COVID-19 and the Acceleration of Behavioral Parent Training Telehealth: Current Status and Future Directions

Abstract

The SARS CO-V-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.

The impact of COVID-19 on child and adolescent mental health and treatment considerations

“…Clinics have primarily relied on telehealth approaches—using audio-only calling or videoconferencing to facilitate interactions between mental health providers and clients. Though existing data suggest that telehealth approaches can be efficacious in treating youth with externalizing disorders ( Sullivan et al, 2021 ), internalizing disorders ( Ros-DeMarize et al, 2021 ), and trauma-related disorders ( Racine et al, 2020 ), few studies to date have tested whether virtual treatment is as effective as in-person care among children ( Greenwood et al, 2022 ).…”

“Will it Work as Well on Zoom?” A Natural Experiment During the Covid-19 Pandemic of Delivering Parenting Groups Via Video Conferencing or in Person

“…First of all, several group leaders experienced that VC-delivery had an impact on reach of the parenting program, in the sense that a more diverse group of parents could participate. This is a common argument for the dissemination of digital interventions in general (Kazdin, 2019 ; Sullivan et al, 2021 ; Vigerland et al, 2016 ), and with the addition of VC to other digital delivery methods the reach could become even wider. On the other hand, the demographics of the included participants suggest that the reach of the digital offering may be narrower in regard to education and larger families, since the parents who choose to be part of ABC-VC on average had higher education, and parents in the on-site condition had more children than those in the VC condition.…”

“…During the Covid-19 pandemic, many services started to provide their regular parenting programs through video conferencing (VC), in lack of access to programs developed for digital or remote use. Despite the necessity for many services to transfer to VC tools during the pandemic (Sullivan et al, 2021 ), the evidence base for this type of remote delivery is rather limited. Only a couple studies with few participants have investigated the use of VC to deliver group-based parenting programs (Canário et al, 2021 ; Fogler et al, 2020 ; Reese et al, 2012 ; Reese et al, 2015 ; Xie et al, 2013 ).…”

“…In other words, it does not matter how effective an intervention is, if it does not reach the intended target group. Potential reach is of course one of the general benefits of digital delivery of interventions (Kazdin, 2019 : Sullivan et al, 2021 ; Vigerland et al, 2016 ). A prerequisite is however the second dimension of RE-AIM: efficacy .…”

“…A demand for other ways to organize parenting programs therefore arose, not the least since the pandemic and its consequences, such as parental stress, loneliness, job loss, and income instability, increased rates of child maltreatment and abuse (Lawson et al, 2020;Rodriguez et al, 2020). One solution to this problem was to offer group parenting programs through remote delivery, instead of on-site meetings (Sullivan et al, 2021).…”