Interventions Developed for Psychiatric and Behavioral Treatment in the Children’s ADHD Telemental Health Treatment Study

摘要

Telemental health (TMH) is one approach to rectifying geographic disparity in access to evidence-based mental health treatment for ADHD. We describe a brief (6-session) intervention for the TMH delivery of medication treatment with psychoeducation and Caregiver Behavioral Training to families of children with ADHD from underserved communities. Information on family engagement, satisfaction, and fidelity to intervention protocols are presented. Overall, both parts of the intervention were well-received by families who engaged with the treatment, who learned information and skills, and who indicated very high levels of satisfaction with treatment, even though it was relatively brief in nature. Mean ratings of satisfaction for the combined ADHD treatment was 38 (range = 27–40) out of a possible total score of 40 on the Client Satisfaction Questionnaire. Both telepsychiatrists and therapists were highly faithful to the intervention protocols, as demonstrated by their independently-rated fidelity. Telepsychiatrists adhered to the intervention protocol with 91.6 ± 9.5 % reliability, and therapists adhered to their intervention protocol with 94.3 % (SD: 9.7 %) reliability This brief stabilization model of intervention is particularly relevant to working with a remote population where treatment resources are scarce. This study demonstrates that it is possible to provide direct psychiatric and behavioral services through telepsychiatry and to train and supervise therapists remotely.