School of Social Work, Rutgers, The State University of New Jersey, 390 George Street, Room 713, New Brunswick, NJ, 08901, USA.
Adm Policy Ment Health. 2024 Jan;51(1):17-34. doi: 10.1007/s10488-023-01300-y. Epub 2023 Sep 29.
The COVID-19 pandemic resulted in increased parenting stress and substance use. At the same time that mental health and social service needs increased, access to services, including among those receiving treatment, decreased due to stay-at-home orders. Few programs were equipped or prepared to translate their interventions to a virtual format at the start of the pandemic. There is a critical need to identify effective adaptations to substance use and family-focused treatment during the COVID-19 pandemic. Effective program adaptations have continued relevance for the expansion of access to family-focused addiction services beyond the pandemic itself, particularly for rural or other hard to reach populations. Seventy-three semi-structured interviews were conducted with the five agencies participating in the implementation of the In-Home Recovery Program (IHRP), an in-home, substance use disorder (SUD) treatment program. Using a rapid analysis approach two coders analyzed interviews for recurring concepts and themes. Facilitators for adapting services included: (1) the introduction of virtual toxicology screens, (2) helping parents access technology, (3) assisting parents with non-identified children to decrease their stress, and (4) anticipating reoccurrences of substances during the pandemic. Barriers to adapting services included: (1) engaging young children in virtual treatment, (2) privacy, and (3) engaging in telehealth with parents experiencing domestic violence or reoccurrence of substances. Findings reveal virtual substance use treatment is possible. Facilitators to adaptation such as providing access to technology and virtual toxicology screens demonstrate the feasibility and acceptability of utilizing telehealth interventions for substance use. Barriers to adaptations were primarily related to the infant mental health component. Telehealth is likely not appropriate for children below the age of five. Individual sessions focusing on caregiving, rather than dyadic treatment may be more suitable to virtual formats.
新冠疫情导致父母的压力和物质滥用增加。与此同时，心理健康和社会服务需求增加，但由于居家令的实施，包括接受治疗的人群在内，获得服务的机会减少。在疫情开始时，很少有项目能够或准备好将其干预措施转化为虚拟形式。因此，迫切需要确定在新冠疫情期间对物质使用和以家庭为中心的治疗进行有效的调整。有效的项目调整对于扩大家庭为中心的成瘾服务的获取途径具有持续的重要意义，尤其是对于农村或其他难以接触到的人群。对参与实施家庭康复计划（IHRP）的五个机构的 73 名工作人员进行了半结构化访谈，该计划是一个家庭内的物质使用障碍（SUD）治疗计划。使用快速分析方法，两位编码员对访谈进行了反复出现的概念和主题分析。适应服务的促进因素包括：（1）引入虚拟毒理学筛查，（2）帮助父母获得技术，（3）协助父母照顾未被识别的孩子以减轻他们的压力，以及（4）在疫情期间预测物质的再次出现。适应服务的障碍包括：（1）让幼儿参与虚拟治疗，（2）隐私问题，以及（3）与经历家庭暴力或物质再次出现的父母进行远程医疗。研究结果表明，虚拟物质使用治疗是可行的。适应的促进因素，如提供获取技术和虚拟毒理学筛查的机会，展示了利用远程医疗干预措施治疗物质使用的可行性和可接受性。适应的障碍主要与婴儿心理健康部分有关。远程医疗可能不适合五岁以下的儿童。专注于护理而不是二元治疗的个别会议可能更适合虚拟形式。
