Satisfaction with videoconference-delivered CBT provided as part of a blended treatment approach for children and adolescents with mental disorders and their families during the COVID-19 pandemic: A follow-up survey among caregivers and therapists
Restricted accessResearch articleFirst published online December, 2024
Satisfaction with videoconference-delivered CBT provided as part of a blended treatment approach for children and adolescents with mental disorders and their families during the COVID-19 pandemic: A follow-up survey among caregivers and therapists
Psychotherapy delivered via videoconferencing (teletherapy) was a well-accepted treatment option for children and adolescents during the early phases of the COVID-19 pandemic. Information on the long-term satisfaction with teletherapy in routine clinical practice is missing.
Methods
Caregivers (parents) and psychotherapists of n = 228 patients (4–20 years) treated in a university outpatient clinic completed a follow-up survey on satisfaction with videoconference-delivered cognitive-behavioral treatment (CBT). The follow-up survey (T2) was conducted about 1 year after initial assessment of treatment satisfaction in 2020 (T1).
Results
At follow up, therapists reported that 79% of families had received teletherapy as part of a blended treatment approach including in-person and videoconference delivery of CBT. Wilcoxon tests revealed that satisfaction with teletherapy was stable over time. In addition, parent ratings of the impact of teletherapy on treatment satisfaction and the therapeutic relationship did not change over time. Therapists’ ratings of the impact of teletherapy on the therapeutic relationship with the caregiver were more negative at T2 compared to T1. Satisfaction with teletherapy was higher for patients with less pandemic-related stress, less externalizing behavior problems, and older age (all r < .35).
Conclusion
The high level of satisfaction with teletherapy for children and adolescents treated in routine clinical practice reported in 2020 was maintained after social distancing regulations were eased in 2021. Teletherapy provided as part of a blended treatment approach is a well-accepted method of treatment delivery for youths with mental health problems. The study was registered in the German Clinical Trials Register (DRKS00028639).
DöpfnerMAdamJHabbelC, et al.; TEMPO-Studiengruppe, B-FAST-Studiengruppe. Die psychische Belastung von Kindern, Jugendlichen und ihren Familien während der COVID-19-Pandemie und der Zusammenhang mit emotionalen und Verhaltensauffälligkeiten. Bundesgesundheitsbl2021; 64: 1522–1532.
2.
Ravens-SiebererUKamanAErhartM, et al.Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adoles Psychiatry2021; 31: 879–889.
3.
PanchalUSalazar de PabloGFrancoM, et al.The impact of COVID-19 lockdown on child and adolescent mental health: systematic review. Eur Child Adoles Psychiatry. Epub ahead of print 2021. https://doi.org/10.1007/s00787-021-01856-w
4.
FernandezEWoldgabrealYDayA, et al.Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clin Psychol Psychotherapy2021; 28: 1535–1549.
5.
MatsumotoKHamataniSShimizuE. Effectiveness of videoconference-delivered cognitive behavioral therapy for adults with psychiatric disorders: Systematic and meta-analytic review. J Med Internet Res2021; 23: e31293.
6.
MazziottiRRutiglianoG. Tele-mental health for reaching out to patients in a time of pandemic: Provider survey and meta-analysis of patient satisfaction. JMIR Ment Health2021; 8: e26187.
7.
NorwoodCMoghaddamNGMalinsS,et al.Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clin Psychol Psychother2018; 25: 797–808.
8.
Aafjes-van DoornKBékésVProutTA. Grappling with our therapeutic relationship and professional self-doubt during COVID-19: Will we use video therapy again?Couns Psychol Q2021; 34: 473–484.
9.
Beck-HiestermannFMLKästnerDGumzA. Onlinepsychotherapie in Zeiten der Corona-Pandemie. Psychotherapeut2021; 66: 372–381.
10.
HoffnungGFeigenbaumESchechterA,et al.Children and telehealth in mental healthcare. What we have learned from COVID-10 and 40,000+ sessions. Psych Res Clin Pract2021; 3: 3. 2021.
