Virtual Online Home-Based Treatment During the COVID-19 Pandemic for Ultra-Orthodox Young Women With Eating Disorders

Latzer, Yael; Herman, Esther; Ashkenazi, Rahel; Atias, Orna; Laufer, Sofia; Ovadia, Ateret Biran; Oppenheim, Tova; Shimoni, Meirv; Uziel, Moria; Stein, Daniel

doi:10.3389/fpsyt.2021.654589

Cited by 12 publications

(11 citation statements)

References 56 publications

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Section: Discussionsupporting

confidence: 83%

“…Considering additional familial views, a recent case study [ 26 ] involving three young women with eating disorders who received a virtual, home-based treatment model of care found perceptions of virtual treatment similar to our study. For example, some patients and families found the online intervention acceptable and assisted in improving their behaviours, but others noted several challenges that acted as barriers to effectiveness, such as feeling anxious and uncomfortable disclosing sensitive information online [ 26 ]. More generally, systematic review results related to patient views of virtual mental health care indicate patient satisfaction with psychotherapeutic interventions and therapeutic alliance that is comparable to in-person delivery [ 27 ]; however this review does not contain findings from the COVID-19 era, which might also have influenced some experiences with virtual care during our study.…”

Section: Discussionsupporting

confidence: 83%

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A qualitative evaluation of team and family perceptions of family-based treatment delivered by videoconferencing (FBT-V) for adolescent Anorexia Nervosa during the COVID-19 pandemic

et al. 2022

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Background During the COVID-19 pandemic, outpatient eating disorder care, including Family-Based Treatment (FBT), rapidly transitioned from in-person to virtual delivery in many programs. This paper reports on the experiences of teams and families with FBT delivered by videoconferencing (FBT-V) who were part of a larger implementation study. Methods Four pediatric eating disorder programs in Ontario, Canada, including their therapists (n = 8), medical practitioners (n = 4), administrators (n = 6), and families (n = 5), participated in our study. We provided FBT-V training and delivered clinical consultation. Therapists recorded and submitted their first four FBT-V sessions. Focus groups were conducted with teams and families at each site after the first four FBT-V sessions. Focus group transcripts were transcribed verbatim and key concepts were identified through line-by-line reading and categorizing of the text. All transcripts were double-coded. Focus group data were analyzed using directed and summative qualitative content analysis. Results Analysis of focus group data from teams and families revealed four overarching categories—pros of FBT-V, cons of FBT-V, FBT-V process, and suggestions for enhancing and improving FBT-V. Pros included being able to treat more patients and developing a better understanding of family dynamics by being virtually invited into the family’s home (identified by teams), as well as convenience and comfort (identified by families). Both teams and families recognized technical difficulties as a potential con of FBT-V, yet teams also commented on distractions in family homes as a con, while families expressed difficulties in developing therapeutic rapport. Regarding FBT-V process, teams and families discussed the importance and challenge of patient weighing at home. In terms of suggestions for improvement, teams proposed assessing a family’s suitability or motivation for FBT-V to ensure it would be appropriate, while families strongly suggested implementing hybrid models of FBT in the future which would include some in-person and some virtual sessions. Conclusion Team and family perceptions of FBT-V were generally positive, indicating acceptability and feasibility of this treatment. Suggestions for improved FBT-V practices were made by both groups, and require future investigation, such as examining hybrid models of FBT that involve in-person and virtual elements. Trial registration ClinicalTrials.gov NCT04678843.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%

A qualitative evaluation of team and family perceptions of family-based treatment delivered by videoconferencing (FBT-V) for adolescent Anorexia Nervosa during the COVID-19 pandemic

et al. 2022

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“…The Maudsley Centre for Child and Adolescent Eating Disorders, which transitioned to online treatment delivery during COVID-19, found that parents ( n = 19) generally felt more comfortable than young people ( n = 14) in online groups and they tended to feel more positive about the online format overall [ 51 ]. In Israel, home-based online treatment during the pandemic brought mixed experiences, including patients’ reluctance to take part, a lack of access to technological devices, the impact of family and religious circumstances, whilst conversely, the virtual option was more positive for some patients and their parents [ 52 ].…”

