestern UniversityEvanstonIllinoisUSA
| | - Douglas K. Snyder
- Department of Psychological and Brain SciencesTexas A&M UniversityCollege StationTexasUSA
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21
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Shetty KV, Sharma U, Kalyanasundaram M, Kumar S, Bamney U. Protocol for developing telephone-based brief psychosocial intervention for COVID-19 patients in India. J Family Med Prim Care 2022; 11:5479-5484. [PMID: 36505530 PMCID: PMC9730994 DOI: 10.4103/jfmpc.jfmpc_1522_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/14/2021] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The ongoing Coronavirus disease 2019 (COVID-19) pandemic has had a huge mental health impact on people, especially the infected population. They are at greater risk of developing psychological symptoms due to the fear of death and developing severe disability, lack of proper treatment and social restrictions, stigma, and discrimination. The early psychological symptoms, if ignored, may have long-term consequences on the health and well-being of COVID patients. Due to the COVID-19 pandemic, the mental health services have been impacted negatively, and the need for technology-based psychological interventions has been identified as an alternative treatment method. Hence, the Telephone-Based Brief Psycho-Social interventions (TBPSI) will be developed for COVID-19 patients. Materials and Method A five-session tele psychosocial intervention including rapport establishment and assessment, supportive counselling, activity scheduling, relaxation technique, and post-assessment will be developed based on the extensive review of the literature. Face and content validation of the intervention package will be done by the mental health experts. Further, the feasibility of the intervention program will be tested on COVID-19 patients in the Dharwad district, and later, the same will be implemented across the COVID hospitals of Karnataka state. Discussion and Conclusion The study results may bring new insights into the culturally sensitive technology-oriented interventions during this pandemic in the country. The paradigm may be shifted from routine treatment to cost-effective and time-based intervention in the public health system in India. The telephonic brief psychosocial interventions can be utilised as a mainstream treatment during non-emergency situations as well.
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Affiliation(s)
- Kannappa V. Shetty
- Department of Psychiatric Social Work, Dharwad Institute of Mental Health and Neuro Sciences (DIMHANS), Dharwad, Karnataka, India,Address for correspondence: Dr. Kannappa V. Shetty, Assistant Professor, Department of Psychiatric Social Work, Dharwad Institute of Mental Health and Neuro Sciences (DIMHANS), Dharwad - 580 008, Karnataka, India. E-mail:
| | - Upasana Sharma
- MD, Ph.D, Independent Public Health Researcher, Chennai, Tamil Nadu, India
| | - Madhanraj Kalyanasundaram
- MD Scientist- D, Division of Environmental Health and Epidemiology, ICMR-NIREH, Bhopal, Madhya Pradesh, India
| | - Sanjeev Kumar
- Ph.D. Assistant Professor of PSW, Centre for PSS in Disaster Management, NIMHANS, Bangalore, Karnataka, India
| | - Urmila Bamney
- M. Phil. Scholar, Department of Social Work, Central University of Karnataka, Kalaburagi, Karnataka, India
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22
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Karrim SB, Flack PS, Naidoo U, Beagle S, Pontin A. The experiences of speech-language therapists providing telerehabilitation services to children with autism spectrum disorder. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e12. [PMID: 36073081 PMCID: PMC9453137 DOI: 10.4102/sajcd.v69i2.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 11/15/2022] Open
Abstract
Background There has been an increased emergence of the use of telerehabilitation by speech-language therapists (SLTs) in South Africa since the COVID-19 pandemic in 2020. Objectives To explore the criteria that SLTs use when recommending telerehabilitation for children with autism spectrum disorder (ASD), the technical skills required, strategies used by SLTs, the restrictions encountered when conducting telerehabilitation and the views of SLTs on telerehabilitation in comparison to face-to-face therapy for children with ASD. Method A descriptive, phenomenological, qualitative study design was utilised. Purposive and snowball sampling techniques were employed. Six SLTs from the private sector, who had experience providing telerehabilitation to children with ASD, were recruited from three provinces in South Africa. Data were gathered via semistructured online interviews and analysed using thematic analysis. Results Two out of five themes that emerged from this study are presented in this paper, i.e. approaches to telerehabilitation and the benefits of telerehabilitation. Results revealed that telerehabilitation was used to provide assessment and therapy during the COVID-19 pandemic lockdowns as an alternative method of service delivery. Assessment and treatment strategies included synchronous and asynchronous methods, family collaboration, social stories, frequent breaks and interactive sessions. Telerehabilitation reduced the client’s and SLT’s travel costs and increased caregiver and clinician satisfaction. Client progress and increased awareness of SLT were viewed as further benefits. Conclusion Telerehabilitation was found to be beneficial to most children with ASD, and in most cases, the benefits far outweighed the challenges encountered. Clinical implications included the need for caregiver support in facilitating effective carryover, an increase in SLTs’ knowledge and the opportunity to provide services to a broader geographical range. Limitations of the study are included.
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Affiliation(s)
- Saira B Karrim
- Discipline of Speech-Language Pathology, School of Health Sciences, University of KwaZulu-Natal, Durban.
