Connection During COVID-19: Pilot Study of a Telehealth Group Parenting Intervention

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: COVID-19; Group; Mentalization; Parenting; Psychotherapy; Telehealth.

Figures

FIGURE 1.. Change in PHQ-9 scores from telehealth initiation to 20-week follow-up (N=10)a

a The solid line indicates a reliable decrease of at least 5.45 points in Patient Health Questionnaire–9 (PHQ-9) score at the 20-week follow-up. Each participant to the left of the line experienced a reliable decrease in depressive symptoms at follow-up. PHQ-9 scores range from 0 to 27, with higher scores indicating greater depression severity. Two participants reported pretreatment PHQ-9 scores of 7 and a change in score of −4 at the 20-week follow-up.

FIGURE 2.. Change in GAD-7 scores from telehealth initiation to 20-week follow-up (N=10)a

a The solid line indicates a reliable decrease of at least 4.47 points in Generalized Anxiety Disorder Scale–7 (GAD-7) score at the 20-week follow-up. Each participant to the left of the line experienced a reliable decrease in anxiety symptoms at follow-up. GAD-7 scores range from 0 to 21, with higher scores indicating greater anxiety severity.