11.
HopkinsLPedwellG. The COVID PIVOT – Re-orienting child and youth mental health care in the light of pandemic restrictions. Psychiatr Q2021; 92: 1259–1270.
12.
SibeoniJManoliosECosta-DrolonE, et al.Clinical practice during the COVID-19 pandemic: A qualitative study among child and adolescent psychiatrists across the world. Child Adoles Psychiat Ment Health2021; 15: 68.
13.
CunninghamNRElySLBarber GarciaBN,et al.Addressing pediatric mental health using telehealth during coronavirus disease-2019 and beyond: A narrative review. Acad Pediatr2021; 21: 1108–1117.
14.
PakyurekMYellowleesPMHiltyDM. The child and adolescent telepsychiatry consultation: Can it be a more effective clinical process for certain patients than conventional practice?Telemed J E-Health2010; 16: 289–292.
15.
American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Telepsychiatry and AACAP Committee on Quality Issues. Clinical update: Telepsychiatry with children and adolescents. J Amer Acad Child Adoles Psychiat2017; 56: 875–893.
16.
ComerJSFurrJMKernsCE, et al.Internet-delivered, family-based treatment for early-onset OCD: A pilot randomized trial. J Consulting Clin Psychol2017; 85: 178–186.
17.
HollmannKHohneckerCSHaigisA, et al.Internet-based cognitive behavioral therapy in children and adolescents with obsessive-compulsive disorder: A randomized controlled trial. Front Psychiat2022; 13: 989550.
18.
NelsonEBarnardMCainS. Treating childhood depression over videoconferencing. Telemed e-Health2003; 9: 49–55.
19.
HimleMBFreitagMWaltherM, et al.A randomized pilot trial comparing videoconference versus face-to-face delivery of behavior therapy for childhood tic disorders. Behav Res Ther2012; 50: 565–570.
20.
PratoAMaugeriNChiarottiF, et al.A randomized controlled trial comparing videoconference vs. face-to-face delivery of behavior therapy for youths with Tourette syndrome in the time of COVID-19. Front Psychiat2022; 24: 862422.
21.
TseYJMcCartyCAVander StoepA,et al.Teletherapy delivery of caregiver behavior training for children with attention-deficit hyperactivity disorder. Telemed e-Health2015; 21: 451–458.
22.
XieY, et al.A study on the effectiveness of videoconferencing on teaching parent training skills to parents of children with ADHD. Telemed e-Health2013; 19: 1–8.
23.
RickettsEJGoetzARCapriottiMR, et al.A randomized waitlist-controlled pilot trials of voice of internet protocol-delivered behavior therapy for youth with chronic tic disorders. J Telemed Telecare2016; 22: 153–162.
24.
BernheimDKellerFFegertJM,et al.Akzeptanz der Videotherapie an einer Ausbildungsambulanz für Verhaltenstherapie für Kinder und Jugendliche in Zeiten der Corona-Pandemie. Einschätzungen aus Patienten-, Sorgeberechtigten – und Therapeutensicht [Satisfaction with videoconferencing psychotheraoy in an out-patient clinic of children and adolescents during the corona pandemic]. Nervenheilkunde2021; 40: 341–347.
25.
PorterCGalloghlyEBurbachF. The effective delivery of digital CBT: A service evaluation exploring the outcomes of young people who completed video conferencing therapy in 2020. Cogn Behav Ther2022; 15: E27.
26.
Mekori-DomachevskyEMatalonNMayerY,et al.Internalizing symptoms impede adolescents’ ability to transition from in-person to online mental health services during the 2019 coronavirus disease pandemic. J Telemed Telecare. Epub ahead of print 2021. https://doi.org/10.1177/1357633X211021293
27.
MeiningerLAdamJvon WirthE, et al.Cognitive-behavioral teletherapy for children and adolescents with mental disorders and their families during COVID-19 pandemic: A survey on acceptance and satisfaction. Child Adoles Psychiat Mental Health2022; 16: 61.