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23
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Tar-Mahomed Z, Kater KA. The perspectives of speech–language pathologists: Providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e7. [PMID: 36073074 PMCID: PMC9452921 DOI: 10.4102/sajcd.v69i2.902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/18/2022] [Accepted: 06/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on every facet of life. This directly included the delivery of health care from allied health professionals such as speech–language pathologists (SLPs) in South Africa. Research has shown that there is limited research done locally on the impact of COVID-19 relating to stroke care. Consequently, this results in a lack of research on the provision of speech, language and swallowing intervention using teletherapy after a stroke from an SLP point of view. Objectives The aim of this study was to explore the experiences of SLPs with regard to their use of teletherapy in a COVID-19 context when providing speech, language and swallowing intervention for patients after a stroke. Methods This study made use of a qualitative approach. An electronic questionnaire was sent to SLPs inviting them to participate in the study. Purposive sampling was used to recruit participants and thematic content analysis was used to analyse the open-ended qualitative questions. Results The findings show that SLPs experienced a variety of facilitators and barriers to using teletherapy. Additionally, issues of access differ across the private and public sector SLPs for both the clients and the SLPs. Conclusion The current study provided research in the field of teletherapy, which is relatively new in the South African context. The study, whilst small in scale, provided some insight into the changes experienced from the shift to teletherapy.
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Affiliation(s)
- Zahraa Tar-Mahomed
- Department of Speech Pathology and Audiology, Faculty of Humanities, School of Human and Community Development, University of the Witwatersrand, Johannesburg.
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24
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Meininger L, Adam J, von Wirth E, Viefhaus P, Woitecki K, Walter D, Döpfner M. Cognitive-behavioral teletherapy for children and adolescents with mental disorders and their families during the COVID-19 pandemic: a survey on acceptance and satisfaction. Child Adolesc Psychiatry Ment Health 2022; 16:61. [PMID: 35902959 PMCID: PMC9330974 DOI: 10.1186/s13034-022-00494-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is challenging for health care systems around the world. Teletherapy (psychotherapy conducted via videoconference) for children and adolescents offers a promising opportunity not only to provide treatment during social distancing restrictions but also to reduce treatment barriers that might prevent families from seeking care independent of the pandemic. Therefore, it is highly important to examine the implementation and especially the acceptance of and satisfaction with teletherapy. METHODS Therapists of 561 patients and parents of 227 patients (total 643 patients) aged 3-20 years treated at a university outpatient unit rated their experiences with teletherapy. RESULTS Following the outbreak of COVID-19, 73% of the patients switched from face-to-face treatment to teletherapy. Both therapists and parents were mainly satisfied with teletherapy and did not report negative impacts on treatment satisfaction or the therapeutic relationship. Stress from COVID-19, age, gender, duration of treatment, psychosocial functioning, and psychopathology were associated with satisfaction, but correlations were low. Sixty-six percent of parents and 53% of therapists intended to use teletherapy in the future. CONCLUSIONS Teletherapy during the COVID-19 pandemic was well accepted by both parents and therapists. Certain patient characteristics were related to satisfaction. Trial registration The study was retrospectively registered in the German Clinical Trials Register (DRKS00028639).
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Affiliation(s)
- Lea Meininger
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Julia Adam
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Elena von Wirth
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Paula Viefhaus
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Katrin Woitecki
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Daniel Walter
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany
| | - Manfred Döpfner
- Faculty of Medicine and University Hospital Cologne, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany.
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Emran A, Smith JA, Iqbal N. Psychotherapists’ experience of the transition to telepsychotherapy amidst COVID-19 in India. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2093164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ashti Emran
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | - Jonathan A. Smith
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Naved Iqbal
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
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26
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Lord SA. COVID Couple Therapy: Telehealth and Somatic Action Techniques. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY 2022; 43:197-209. [PMID: 35942399 PMCID: PMC9347793 DOI: 10.1002/anzf.1487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In March of 2020, during the global COVID-19 pandemic, therapists quickly transitioned to telehealth platforms to provide their services. Teletherapy, while subject to some constraints, presents unique opportunities to work creatively with couples, particularly during these uncertain times. This paper offers a case study of work with a couple using systemic, developmental attachment, dialogical, and somatic trauma theories. Action techniques, including doubling, ideal futures creation, and a foam roller trust exercise are employed to facilitate change processes as couples face the chaos and unknowns of the pandemic and the difficulties that have become triggered between them. These exercises help to open perspective, increase awareness, and lower resistance to change. Couples are able to physically enact and metabolise alternative realities while discharging excess energies in familiar surroundings.
