Exploring the Efficacy of Telehealth for Family Therapy Through Systematic, Meta-analytic, and Qualitative Evidence

McLean, Siân A.; Booth, Anna; Schnabel, Alexandra; Wright, Bradley J.; Painter, Felicity; McIntosh, Jennifer

doi:10.1007/s10567-020-00340-2

Cited by 45 publications

(37 citation statements)

References 49 publications

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“…Our findings demonstrate slightly higher effectiveness for improving parent mental health than other meta-analyses of online parenting and telehealth family therapy interventions, which reported small to moderate effect sizes, with Hedge's g ranging from − 0.29 to − 0.31 (McLean et al, 2021;Spencer et al, 2020;Thongseiratch et al, 2020). Prior meta-analyses focused exclusively on parenting or family health interventions with children ranging from 0 to over 18 years old, whereas the current investigation included a broad range of programs and focused on mental health outcomes among parents of young children.…”

Section: Discussioncontrasting

confidence: 62%

“…However, the use of eHealth is a relatively new area in family care. To date there have been only a few eHealth-related meta-analyses, including four looking at online or technology-assisted parenting programs (Florean et al, 2020 ; Harris et al, 2020 ; Spencer et al, 2020 ; Thongseiratch et al, 2020 ) and one of telehealth family therapy programs (McLean et al, 2021 ), all with parent mental health as secondary outcomes. Some recent meta-analyses have also examined eHealth interventions for postpartum mental health (Feng et al, 2021 ; Zhao et al, 2021 ; Zhou et al, 2020 ), which represents a distinct period with unique challenges and care provisions where treatment needs and content would differ from that after infancy.…”

Section: Introductionmentioning

confidence: 99%

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Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

MacKinnon

Silang

Penner

et al. 2022

Clin Child Fam Psychol Rev

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Parent stress and mental health problems negatively impact early child development. This study aimed to systematically review and meta-analyze the effect of eHealth interventions on parent stress and mental health outcomes, and identify family- and program-level factors that may moderate treatment effects. A search of PsycINFO, Medline, CINAHL, Cochrane and Embase databases was conducted from their inception dates to July 2020. English-language controlled and open trials were included if they reported: (a) administration of an eHealth intervention, and (b) stress or mental health outcomes such as self-report or clinical diagnosis of anxiety and depression, among (c) parents of children who were aged 1–5 years old. Non-human studies, case reports, reviews, editorials, letters, dissertations, and books were excluded. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Random-effects meta-analyses of standardized mean differences (SMD) were conducted and meta-regressions tested potential moderators. 38 studies were included ( N = 4360 parents), from 13 countries (47.4% USA). Meta-analyses indicated eHealth interventions were associated with better self-reported mental health among parents (overall SMD = .368, 95% CI 0.228, 0.509), regardless of study design ( k = 30 controlled, k = 8 pre-post) and across most outcomes ( k = 17 anxiety, k = 19 depression, k = 12 parenting stress), with small to medium effect sizes. No significant family- or program-level moderators emerged. Despite different types and targets, eHealth interventions offer a promising and accessible option to promote mental health among parents of young children. Further research is needed on moderators and the long-term outcomes of eHealth interventions. Prospero Registration: CRD42020190719. Supplementary Information The online version contains supplementary material available at 10.1007/s10567-022-00385-5.

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Section: Discussioncontrasting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

MacKinnon

Silang

Penner

et al. 2022

Clin Child Fam Psychol Rev

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“…Other concerned individuals noted that a lack of privacy meant that they could not fully embrace the therapeutic relationship and thus did not expect telehealth to be effective. However, a meta-analysis of telehealth efficacy has reported that online telehealth options were equivalent to in-person interventions, indicating that these concerns may be related to anxiety around change rather than an actual failure [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

Understanding the conversation around COVID-19 and eating disorders: A thematic analysis of Reddit

2022

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Background Current research has found dramatic changes in the lives of those with eating disorders (EDs) during the COVID-19 pandemic. We build on existing research to investigate the long-term effects and adaptations that people with EDs have faced due to COVID-19 related changes. Method We collected 234 posts from three separate time periods from the subreddit r/EatingDisorders and analyzed them using thematic analysis. The posts were examined for initial patterns, and then those concepts were grouped into themes to reveal the authentic experiences of people living with EDs during the COVID-19 pandemic. Results Initially, we found “lack of control” and “familial influences (loved ones seeking support)” emerge as themes within our broader data set throughout all three timeframes. There were additional themes that were present in only one or two of the collection periods. These themes consisted of “symptom stress,” “technical stresses and concerns,” and “silver linings.” Conclusions Our analysis shows that people with EDs have fought significantly during the pandemic. Initially, the (lack of) control and routine in their lives has caused symptoms to become more challenging, while being forced to move back home also caused significant stress. However, concerns transformed as the pandemic progressed, resulting in new pressures causing people to exhibit novel ED symptoms or relapse altogether. Also notable is the relatively few COVID-specific posts as the pandemic progressed, suggesting that people have accepted COVID as their “new normal” and begun to build resilience to the challenges associated. These are vital factors for clinicians to consider as they begin taking existing and new patients, particularly as face-to-face treatment options become a possibility again. Plain English Summary Existing research shows that the COVID-19 pandemic has transformed the lives of people who live with eating disorders in various ways. First, the pandemic has placed barriers on the path to recovery by limiting coping mechanism (and sometimes removing them altogether) and changing their relationships with food and the people in their lives. Second, the pandemic has forced treatment options to change since ED patients can no longer seek treatment face-to-face. Finally, there have been unexpected benefits to the pandemic, such as allowing individuals time to slow down and focus on their mental health. Previous studies examined individuals in clinical contexts rather than in their natural environments. We explored an online forum for people with eating disorders for the various themes that were discussed at three points over the period of March 2020-December 2020 and found that many people with EDs report worsening symptoms or relapse. However, we also noted that, compared to the beginning of the pandemic, people seemed to be less frequently asking for support during the third data collection period, implying an adaptation to the “new normal” of life in a pandemic. We conclude with a discussion of the findings.

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“…TH has been used in a limited capacity in GI and pediatric medicine (Bestsennyy et al, 2020;Kriem & Rahhal, 2020;Sisk et al, 2020;Wosik et al, 2020). Prior to the pandemic, TH was commonly used in treatment of pediatric mental health issues, obesity, sleep problems, and chronic pain (Cunningham et al, 2021;McLean et al, 2021;Myers & Comer, 2016). It had also been used sporadically as an intervention to support families of children transitioning home following hospital discharge, including those with GI-related problems (Dick et al, 2004;Raphael et al, 2019).…”

Section: Available Knowledgementioning

confidence: 99%

Determining factors that influence parents' perceptions of telehealth provided in a pediatric gastroenterological practice: A quality improvement project

Dempsey

Serino-Cipoletta

Marinaccio

et al. 2022

Journal of Pediatric Nursing

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Exploring the Efficacy of Telehealth for Family Therapy Through Systematic, Meta-analytic, and Qualitative Evidence

Cited by 45 publications

References 49 publications

Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

Understanding the conversation around COVID-19 and eating disorders: A thematic analysis of Reddit

Determining factors that influence parents' perceptions of telehealth provided in a pediatric gastroenterological practice: A quality improvement project

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