Delivering Psychosocial Interventions Through Videoconferencing: Pilot Efforts to Reach Rural Families

Background:   Families who live in rural areas face significant obstacles in accessing skilled mental health care (Office for the Advancement of Telehealth, 1998).  Over the past two decades, researchers have examined the feasibility, acceptability and effectiveness of various telehealth approaches to reaching underserved families in need of mental health support (Stamm & Cunningham, 2005).  As a result, telehealth applications have become more affordable, accessible, flexible, and more appropriate for clinician-to-family interactions.  Finding ways to harness this technology in order to improve access to quality mental health supports for youth with ASD and their families is an important goal.

Objectives:   The present study is an examination of the development and piloting of a telehealth version of a manualized, empirically-supported intervention designed to promote adaptive coping in youth with ASD and significant fears and anxieties (Facing Your Fears Program, Reaven et al, 2009).  We plan to describe the challenges in developing and executing the program, summarize the feedback from families in rural areas, and present data from two parent-child dyads who completed an individual treatment course during this piloting phase. 

Methods:   Beginning with a qualitative discussion of clinician and family perceptions of the credibility, feasibility, and acceptability of using videoconferencing to connect clinical specialists with families, a case study approach will be used to illustrate the challenges and potential advantages of delivering psychosocial treatment through videoconferencing.  Youth engagement in the intervention (among other variables) will be examined by coding level of participation via interval recording using a NOLDUS coding system.  Behavioral coders will be blind to the research questions.

Results:    Impact of the intervention on youth anxiety, parent sense of competence, and youth quality of life will be discussed.  Limitations and obstacles faced in these early piloting efforts will also be shared.

Conclusions: There are many challenges inherent to translating a psychosocial intervention package into a format that is appropriate for telehealth delivery.  Potentially an innovative way to increase access to specialized mental health care, there is much to be learned about how to modify practice models, prepare clinicians, and orient families to use technology to engage in psychosocial interventions.