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27
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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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28
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Orlowski EW, Friedlander ML, Megale A, Peterson EK, Anderson SR. Couple and family therapists’ experiences with Telehealth during the COVID-19 pandemic: a phenomenological analysis. CONTEMPORARY FAMILY THERAPY 2022; 44:101-114. [PMID: 35400810 PMCID: PMC8978774 DOI: 10.1007/s10591-022-09640-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Abstract
In designing this study, we aimed to obtain a rich, phenomenological understanding of the experiences of couple and family therapists who transitioned their practice to telehealth due to the COVID-19 pandemic. Twelve experienced therapists from the U.S., Spain and Australia were interviewed in depth about their experiences of this transition, particularly how they developed and maintained therapeutic alliances in a virtual context with couples and families suffering pandemic-related hardships. The qualitative analysis identified 40 themes reflecting participants’ initial impressions of telehealth and their positive and negative reactions and adjustments to practicing remotely. Upon overcoming some initial wariness about providing services virtually, many participants described advantages to this way of working with families. Indeed, participants were creative in adjusting to this novel therapy modality, finding new ways to connect emotionally with their clients, to work meaningfully with children, to assess in-session dynamics, and to ensure their clients’ privacy and safety. Notably, several participants commented on the relatively slower development of alliances with new cases and the challenge of repairing split alliances between family members. Many of these difficulties were described as due to having minimal access to their clients’ raw emotions and the inability to use typical systemic interventions, such as moving family members around physically. Participants also reflected on being a “participant observer” to the upheaval caused by the pandemic, a distressing experience they shared with the families in their care.
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Affiliation(s)
- Edmund W. Orlowski
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
| | - Myrna L. Friedlander
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
| | - Allison Megale
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
| | - Emily K. Peterson
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
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29
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McKee GB, Pierce BS, Tyler CM, Perrin PB, Elliott TR. The COVID-19 Pandemic's Influence on Family Systems Therapists' Provision of Teletherapy. FAMILY PROCESS 2022; 61:155-166. [PMID: 33913526 PMCID: PMC8239780 DOI: 10.1111/famp.12665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The COVID-19 pandemic has altered life globally like no other event in modern history, and psychological service changes to meet the resultant impacts on families have not been assessed in the empirical literature. The purpose of the current study was to examine whether family systems therapists increased their teletherapy use during the pandemic relative to prepandemic usage, and whether projected postpandemic rates would remain at the same level; further, environmental and demographic predictors of these changes were examined. In May 2020, a sample of 626 family systems therapists (58.6% women, 40.6% men; M = 57.4 years old; M years in practice = 25.5) completed a national online study assessing these variables. Results suggested that family systems therapists performed 7.92% of their clinical work using teletherapy before the pandemic and 88.17% during the pandemic. They also projected that they would perform 36.57% of their clinical work using teletherapy after the pandemic. Teletherapy uptake was unrelated to primary practice setting, provider age, gender, race/ethnicity, and practice location (urban/suburban vs. rural) but was higher for family systems therapists who reported increased supportive teletherapy policies and training in their practice setting. Organizational infrastructure and availability of training played an important role in influencing teletherapy uptake during the pandemic. Family systems therapists have a unique opportunity to deploy teletherapy modalities to meet the needs of families during the COVID-19 pandemic, and infrastructure and training to do so may facilitate that work.
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Affiliation(s)
- Grace B. McKee
- Advanced Fellowship Program in Mental Illness Research and TreatmentMid‐Atlantic Mental Illness Research Education and Clinical Center (MIRECC)Central Virginia Veterans Affairs Health Care SystemRichmondVAUSA
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | | | - Carmen M. Tyler
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Paul B. Perrin
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
- Central Virginia Veterans Affairs Health Care SystemRichmondVAUSA
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Rabeyron T. When the Truth Is Out There: Counseling People Who Report Anomalous Experiences. Front Psychol 2022; 12:693707. [PMID: 35058829 PMCID: PMC8764292 DOI: 10.3389/fpsyg.2021.693707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/22/2021] [Indexed: 01/08/2023] Open
Abstract
In this paper, we propose a clinical approach to the counseling of distressing subjective paranormal experiences, usually referred to as anomalous or exceptional experiences in the academic field. These experiences are reported by a large part of the population, yet most mental health practitioners have not received a specific training in listening constructively to these experiences. This seems all the more problematic since nearly one person in two find it difficult to integrate such experiences, which can be associated with different forms of psychological suffering. After having described briefly several clinical approaches already developed in this area, we outline the main aspects of clinical practice with people reporting exceptional experiences, in particular the characteristics of the clinician's attitude toward the narrative of unusual events. We then present the core components of a Psychodynamic Psychotherapy focused on Anomalous Experiences (PPAE) based on three main steps: phenomenological exploration, subjective inscription and subjective integration of the anomalous experience. Such an approach, based on a non-judgmental and open listening, favors the transformation of the ontological shock that often follows the anomalous experiences into a potential source of integration and psychological transformation.
