Pediatric behavioral telehealth in the age of COVID-19: Brief evidence review and practice considerations

Abstract

Considerable efforts over the last decade have been placed on harnessing technology to improve access to behavioral health services. These efforts have exponentially risen since the outbreak of the Coronavirus disease 2019 (COVID-19), which has prompted a move to novel systems of care, largely based on telehealth delivery. This article aims to provide a broad review of evidence for telehealth assessment and treatment of externalizing disorders and internalizing disorders in children and discuss practice considerations and established guidelines for telehealth delivery. Existing literature supports the promise of behavioral health interventions including behavioral parent training and combination approaches for externalizing disorders as well as cognitive-behavioral based interventions for internalizing disorders. There is a scarcity of work on assessment via telehealth compared with the available treatment literature. While treatment may be most pressing given the COVID-19 circumstances to continue delivery of care, movement toward establishing evidence-based assessment via telehealth will be of increased importance. Lastly, practice guidelines have been set forth by national associations, professional societies, and supported by the development of national Telehealth Centers of Excellence. These guidelines and practice considerations are discussed within the context of COVID-19.

Community Mental Health Clinicians’ Perspectives on Telehealth During the COVID-19 Pandemic: Mixed Methods Study

“…Clinicians broadly reported that telehealth can be a good option for many clients in that it is convenient, generally acceptable, and may even provide surprising benefits such as increased creativity and collaboration, increased parental involvement, and an ability for clinicians to gain a more intimate understanding of their clients’ home environment (ie, more ecological validity), which can provide clinically important information that would not otherwise be available. These benefits are supported by other studies [ 50 , 51 ], and provide promising implications regarding the potential for the longstanding use of telehealth for clients who prefer this modality. Positive views about telehealth are also reflected in our quantitative data, which show relatively favorable ratings of telehealth, especially when considering the quick pivot and lack of preparation.…”

Pediatric Telemedicine

“… 33 Other studies also found acceptable concordance with guideline-based care for the assessment and treatment of children with behavior health and externalizing disorders, including attention and disruptive behavior problems. 34 Importantly, telemedicine can also be used to facilitate COVID-19 screening, diagnosis, and monitoring from home. 35 …”

Mental health and wellbeing of children and adolescents during the covid-19 pandemic

“…The American Academy of Pediatrics,120 Philippine Pediatric Society,121 American Academy of Child and Adolescent Psychiatry,122 and the American Psychiatric Association123 recommend routine and crisis telemedicine and teleconsultation, and the International Paediatric Association124 currently recommends these during the pandemic. Telepsychiatry is widely used and effective125; however, access is inequitable,120124125126 and it may not be effective for many young children who require interactive play therapies.…”