Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay).
Am J Psychother. 2022 Jun 15;75(2):67-74. doi: 10.1176/appi.psychotherapy.20210005. Epub 2021 Sep 16.
The COVID-19 pandemic has resulted in considerable stress for families, placing parents at risk for heightened psychological distress, while prompting widespread changes in mental health service delivery. This study evaluated treatment engagement, acceptability, and psychiatric distress among participants in the telehealth adaptation of the Connecting and Reflecting Experience (CARE) program after the onset of COVID-19.
CARE is a transdiagnostic, bigenerational, mentalizing-focused group parenting intervention based out of an outpatient child mental health clinic in an underserved urban community. Individuals participating in CARE during the clinic's transition to telehealth services were recruited for participation in this pre-post design pilot study. Participants (N=12) completed self-report surveys before and after their first telehealth group session and at their 20-week follow-up. Quantitative and qualitative measures were used to evaluate psychiatric symptoms, treatment engagement, and preliminary acceptability of the adaptation.
Self-reported mood and anxiety symptoms decreased significantly after 20 weeks of telehealth therapy. Participants reported high levels of therapeutic alliance and group cohesion in the telehealth format. Results also showed minimal participant-reported privacy concerns and a trend toward increased treatment engagement.
These findings have implications regarding the acceptability of teletherapy interventions for caregivers of children during this period of heightened vulnerability and limited access to social support and health services. They also are relevant to establishing the preliminary acceptability of mentalizing-focused parenting inventions delivered via telehealth.
新冠疫情大流行给家庭带来了巨大压力，使父母面临心理困扰加剧的风险，同时也促使精神卫生服务的广泛变革。本研究评估了新冠疫情爆发后，接受基于心理教育的连接和反思经验（CARE）项目的远程医疗调整的参与者的治疗参与度、可接受性和精神困扰。
CARE 是一种基于门诊儿童心理健康诊所的跨诊断、两代人、重视心理化的群体养育干预措施，在服务不足的城市社区中实施。在诊所向远程医疗服务过渡期间，参与 CARE 的个人被招募参加本预-后设计的试点研究。参与者（N=12）在参加第一次远程医疗团体会议之前和之后以及在第 20 周随访时完成了自我报告的问卷调查。使用定量和定性措施来评估精神病症状、治疗参与度和适应的初步可接受性。
远程医疗治疗 20 周后，自我报告的情绪和焦虑症状显著下降。参与者报告在远程医疗模式下有高度的治疗联盟和团体凝聚力。结果还显示参与者报告的隐私问题很少，治疗参与度呈上升趋势。
这些发现对在这个脆弱时期和获得社会支持和卫生服务有限的情况下，远程治疗干预措施对儿童照顾者的可接受性有影响。它们还与通过远程医疗提供的以心理教育为重点的养育发明的初步可接受性相关。
