Feasibility and effectiveness of a telehealth service delivery model for treating childhood posttraumatic stress: A community-based, open pilot trial of trauma-focused cognitive–behavioral therapy.

Abstract

Telepsychotherapy (also referred to as telehealth or telemental health), the use of videoconferencing to deliver psychotherapy services, offers an innovative way to address significant gaps in access to care and is being used to deliver a variety of treatments for youth. Although recent research has supported the effectiveness of telehealth delivery of a variety of interventions for children, the literature has focused very little on childhood posttraumatic stress disorder. This pilot study examined the feasibility and potential effectiveness of trauma-focused cognitive-behavioral therapy (TF-CBT) delivered via telepsychotherapy in community-based locations of either schools or patient homes. Telepsychotherapy treatment was delivered to 70 traumaexposed youth in 7 underserved communities. Of these, 88.6% completed a full course of TF-CBT and 96.8% of these treatment completers no longer met diagnostic criteria for a trauma-related disorder at posttreatment. Results demonstrated clinically meaningful symptom change posttreatment, with large effect sizes evident for both youthand caregiver-reported reduction in posttraumatic stress disorder symptoms. The resultsEditor'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.

Pediatric behavioral telehealth in the age of COVID-19: Brief evidence review and practice considerations

“…2017 77 Case series- Comer et al. 2014 76 -Reductions in anxiety symptoms -comparable improvements in functional outcomes across groups Anxiety Family Based CBT 7–14 Multiple Baseline- Carpenter et al., 2018 78 -Significant proportion were treatment responders -maintained 3 month follow up PCIT CALM for Early Childhood Anxiety 4–8 Case Study- Cooper-Vince et al., 2016 87 -reduction in anxiety symptoms PTSD Trauma Focused CBT (TF-CBT) 7–16 Pilot open trial- Stewart et al., 2017 82 Large community open trial- Stewart et al., 2020 81 -Reduction in PTSD symptoms -feasibility in underserved communities Eating Disorders (Anorexia) Family Based Treatment (FBT) 13–18 Case Series- Anderson et al., 2017 90 -Increases in BMI -decreased eating disorder symptoms Note. CBT = Cognitive Behavioral Therapy, OCD = Obsessive Compulsive Disorder, PTSD = Post-Traumatic Stress Disorder, BMI = Body Mass Index, RCT = randomized controlled trial.…”

“… 80 One large community based open trial of 70 trauma-exposed children demonstrated reduction in PTSD symptoms after receiving telehealth delivered TF-CBT. 81 Telehealth delivered TF-CBT is also supported by smaller open trails 82 and case series documenting its efficacy with Hispanic/Latinx youth. 83…”

Needs, gaps and opportunities for standard and e-mental health care among at-risk populations in the Asia Pacific in the context of COVID-19: a rapid scoping review

“…Children and youth were the third most highly-represented priority population identified in the literature (see Table 3 ). Primary research studies indicate that children and youth are already at high risk of poor mental health, with COVID-19 expected to worsen this risk [ 116 ]. In a cross-sectional survey of n = 3613 youth from 20 provinces in China, depression rates of 22.28% were found during the pandemic, compared with pre-pandemic rates of 13.2% [ 47 ].…”

Pediatric Mental Healthcare Providers’ Perceptions of the Delivery of Partial Hospitalization and Outpatient Services via Telehealth during the COVID-19 Pandemic

“…The relatively lower rates of provider satisfaction and more mixed perceptions of telehealth delivery in our study may not only reflect the inclusion of PHPs, but also the rapid transition to telehealth among all providers necessitated by the COVID-19 pandemic. This rapid transition precluded the types of comprehensive preparation and training that have often preceded the delivery of telehealth interventions reported in other studies, such as training in the use of telehealth platforms and detailed protocols or interactive treatment activities designed specifically for virtual delivery (e.g., Myers et al, 2015;Stewart et al, 2020). While providers in both the outpatient clinic and PHPs received brief trainings in telehealth documentation and billing, they received very little support in how to effectively translate interventions designed for in-person delivery to a telehealth platform in an engaging manner.…”