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Affiliation(s)
- Thomas Rabeyron
- Department of Psychology, Interpsy, Université de Lorraine, Nancy, France.,Department of Psychology, KPU, University of Edinburgh, Edinburgh, United Kingdom.,Institut Universitaire de France, Paris, France
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COVID 19 and Implementing E-Mental Health using the VRIO Strategic Planning Framework. INTERNATIONAL JOURNAL OF E-COLLABORATION 2022. [DOI: 10.4018/ijec.299005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coronavirus has disrupted normalcy for communities and businesses across the globe. With massive shutdowns across the world, organizations were forced to assess their business operations and determine how to sustain in such turbulent times. Mental health clinics faced equivalent barriers as the structure of engaging with clients in a face to face setting was similarly disrupted. The implementation of e-mental health structures were clear targets of change as clinics needed to continue to serve the mentally fragile. Strategic planning calls for thoughtful collaboration, collection, and consideration of the necessary adaptations to meet the mission and vision of the organization. Strategic frameworks like the Value, Rarity, Imitability, and Organization are useful tools for mental health clinics to plan on shifting their operations from an in-person to a virtual environment.
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Wilks CR, Gurtovenko K, Rebmann K, Williamson J, Lovell J, Wasil AR. A systematic review of dialectical behavior therapy mobile apps for content and usability. Borderline Personal Disord Emot Dysregul 2021; 8:29. [PMID: 34857035 PMCID: PMC8639404 DOI: 10.1186/s40479-021-00167-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT may be useful in increasing access to care and augmenting in-person DBT. This review examines DBT based apps, with a specific focus on content quality and usability. METHODS All apps referring to DBT were identified in Google Play and iOS app stores and were systematically reviewed for app content and quality. The Mobile App Rating Scale (MARS) was used to evaluate app usability and engagement. RESULTS A total of 21 free to download apps were identified. The majority of apps (71%) included a component of skills training, five apps included a diary card feature. Most (76.19%) apps were designed to function without help from a therapist. The average user "star" rating was 4.39 out of 5. The mean overall MARS score was 3.41, with a range of 2.15 to 4.59, and 71.43% were considered minimally 'acceptable,' as defined by a score of 3 or higher. The average star rating was correlated with the total MARS score (r = .51, p = .02). Estimates of app usage differed substantially between popular and unpopular apps, with the three most popular apps accounting for 89.3% of monthly active users. CONCLUSIONS While the present study identified many usable and engaging apps in app stores designed based on DBT, there are limited apps for clinicians. DBT based mobile apps should be carefully developed and clinically evaluated.
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Affiliation(s)
- Chelsey R Wilks
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Way, St. Louis, MO, USA.
| | - Kyrill Gurtovenko
- Department of Psychiatry and Behavioral Sciences, University of Washington, Washington, USA
- Seattle Children's Hospital, Department of Psychiatry and Behavioral Medicine, Washington, USA
| | - Kevin Rebmann
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Way, St. Louis, MO, USA
| | - James Williamson
- Seattle Children's Hospital, Department of Psychiatry and Behavioral Medicine, Washington, USA
| | - Josh Lovell
- Department of Psychology, Hofstra University, Hofstra, USA
| | - Akash R Wasil
- Department of Psychology, University of Pennsylvania, Pennsylvania, USA
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Kanter JB, Williams DT, Rauer AJ. Strengthening lower-income families: Lessons learned from policy responses to the COVID-19 pandemic. FAMILY PROCESS 2021; 60:1389-1402. [PMID: 34553388 PMCID: PMC8652884 DOI: 10.1111/famp.12716] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 05/02/2023]
Abstract
Families are navigating an unstable economy due to COVID-19. Financial stressors have the potential to strain intimate relationships and exacerbate prior inequities across lower-income families. Notably, the economic impact of COVID-19 disproportionately influenced Black and Latinx families. As a response to families' economic adversity during the pandemic, the federal government initiated the CARES Act. This type of federal response to lower-income families, however, is not new. The purpose of this paper is to contextualize and historicize previous and current efforts to mitigate the consequences of financial hardship on families by comparing the assumptions and efficacy of the Healthy Marriages Initiative and the CARES act. We conclude with four recommendations to promote well-being in lower-income families: (1) acknowledging and reducing inequities that disproportionally impact families racialized as Black or Latinx; (2) intervening to mitigate stressors surrounding families; (3) using innovative methods to deliver relationship education; and (4) considering prevention versus intervention strategies.
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Affiliation(s)
- Jeremy B. Kanter
- Department of Child and Family StudiesThe University of TennesseeKnoxvilleTNUSA
| | | | - Amy J. Rauer
- Department of Child and Family StudiesThe University of TennesseeKnoxvilleTNUSA
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Beaudoin MN, Maclennan R. Mindfulness and Embodiment in Family Therapy: Overview, Nuances, and Clinical Applications in Poststructural Practices. FAMILY PROCESS 2021; 60:1555-1567. [PMID: 33382466 DOI: 10.1111/famp.12624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This paper discusses the inclusion of ideas from mindfulness, embodiment, and associated brain research in poststructural family therapies. Connecting research and practice across diverse fields is presented as enriching therapeutic work, increasing clinical effectiveness, and broadening options for families seeking our assistance. Ways of incorporating mindfulness and embodiment are described and offer distinctively novel practices not typically used in traditional forms of poststructural therapies. These innovative practices are illustrated by clinical work with a mother and her five-year- daughter who survived a dangerous health crisis and an extremely painful hospitalization. Therapeutic work with this family exemplifies how traumatic experiences are not always accessible through linguistic means alone. Working with interpersonal mind-body practices can uniquely contribute to relaxing the sympathetic nervous system and activating the social engagement branch of the parasympathetic nervous system. The inclusion of such practices can provide valuable opportunities to facilitate the emergence of preferred experiences of self for all family members.