Section: Resultsmentioning

confidence: 99%

Review of Ireland’s First Year of the COVID-19 Pandemic Impact on People Affected by Eating Disorders: ‘Behind Every Screen There Was a Family Supporting a Person with an Eating Disorder’

Parsons

Murphy

Malone

et al. 2021

JCM

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Irish society went into one of the most stringent lockdowns in March 2020 due to the COVID-19 pandemic, and barring a few weeks, remains highly restricted at time of writing. This has produced a wide range of challenges for those affected by eating disorders, as well as treatment services and Bodywhys, The Eating Disorders Association of Ireland. Current research indicates that COVID-19 has impacted across three key areas—the experience of those with an eating disorder, the experience of service provision, and the impact on the family situation. Drawing on monitoring and evaluation data gathered by Bodywhys, this paper details the challenges faced by those affected by eating disorders in Ireland and how the organisation responded to these challenges, providing support in various forms to people with eating disorders and their families.

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“…The study's participants with eating disorders reported the opposite: they reported greater comfort and perceived efficiency of remote therapeutic services. Since the start of the COVID-19 pandemic, a number of studies have explored the initial effects of widespread moves to telehealth for patients with eating disorders and have shown mixed results [46][47][48][49][50]. Treatment modalities on line can lead to greater disinhibition and openness among avoidant personalities [51,52] because of their greater sense of safety.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the rapid implementation of telehealth during the COVID-19 pandemic: a qualitative study among adolescents and their parents

Carretier

Bastide²,

Lachal

et al. 2022

Eur Child Adolesc Psychiatry

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The Coronavirus Disease 2019 (COVID-19) pandemic catalysed an abrupt explosion in the use telepsychiatry for the delivery of mental health services. We aimed to explore the experience of telemedicine use during this period among adolescent outpatients and inpatients and their parents. This qualitative study took place in a French adolescent medicine and psychiatry department during the first lockdown. Data collection by purposive sampling continued until we reached theoretical sufficiency. The interviews were analysed by applying Interpretative Phenomenological Analysis which is based on an iterative, inductive process. It included 20 participants: 10 adolescents and 10 parents. The analysis showed three themes:(1) facilitators of a switch from face-to-face to tele-consultation: (a) the context of health emergency, (b) the integration of parents in the treatment, (c) the choice between telephone or video consultation; (2) distance from the therapist's gaze and its consequences: (a) an obstacle to decrypting clinical nonverbal communication, (b) effectiveness depends on the severity of the adolescent's symptoms, (c) and on the previous quality of the therapeutic relationship; (3) awareness of the value of the face-to-face therapeutic space. In the post-COVID era, practitioners would benefit from combining both approaches, face-to-face and remote, based on the quality of the therapeutic alliance, the pathology, the parents' availability for in-person participation, and the patient's age. Future quantitative research will also be necessary to establish the extent to which the experiences described by the participants in this study reflect those of a broader population.

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Virtual Online Home-Based Treatment During the COVID-19 Pandemic for Ultra-Orthodox Young Women With Eating Disorders

Cited by 12 publications

References 56 publications

A qualitative evaluation of team and family perceptions of family-based treatment delivered by videoconferencing (FBT-V) for adolescent Anorexia Nervosa during the COVID-19 pandemic

A qualitative evaluation of team and family perceptions of family-based treatment delivered by videoconferencing (FBT-V) for adolescent Anorexia Nervosa during the COVID-19 pandemic

Review of Ireland’s First Year of the COVID-19 Pandemic Impact on People Affected by Eating Disorders: ‘Behind Every Screen There Was a Family Supporting a Person with an Eating Disorder’

Evaluation of the rapid implementation of telehealth during the COVID-19 pandemic: a qualitative study among adolescents and their parents

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