The Therapist-assisted Online Parenting Strategies (TOPS) program for parents of adolescents with clinical anxiety or depression: Development and feasibility pilot

Abstract

ObjectiveTo develop a Therapist-assisted Online Parenting Strategies (TOPS) program that is acceptable to parents whose adolescents have anxiety and/or depressive disorders, using a consumer consultation approach.MethodsThe TOPS intervention was developed via three linked studies. Study 1 involved content analysis of feedback from participants (N = 56) who received a web-based preventive parenting intervention called Partners in Parenting (PiP), as part of a randomised controlled trial. Study 2 involved stakeholder consultations with: (i) parents of adolescents aged 12–17 years (N = 6), and (ii) mental health professionals (N = 28), to identify adaptations to PiP that are required to make it appropriate for parents of adolescents with anxiety and depressive disorders. Study 3 was a pilot of the resulting TOPS program with professionals (N = 10) and a small sample of parents (N = 3) to assess the acceptability of the program content and format that involved online modules and videoconferencing coaching.ResultsStudy 1 indicated a need for an enhanced program for parents whose adolescents are experiencing anxiety and depressive disorders, while findings from Study 2 informed the content of the new TOPS program. In Study 3, mental health professionals endorsed the structure and content, while parents affirmed the acceptability of the TOPS program. Feedback from Studies 2 and 3 indicated that the therapist-coach was a valuable resource to (i) provide parents with strategies that are associated with the alleviation of adolescent anxiety and depression, (ii) discuss difficulties in implementing these strategies, (iii) assist parents with overcoming these difficulties; and (iv) support the development of a relapse prevention plan. Professionals felt that the TOPS program would broaden parental knowledge about how to recognise and respond to symptoms of clinical anxiety and depression in their adolescent.ConclusionsThis study provided preliminary support for the feasibility, acceptability and perceived usefulness of the TOPS program.

A Systematic Review on TeleMental Health in Youth Mental Health: Focus on Anxiety, Depression and Obsessive-Compulsive Disorder

“…with TMH). Overall, most of studies here retrieved demonstrated the superiority of TMH interventions over the placebo or a comparable efficacy of TMH intervention to face-to-face modality with regards to studies on youth anxiety [ 29 , 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] depression [ 9 , 21 , 38 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 83 , 84 , 85 , 86 ] or OCD [ 70 , 71 , 73 , 74 , 75 , 76 , 77 , 87 ]. Comput...…”

“…Furthermore, parent-focused Internet-delivered CBT appear to be as well effective as an early intervention in treating preschool-age children with anxiety disorders in a modified version of the BRAVE-ONLINE program [ 31 ]. Studies including mixed samples (i.e., individuals with anxiety and depressive symptomatology) similarly reported improvements in both clinical dimensions [ 37 , 40 , 41 , 42 , 43 , 46 , 83 ]. Moreover, both computer-based and therapist-delivered online psychotherapy (i.e., cognitive behaviour therapy, CBT) for youth depression have been demonstrated to be effective, cost-effective and very comparable with face-to-face treatment [ 49 , 50 , 51 , 84 , 85 , 86 ].…”

“…Thirdly, few studies own a large sample size, mainly being carried out on small sample sizes, with mixed samples (i.e., anxious and depressive individuals, some including both parents/caregivers and patients). Finally, some studies are only pilot study or evaluated the feasibility and acceptability of computer-assisted or internet-based CBT or TMH interventions, without reporting completed findings [ 29 , 46 , 69 , 77 ].Therefore, further studies should include longer term follow-up (in order to assess the effectiveness in naturalistic settings); larger sample sizes to examine mediators and moderators of outcomes following TMH interventions in youngsters affected with anxiety disorders, major depressive disorder or OCD; provide complementary parent self-report measures (in order to compare and integrate findings coming from self-report assessments provided by young people) and clinician-based assessments during each TMH session. Moreover, further studies should investigate and define specific standardized, age- and young-tailored Internet-delivered protocols address to youth anxiety disorders (i.e., social anxiety, generalized anxiety disorder, separation anxiety disorder, phobias, etc.…”

“…with TMH). Overall, most of studies here retrieved demonstrated the superiority of TMH interventions over the placebo or a comparable efficacy of TMH intervention to face-to-face modality with regards to studies on youth anxiety [29][30][31][32][33][34][36][37][38][39][40][41][42][43][44][45] depression [9,21,38,46,[83][84][85][86] or OCD [70,71,[73][74][75][76][77]87]. Computer-assisted CBT approaches have been proposed as a complementary or alternative modes of treatment delivery aimed at increasing access to therapy for many mental health problems, including youth anxiety disorders [29][30][31][32][33][34][36][37][38][39][40][41][42][43][44]…”

“…An online, randomized, non-inferiority design, synchronous VC to in-person counselling using solution-focused brief therapy in a sample of college students who were seeking help for mild-to-moderate anxiety, showed significant changes in Beck Anxiety Inventory scale and in social anxiety levels in both interventions without any significant differences in effectiveness of the two delivery methods [ 45 ]. A feasibility pilot study of a therapist-assisted online parenting strategies (TOPS) program addressed to parents whose adolescents (aged 12–17 years) are affected with anxiety and/or depressive disorders reported an overly acceptability and perceived usefulness of a web-based program which also involves parents/caregivers of affected adolescents [ 46 ].…”