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Foley S, Badinlou F, Brocki KC, Frick MA, Ronchi L, Hughes C. Family Function and Child Adjustment Difficulties in the COVID-19 Pandemic: An International Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11136. [PMID: 34769654 PMCID: PMC8582895 DOI: 10.3390/ijerph182111136] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022]
Abstract
To estimate specific proximal and distal effects of COVID-19-related restrictions on families on children's adjustment problems, we conducted a six-site international study. In total, 2516 parents from Australia, China, Italy, Sweden, the United Kingdom, and the United States of America living with a young child (Mage = 5.77, SD = 1.10, range = 3 to 8 years, 47.9% female) completed an online survey between April and July 2020. The survey included the Strengths and Difficulties Questionnaire and family risk factors (parent distress, parent-child conflict, couple conflict, and household chaos) as well as a scale to index COVID-19-related family disruption. Our analyses also included public data on the stringency of national restrictions. Across the six sites, parental responses indicated elevated levels of hyperactivity, conduct, and emotion problems in children from families characterized by heightened levels of parent distress, parent-child conflict, and household chaos. In contrast, increased peer problems were more strongly related to COVID-19-related social disruption and stringency measures. Mediation models demonstrated that associations between COVID-19 social disruption and child difficulties could be explained by parental distress. Taken together, these results suggest that although the experience of the pandemic differed across countries, associations between COVID-19-related family experiences and child adjustment difficulties were similar in their nature and magnitude across six different contexts. Programs to support family resilience could help buffer the impact of the pandemic for two generations.
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Affiliation(s)
- Sarah Foley
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh EH8 8AQ, UK
| | - Farzaneh Badinlou
- Department of Psychology, Uppsala University, 751 42 Uppsala, Sweden; (F.B.); (K.C.B.); (M.A.F.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, 117 63 Stockholm, Sweden
| | - Karin C. Brocki
- Department of Psychology, Uppsala University, 751 42 Uppsala, Sweden; (F.B.); (K.C.B.); (M.A.F.)
| | - Matilda A. Frick
- Department of Psychology, Uppsala University, 751 42 Uppsala, Sweden; (F.B.); (K.C.B.); (M.A.F.)
| | - Luca Ronchi
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Claire Hughes
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RQ, UK;
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Martínez N, Connelly CD, Pérez A, Calero P. Self-care: A concept analysis. Int J Nurs Sci 2021; 8:418-425. [PMID: 34631992 PMCID: PMC8488814 DOI: 10.1016/j.ijnss.2021.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives There is extensive literature from various disciplines on self-care, an important aspect of nursing intervention via evaluation and education, but its meaning remains unprecise due to the difficulty integrating the diverse definitions developed over time across disciplines. Therefore, it is vital to clarify the meaning of self-care and formulate the defining attributes, antecedents, and consequences to self-care. Methods Walker and Avant’s concept analysis approach was used to analyze the concept of self-care. A search of the literature was completed using the databases CINAHL, PubMed, and EBSCOhost for years 1975–2020; literature search included peer-review articles, full-text publications, and available in English. A total of 31 articles were reviewed, and saturation was reached. Results An extensive review of the literature revealed salient characteristics that reflected the most frequently used terms associated with the concept. Guided by Walker and Avant’s method, three defining attributes emerged as common themes: awareness, self-control, and self-reliance. Conclusions A clarified definition was identified: the ability to care for oneself through awareness, self-control, and self-reliance in order to achieve, maintain, or promote optimal health and well-being.
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Affiliation(s)
- Nicole Martínez
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Cynthia D Connelly
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Alexa Pérez
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Patricia Calero
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
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Isobel S. Trauma-informed qualitative research: Some methodological and practical considerations. Int J Ment Health Nurs 2021; 30 Suppl 1:1456-1469. [PMID: 34310829 DOI: 10.1111/inm.12914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/02/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
Mental health nurses who engage in research are likely to undertake research on sensitive topics, related to experiences of illness, care delivery and treatment. With recognition of the high prevalence of trauma in the lives of people who interact with mental health services, it is likely that many research participants will have experienced trauma in their lives and that while this may not be the focus of the research, sensitivity and awareness are required. Reference to 'trauma-informed' approaches in research design and practice is emerging in fields such as trauma-focused research and social sciences; however, it has not yet been applied to nurses. Trauma-informed approaches can build upon existing ethical and methodological frameworks to inform how mental health nurses go about qualitative research and what they need to consider when doing so. This discursive paper explores some of the implications of awareness and sensitivity to trauma for research undertaken by mental health nurses, including practical and methodological considerations. Recommendations include training and structural supports for nurse researchers, collaborative research designs, consideration of the environments where research occurs, awareness of approaches to distress and inclusion of trauma sensitivity within research policies, frameworks and leadership, alongside vigilance to interpersonal approach and the establishment and protection of psychological safety throughout. Continuing to undertake research on topics, and with people, where trauma is present, is essential to ensure ongoing awareness. Many of the existing skills held by mental health nurses can also support research to be undertaken in trauma-informed ways.
