Family-focused therapy via videoconferencing
ABSTRACT A 30-year-old veteran with a diagnosis of schizoaffective disorder and his mother were referred for family-focused therapy (FFT), an empirically-supported, manual-based treatment. The veteran had had multiple hospitalizations and experienced chronic auditory hallucinations for self-harm. Minor modifications to FFT were made for implementation via videoconferencing (at a bandwidth of 384 kbit/s). This may have enhanced the treatment by making the process of communication and problem-solving more explicit. The course of FFT was successfully completed, and the veteran and family showed a high level of satisfaction with care as well as improved medication adherence, good quality of life, high levels of hope, good interpersonal functioning, and very mild negative and positive psychiatric symptoms. This veteran had previous exposure to telemental health, which may have influenced his willingness to receive tele-FFT and perhaps affected the outcome of the case. The ability to provide this type of service to people in rural areas is important.
SourceAvailable from: Kristy Straits-Troster[Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVE This study evaluated the feasibility, acceptability, and helpfulness of implementation of multifamily group treatment for traumatic brain injury (TBI) among veterans who sustained a TBI during the wars in Iraq and Afghanistan and their families or caregivers. METHODS Veterans and their family members who participated in an open clinical trial (August 2010-March 2011) of multifamily psychoeducation for TBI at two Veterans Affairs medical centers were invited to one of three focus groups. Participants were asked about problems experienced before and during the intervention, aspects of treatment that were helpful, and improvements that would facilitate effective implementation of multifamily group treatment for TBI. Postintervention focus group transcripts were analyzed by utilizing qualitative content analysis. RESULTS Participants included eight veterans with TBI and eight family members. Five themes emerged: exploring common struggles and reducing isolation, building skills to cope with TBI and related problems, restoring relationships through communication and understanding, increasing understanding of the interconnection between TBI and posttraumatic stress disorder, and improving the multifamily group experience and increasing treatment engagement of veterans and families. Veterans and family members found multifamily group treatment for TBI highly acceptable and offered recommendations to improve and increase access to the program. CONCLUSIONS The results supported the feasibility and acceptability of multifamily group treatment for TBI. Specific recommendations to improve this psychoeducational intervention and its implementation are offered.Psychiatric services (Washington, D.C.) 03/2013; 64(6). DOI:10.1176/appi.ps.001632012 · 1.99 Impact Factor
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ABSTRACT: OBJECTIVE This study evaluated the initial efficacy and feasibility of implementing multifamily group treatment for veterans with traumatic brain injury (TBI). METHODS Veterans at two Veterans Affairs medical centers were prescreened by their providers for participation in an open trial of multifamily group treatment for TBI. Enrollment was limited to consenting veterans with a clinical diagnosis of TBI sustained during the Operation Enduring Freedom-Operation Iraqi Freedom era, a family member or partner consenting to participate, and a score ≥20 on the Mini-Mental State Examination. The nine-month (April 2010-March 2011) trial consisted of individual family sessions, an educational workshop, and bimonthly multifamily problem-solving sessions. Interpersonal functioning and symptomatic distress among veterans and family burden, empowerment, and symptomatic distress among families were assessed before and after treatment. RESULTS Providers referred 34 (58%) of 59 veterans screened for the study; of those, 14 (41%) met criteria and consented to participate, and 11 (32%) completed the study. Severity of TBI, insufficient knowledge about the benefits of family involvement, and access problems influenced decisions to exclude veterans or refuse to participate. Treatment was associated with decreased veteran anger expression (p≤.01) and increased social support and occupational activity (p≤.05), with effect sizes ranging from .6 to 1.0. Caregivers reported decreased burden (p≤.05) and increased empowerment (p≤.01). CONCLUSIONS The results supported implementation of a randomized controlled trial, building in education at the provider and family level.Psychiatric services (Washington, D.C.) 03/2013; 64(6). DOI:10.1176/appi.ps.001622012 · 1.99 Impact Factor
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ABSTRACT: Despite growing research in the past two decades involving Internet-supported or online mental health interventions, there has been only a few attempts to provide a synthesis of the research findings and future trends. The Internet has grown exponentially during this time, providing greater access to a wider population than ever before. Consequently, online mental health interventions have the potential to be cost-effective, convenient, and reach a more diverse population than traditional, face-to-face interventions. This paper reviews and summarizes the current research for online mental health interventions and discusses future trends. These interventions range from psychoeducational static webpages and complex, personalized, interactive cognitive-behavioral-based self-help programs, to videoconferencing, self-help support groups, blogging, and professional-led online therapy. Future trends in online interventions include the greater prevalence of online therapy and the use of video chat and videoconferencing technologies to enhance and extend the therapeutic relationship. The use of texting or short message service (SMS), mobile communications, smart phone applications, gaming, and virtual worlds extends the intervention paradigm into new environments not always previously considered as intervention opportunities. We find that there is strong evidence to support the effective use and future development of a variety of online mental health applications.Journal of Technology in Human Services 07/2011; 29(3):155-196. DOI:10.1080/15228835.2011.616939