Telepsychotherapy with children and families: Lessons gleaned from two decades of translational research.

Abstract

The novel coronavirus, COVID-19, has led to sweeping changes in psychological practice and the concomitant rapid uptake of telepsychotherapy. Although telepsychotherapy is new to many clinical psychologists, there is considerable research on telepsychotherapy treatments. Nearly two decades of clinical research on telepsychotherapy treatments with children with neurological conditions has the potential to inform emerging clinical practice in the age of COVID-19.Toward that end, we synthesized findings from 14 clinical trials of telepsychotherapy problemsolving and parent training interventions involving more than 800 children and families with diverse diagnoses including traumatic brain injury, epilepsy, brain tumors, congenital heart disease, and perinatal stroke. We summarize efficacy across studies and clinical populations and report feasibility and acceptability data from the perspectives of parents, children, and therapists.We describe adaptation for international contexts and strategies for troubleshooting technological challenges and working with families of varying socioeconomic strata. The extensive research literature reviewed and synthesized provides considerable support for the utility of telepsychotherapy with children with neurological conditions and their families and underscores its high level of acceptability with both diverse clinical populations and providers. During this period of heightened vulnerability and stress and reduced access to usual supports and services, telepsychotherapy approaches such as online family problem-solving treatment and online parenting skills training may allow psychologists to deliver traditional evidence-based treatments virtually while preserving fidelity and efficacy.

Transdiagnostic feasibility trial of internet-based parenting intervention to reduce child behavioural difficulties associated with congenital and neonatal neurodevelopmental risk: introducing I-InTERACT-North

“…Given the already virtual platform of the program, the onset of physical distancing measures that occurred within the last 2 months of the study did not disrupt adherence or completion. This study now adds to the decades of telepsychological intervention research that offer promise for the use of virtual modalities to address common outcomes following brain injury, and ultimately support positive outcomes for children and families (Wade et al, 2020). The COVID-19 pandemic also offers an important reminder of the variety of clinical and rehabilitative roles neuropsychologists may offer.…”

“…Increasingly, clinicians are using technology-assisted clinical modalities, including psychotherapy, to increase accessibility by addressing commonly reported barriers to receiving services (e.g., Wade et al, 2009;Wade et al, 2020). Psychotherapeutic parenting interventions, including PCIT, are effective when translated to telepsychotherapy modalities (e.g., Comer et al, 2017;Wade et al, 2017).…”

Terapia On-line com Casais e Famílias: Prática e Formação na Pandemia de Covid-19

“…A pandemia também acarretou mudanças importantes na forma como psicólogos e outros profissionais da saúde mental prestam atendimento a seus clientes e interagem com colegas, exigindo a rápida transição da modalidade presencial para a modalidade remota, em muitos casos (Gritti, 2020;Matheson, Bohon, & Lock, 2020;Wade et al, 2020). Em atenção a essa demanda emergente, no Brasil, o Conselho Federal de Psicologia (CFP) regulamentou a expansão dos serviços psicológicos prestados por meio das tecnologias da informação e da comunicação (TICs) durante a pandemia (Conselho Federal de Psicologia, 2020a).…”

“…Não obstante, questões complexas sobre atendimentos remotos têm sido levantadas, sobretudo por terapeutas de casal e família, os quais, até então, vinham realizando seu trabalho quase exclusivamente na modalidade presencial (Lebow, 2020;Pickens, Morris, & Johnson, 2020). Essas questões incluem aspectos técnicos e éticos, com destaque a como engajar os membros da família via videoconferência, evitar distrações no ambiente doméstico, adaptar intervenções que envolvam crianças pequenas e garantir a privacidade dos membros da família que estão em atendimento frente àqueles que não estão (Lebow, 2020;Wade et al, 2020).…”

“…Nesse contexto, terapeutas de casal e família têm referido preocupações quanto à relação terapêutica, à efetividade dos atendimentos remotos bem como aos recursos mais apropriados e seguros para realizá-los (Lebow, 2020;Wade et al, 2020). As fragilidades na formação em terapia on-line com casais e famílias se associam também a dúvidas quanto a indicações e contraindicações dessa modalidade, inclusive entre profissionais com experiência em terapia on-line individual (Wrape & McGinn, 2019).…”