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Affiliation(s)
- Sophie Isobel
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Doherty WJ, Harris SM, Hall EL, Hubbard AK. How long do people wait before seeking couples therapy? A research note. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:882-890. [PMID: 33411353 DOI: 10.1111/jmft.12479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
A widely cited but poorly supported idea in the couples therapy field is that the average couple waits six years before starting therapy for serious relationship problems. This figure is often accompanied by the notion that many couples come "too late" and have poor prospects for recovery. This is the first large-sample study on the delay between the onset of serious marital problems and entry into couples therapy (N = 270) and individual therapy (N = 101) for relationship problems. We found an average interval of 2.68 years from onset of problems and entering couples therapy, with the great majority of couples entering therapy within two years. Findings were similar for seeking individual therapy for relationship problems. The main clinical implication is that therapists have little reason to be pessimistic about the majority of couples waiting so long before starting therapy that their problems are not resolvable.
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Affiliation(s)
- William J Doherty
- University of Minnesota, St. Paul, MN, USA
- Department of Family Social Science, University of Minnesota, St. Paul, MN, USA
| | - Steven M Harris
- University of Minnesota, St. Paul, MN, USA
- Department of Family Social Science, University of Minnesota, St. Paul, MN, USA
| | - Eugene L Hall
- Boston University, Boston, MA, USA
- Postdoctoral Research Associate at the Danielsen Institute, Boston University, Boston, MA, USA
| | - Aimee K Hubbard
- University of Minnesota, St. Paul, MN, USA
- Department of Family Social Science, University of Minnesota, St. Paul, MN, USA
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Hogue A, Becker SJ, Wenzel K, Henderson CE, Bobek M, Levy S, Fishman M. Family involvement in treatment and recovery for substance use disorders among transition-age youth: Research bedrocks and opportunities. J Subst Abuse Treat 2021; 129:108402. [PMID: 34080559 PMCID: PMC8380649 DOI: 10.1016/j.jsat.2021.108402] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/30/2022]
Abstract
This article presents a narrative review and conceptual framework for research on family involvement across the continuum of substance use disorder (SUD) services for transition-age youth (ages 15-26). Though families are powerful resources for enhancing treatment and recovery success among youth with SUDs, they are not routinely included in clinical practice. This article summarizes youth SUD prevalence and service utilization rates and presents developmental and empirical rationale for increasing family involvement in services. It then describes key research issues on family involvement across the SUD services continuum: Problem Identification, Treatment Engagement, Active Treatment, Recovery Support. Within each phase, it highlights bedrock research findings and suggests promising opportunities for advancing the scientific knowledge base on family involvement. The main goals are to endorse family-oriented practices for immediate adoption in routine care and identify areas of research innovation that could significantly enhance the quality of youth SUD services.
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Affiliation(s)
- Aaron Hogue
- Partnership to End Addiction, United States of America.
| | - Sara J Becker
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, United States of America
| | - Kevin Wenzel
- Maryland Treatment Centers, United States of America
| | | | - Molly Bobek
- Partnership to End Addiction, United States of America
| | - Sharon Levy
- Boston Children's Hospital, Harvard Medical School, United States of America
| | - Marc Fishman
- Maryland Treatment Centers, United States of America
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Zayde A, Kilbride A, Kucer A, Willis HA, Nikitiades A, Alpert J, Gabbay V. Connection During COVID-19: Pilot Study of a Telehealth Group Parenting Intervention. Am J Psychother 2021; 75:67-74. [PMID: 34525847 PMCID: PMC9490759 DOI: 10.1176/appi.psychotherapy.20210005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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.
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Affiliation(s)
- Amanda Zayde
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Anna Kilbride
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Audrey Kucer
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Henry A Willis
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Adella Nikitiades
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Jonathan Alpert
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Vilma Gabbay
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
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Drieves AA. Case Examples and Process-Oriented Questions in Teletherapy with Couples and Families. FAMILY PROCESS 2021; 60:1048-1061. [PMID: 34189727 DOI: 10.1111/famp.12680] [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: 06/13/2023]
Abstract
This paper shares learned experiences in teletherapy (also called tele-mental-health, remote video therapy, and virtual therapy) with couples and families. It aims to enhance teletherapy practice with couples and families by providing tools for screening and coaching. The paper describes common pitfalls in teletherapy with couples and families and how to avoid or address them, describes the opportunities for added insight when engaging couples and families in teletherapy from their homes, provides concrete interventions in the form of process-focused questions which therapists can draw from, and provides case examples. The case examples and process-oriented questions focus on four areas: screening, logistical coaching of technology, using the family's meeting place to learn about the family, and avoiding pitfalls.
