Changes in daily life created by the novel coronavirus (COVID-19) pandemic have resulted in a largely unprecedented situation for millions of families worldwide. Families are under considerable stress, and parents may experience greater psychological distress and disruptions in the parent-child relationship. Some parents may be particularly vulnerable to recent stressors, including those with preexisting psychological disorders and family dysfunction. In the United States, military veterans are one such at-risk population. Recent challenges may exacerbate preexisting conditions and heighten parenting stress, thereby negatively impacting child and family functioning. In this article, we share our experiences developing and piloting a telepsychotherapy parenting skills program for military veterans. The intervention, Online Parenting Pro-Tips (OPPT), combined web-based educational modules addressing child development and positive parenting with live coaching (via videoconferencing link) of parenting skills. Forty-one veterans with a child between the ages of 3 and 9 years enrolled in this trial and 22 completed the 6-session intervention. Veterans who completed the intervention experienced significant reductions in depression, parenting stress, and family dysfunction, with medium to large effect sizes (Cohen's d ranged from .53 to .98). Veterans also reported significant improvements in their child's behaviors. These findings have important implications pertaining to the feasibility and Editor's Note. This article received rapid review due to the time-sensitive nature of the content, but our standard high-quality peer review process was upheld.
BackgroundWe report findings from an intervention study using telehealth modalities to determine whether provision of telehealth services can improve access to care and increase adherence to cognitive therapy in veterans with mild traumatic brain injury (TBI) while matching traditional care in terms of outcomes.Material/MethodsVeterans who were initially non-adherent to clinic-based cognitive therapy were offered a newly developed treatment. The control participants were selected from patient records of veterans who had completed cognitive treatment and matched to MOPS-VI participants on the basis of age, marital or relationship status, and composite memory index score. Baseline and post-treatment cognitive functioning as assessed by the Test of Memory and Learning 2nd Edition (TOMAL-2) was obtained for all participants. The MOPS-VI modules were designed to increase understanding of TBI and elicit problem-solving skills for attention and memory impairment.ResultsSixty-seven percent of veterans (who were assigned to the MOPS-VI treatment group because they were initially non-adherent with the clinic-based treatment) completed the MOPS-VI telemedicine treatment. Results of a two-way analysis of Variance (ANOVA) comparing baseline and follow-up scores on the TOMAL-2 in the MOPS-VI and control groups revealed there was a significant pre-post assessment effect, indicating that participant’s memory and learning improved after treatment for both MOPS-VI and standard treatment groups. There was no significant difference between clinic-based treatment and MOPS-VI therapy.ConclusionsPreliminary evidence supports the efficacy of the treatment, defined as increased compliance in completing the treatment program, and improvements in standardized memory and learning test results comparable to those following clinic-based treatment.
Mark Ylvisaker paved the cognitive rehabilitation pathway for generations to follow. Many of us who have come after are driving the avenues he worked so hard to create. His work was seminal in the fact that he blended disciplines, seamlessly creating a multidisciplinary approach to treatment. Incorporating ideas founded in psychology into standard speech therapy had not been successfully implemented prior to Dr. Ylvisaker. He brought credibility and recognition to the role a speech-language pathologist (SLP) must play in cognitive rehabilitation. This article highlights Dr. Ylvisaker's influence on the development of my programmatic research on the treatment of individuals with brain injury.
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