28.
KhatibAGelkopfMKapolnikE,et al.The assessment of effectiveness by therapists of online therapy during the COVID-19 pandemic era in Israel. J Psychother Integr2022; 32: 83–94.
DöpfnerMGörtz-DortenA. Corona Belastungsbogen. Unveröffentlicht, Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters an der Uniklinik Köln; 2020.
31.
NikolaidisAPaksarianDAlexanderL, et al.The Coronavirus Health and Impact Survey (CRISIS) reveals reproducible correlates of pandemic-related mood states across the Atlantic. Sci Rep2021; 11: 8139.
32.
TreierAKHolasVGörtz-DortenA, et al.Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families. Eur Child Adolesc Psychiatry. Epub ahead of print 2022. https://doi.org/10.1007/s00787-022-02106-3
33.
DöpfnerMSteinhausenHC. Kinder-Diagnostik-System (KIDS), Band 3: Störungsübergreifende Verfahren zur Diagnostik psychischer Störungen. Göttingen: Hogrefe, 2012.
34.
ShafferDGouldMSBrasicJ, et al.A children's global assessment scale (CGAS). Archives Gen Psychiatr1983; 40: 1228–1231.
35.
DöpfnerMPlückJKinnenC. Manual deutsche Schulalter-Formen der Child Behavior Checklist von Thomas M. Achenbach. Elternfragebögen über das Verhalten von Kindern und Jugendlichen, (CBCL/6-18R), Lehrerfragebögen über das Verhalten von Kindern und Jugendlichen (TRF/6-18R), Fragebogen für Jugendliche (YSR/11-18R). Göttingen: Hogrefe. 2014.
BoyerLBaumstarck-BarrauKCanoN, et al.Assessment of psychiatric inpatient satisfaction: A systematic review of self-reported instruments. Eur Psychiat2009; 24: 540–549.
38.
KinnersleyPStottNPetersT, et al.A comparison of methods for measuring patient satisfaction with consultations in primary care. Fam Pract1996; 13: 41–51.
39.
CataldoFChangSMendozaA,et al.A perspective on client-psychologist relationships in videoconferencing psychotherapy: Literature review. JMIR Ment Health2021; 8: e19004.
40.
ViefhausPDöpfnerMDachsL, et al.Treatment satisfaction following routine outpatient cognitive-behavioral therapy of adolescents with mental disorders: A triple perspective of patients, parents and therapists. Eur Child Adolesc Psychiatry2019; 28: 543–556.
41.
ViefhausPDöpfnerMDachsL, et al.Parent- and therapist-rated treatment satisfaction following routine child cognitive-behavioral therapy. Eur Child Adolesc Psychiatry2021; 30: 427–439.
42.
Von WeinrichPKongQLiuY. Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care. J Telemed Telecare. Epub ahead of print 2022: 1–24.
43.
MigliettaEBelessiotis-RichardsCRuggeriM,et al.Scales for assessing patient satisfaction with mental health care: A systematic review. J Psychiat Res2018; 100: 33–46.
44.
BattaglieseGCaccettaMLuppinoOI, et al.Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness. Behav Res Ther2015; 75: 60–71.
45.
OudMDe WinterLVermeulen-SmitE, et al.Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis. Euro Psychiat2019; 57: 33–45.
46.
WalterDDachsLFaberM, et al.Effectiveness of outpatient cognitive-behavioral therapy for adolescents under routine care conditions on behavioral and emotional problems rated by parents and patients: An observational study. Euro Child Adoles Psychiat2018; 27: 65–77.
47.
WalterDDachsLFahrwick zum HagenJ, et al.Parent and teacher rated effectiveness of cognitive-behavioral therapy for children and adolescents under usual care conditions in a university outpatient clinic. Child Psychiat Hum Dev2019; 50: 533–545.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