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Lebow JL. Couple and family therapy (and families) in the digital age. FAMILY PROCESS 2021; 60:689-693. [PMID: 34580874 DOI: 10.1111/famp.12705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Jay L Lebow
- Editor, Family Process and Family Institute at Northwestern, Northwestern University, Evanston, Illinois, USA
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Marcelin LH, Cela T, Dembo R, Jean‐Gilles M, Page B, Demezier D, Clement R, Waldman R. Remote delivery of a therapeutic intervention to court-mandated youths of Haitian descent during COVID-19. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2938-2958. [PMID: 33734451 PMCID: PMC8251117 DOI: 10.1002/jcop.22559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/19/2021] [Accepted: 03/07/2021] [Indexed: 06/12/2023]
Abstract
The threat generated by the COVID-19 pandemic has triggered sudden institutional changes in an effort to reduce viral spread. Restrictions on group gatherings and in-person engagement have increased the demand for remote service delivery. These restrictions have also affected the delivery of court-mandated interventions. However, much of the literature has focused on populations that voluntarily seek out face-to-face medical care or mental health services, whereas insufficient attention has been paid to telehealth engagement of court-mandated populations. This article draws on data gathered on an NIH/NIDA-funded study intervention implemented with juvenile justice-involved youths of Haitian heritage in Miami-Dade County, Florida, during the COVID-19 public health crisis. We explore the process of obtaining consent, technological access issues, managing privacy, and other challenges associated with remote delivery of family-based therapy to juvenile justice-involved youth. Our aim is to provide some insights for consideration by therapists, healthcare workers, advocates, researchers, and policymakers tasked with finding alternative and safer ways to engage nontraditional populations in health services. The clinical trial registration number is NCT03876171.
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Affiliation(s)
- Louis Herns Marcelin
- Department of AnthropologyUniversity of MiamiCoral GablesFloridaUSA
- Department of Public Health SciencesUniversity of MiamiMiamiFloridaUSA
- Laboratory on Health, Family and MigrationInteruniversity Institute for Research and Development (INURED)Port‐au‐PrinceHaiti
| | - Toni Cela
- Department of AnthropologyUniversity of MiamiCoral GablesFloridaUSA
- Laboratory on Health, Family and MigrationInteruniversity Institute for Research and Development (INURED)Port‐au‐PrinceHaiti
| | - Richard Dembo
- Department of CriminologyUniversity of South FloridaTampaFloridaUSA
| | - Michèle Jean‐Gilles
- Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFloridaUSA
| | - Bryan Page
- Department of AnthropologyUniversity of MiamiCoral GablesFloridaUSA
| | - Danna Demezier
- Department of AnthropologyUniversity of MiamiCoral GablesFloridaUSA
| | - Roy Clement
- Department of AnthropologyUniversity of MiamiCoral GablesFloridaUSA
| | - Rachel Waldman
- Department of AnthropologyUniversity of MiamiCoral GablesFloridaUSA
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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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Ilagan GS, Heatherington L. Advancing the understanding of factors that influence client preferences for race and gender matching in psychotherapy. COUNSELLING PSYCHOLOGY QUARTERLY 2021. [DOI: 10.1080/09515070.2021.1960274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hertlein KM, Drude K, Jordan SS. "What Next?": Toward telebehavioral health sustainability in couple and family therapy. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:551-565. [PMID: 33818791 DOI: 10.1111/jmft.12510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
As a response to the COVID-19 global crisis, many in the couple/marital and family therapy (CMFT) professional community quickly met the challenge of providing services to clients via telebehavioral health (TBH) services. As this public health emergency endures, family therapists must continue to engage in TBH practice professionally and ethically. The rapid adoption of TBH with minimal training and experience during this public health emergency can result in crises for both individual therapists as well as for the profession in implementing electronic record-keeping, conducting virtual sessions, and communicating online with various clinical populations. The risk of insufficient training and supervision create a challenge to new and experienced family therapists. This article summarizes the work done by the profession thus far to respond to this public health emergency and presents a roadmap of recommendations for navigating those challenges into the future and offers ideas about how to sustain quality TBH practice.
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Cortis N, Smyth C, valentine K, Breckenridge J, Cullen P. Adapting Service Delivery during COVID-19: Experiences of Domestic Violence Practitioners. BRITISH JOURNAL OF SOCIAL WORK 2021; 51:1779-1798. [PMID: 34393655 PMCID: PMC8344860 DOI: 10.1093/bjsw/bcab105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 05/07/2023]
Abstract
COVID-19 rapidly altered patterns of domestic and family violence, increasing the complexity of women's needs, and presenting new barriers to service use. This article examines service responses in Australia, exploring practitioners' accounts of adapting service delivery models in the early months of the pandemic. Data from a qualitatively enriched online survey of practitioners (n = 100) show the ways services rapidly shifted to engage with clients via remote, technology-mediated modes, as physical distancing requirements triggered rapid expansion in the use of phone, email, video calls and messaging, and many face-to-face interventions temporarily ceased. Many practitioners and service managers found that remote service delivery improved accessibility and efficiency. Others expressed concerns about their capacity to assess risk without face-to-face contact, and were unsure whether new service modalities would meet the needs of all client groups and reflect best practice. Findings attest to practitioners' mixed experiences during this period of rapid service innovation and change, and underline the importance of monitoring emerging approaches to establish which service adaptations are effective for different groups of people, and to determine good practice for combining remote and face-to-face service options in the longer term.
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Affiliation(s)
- Natasha Cortis
- Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Correspondence to Associate Professor Natasha Cortis, Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia. E-mail:
| | - Ciara Smyth
- Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kylie valentine
- Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jan Breckenridge
- School of Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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Jones M, Howe AJ. Taking the therapeutic community outside in the COVID-19 pandemic. THERAPEUTIC COMMUNITIES 2021. [DOI: 10.1108/tc-12-2020-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The COVID-19 pandemic has affected psychotherapy practice. A common change is a move to online sessions over video calls. In their therapeutic community (TC) for those with personality disorders, the authors have used video calls but not all clients could work in this way. The authors decided to meet patients outside and walked with them while adhering to government guidelines. This study aims to present the authors’ experience with one client who was interviewed afterwards about the experience.
Design/methodology/approach
A total of 10 walking therapy sessions of 60-min duration were conducted with the patient. After the sessions, both the patient and therapist were interviewed about their experience. The resulting interviews with both patient and therapist were thematically analysed independently by both authors.
Findings
There were common themes to both the client and therapist’s account following thematic analysis. These were: modelling and normalising in the real world, replacing what COVID-19 had taken away from the TC experience, changes at home, therapist disclosure, outcomes and good endings and being outside of the clinical environment.
Research limitations/implications
The authors have presented a single case of the patient and therapist experience of outdoor therapy sessions in a TC context response to the COVID-19 pandemic. The findings are not generalisable and can only provide a suggestion at the positive potential for working in this way. The authors hope that the positive effects of outdoor therapy noted here may inspire other clinicians to consider similar novel approaches in their work.
Originality/value
This study describes a novel way that a TC has adapted to the COVID-19 pandemic.
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Puspitasari AJ, Heredia D, Gentry M, Sawchuk C, Theobald B, Moore W, Tiede M, Galardy C, Schak K, Clinic M. Rapid Adoption and Implementation of Telehealth Group Psychotherapy During COVID 19: Practical Strategies and Recommendations. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:492-506. [PMID: 34188434 PMCID: PMC8223010 DOI: 10.1016/j.cbpra.2021.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
Behavioral health services have been tasked with rapidly adopting and implementing teletherapy during the SARS-CoV-2/COVID-19 pandemic to assure patient and staff safety. Existing teletherapy guidelines were developed prior to the pandemic and do not capture the nuances of rapidly transitioning in-person individual and group-based treatments to a teletherapy format. In this paper, we describe our approach to quickly adapting to a teletherapy technology platform for an intensive outpatient program (IOP) guided by cognitive and behavioral modular principles for adults with serious mental illness. A review of existing guidelines was conducted and the staged approach for teletherapy implementation (Muir et al., 2020) was selected as the most appropriate model for our organizational context. We describe the most pertinent implementation strategies and report our preliminary findings detailing the feasibility of IOPs delivered via telehealth. This model of rapid teletherapy implementation offers practical clinical guidelines for administrators and clinicians seeking to transition traditional in-person behavioral health services to a teletherapy format.
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A Pilot Study Comparing Teletherapy with the Conventional Face-to-Face Therapy for Speech-Language Disorders. Indian J Otolaryngol Head Neck Surg 2021; 73:366-370. [PMID: 34075335 PMCID: PMC8160551 DOI: 10.1007/s12070-021-02647-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022] Open
Abstract
Abstract Speech-language therapists along with affected individuals face various challenges for accomplishing the rehabilitation services. In the current COVID19 pandemic scenario, telerehabilitation has emerged as a substitute to the traditional face-to-face therapy, and is the only option possible in some cases. To subjectively assess the feasibility & acceptability of telerehabilitation provided by speech-language pathologist to patients of speech and language disorders. This qualitative study includes 20 patients suffering from disorders of fluency, voice, swallowing and neurogenic disorders. The participants included were undergoing face-to-face therapy at our institute. After the completion of face-to-face session series, telerehabilitation services were provided through a video calling app. The outcomes of teletherapy were assessed subjectively using a structured questionnaire on 11 parameters using a Likert scale. Of the included 20 patients, after completion of teletherapy, four patients chose the physical interaction as the preferred mode of therapy while 16 chose teletherapy as the preferred mode. Except three clients who rated their overall satisfaction as ‘3’, others rated as ‘4’ or ‘5’.The therapists were satisfied with the outcomes in 17 cases, and were pleased with the overall progress of all the clients (rated 4 or 5). Telerehabilitation is a reliable method to deliver speech and language services at community level, on long-term basis, as is proven by the high satisfaction scores among the clients as well as the service providers. Clinical Trial Registration The trial has been registered in Clinical Trials Registry of India (CTRI) vide number CTRI/2018/04/ 012,922 (http://ctri.nic.in/Clinicaltrials/login.php) on 02/04/2018.
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