Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 17, 2022
Date Accepted: Feb 7, 2023
Clinical and Psychosocial Outcomes Associated with a Telebehavioral Health Platform for Families: A Retrospective Study
ABSTRACT
Background:
The burden of pediatric mental illness in the US has steadily worsened over the past decade. A recent increase in employer-sponsored behavioral health programs has focused on the needs of the general population, largely designed for the care of adults, and not the specialized needs of children and their families.
Objective:
To evaluate a technology-enabled pediatric and family behavioral health service for commercially-insured populations that provides educational content, tele-behavioral health coaching, tele-behavioral health care including psychotherapy and psychiatry, and care escalation and coordination.
Methods:
For this retrospective cohort analysis for members using the service between February and September 2022, we evaluated clinical outcomes for children and their caregivers using the Pediatric Symptom Checklist-17 (PSC-17), Generalized Anxiety Disorder 7-Item (GAD-7), Patient Health Questionnaire 8-Item (PHQ-8), and Caregiver Strain Questionnaire - Short Form 7 (CGSQ-SF7).
Results:
Of 4,091 participants who signed up for the service, 48 (1%) were referred out for more intensive care; 2,393 (58%) were referred to tele-coaching; and 1,698 (41%) were referred to tele-psychotherapy/psychiatry. Among the 703 members completing the intervention and providing pre- and post-intervention outcomes data; 386 (55%) utilized psychoeducational content, 345 (49%) received tele-coaching; and 358 (51%) received tele-psychotherapy/psychiatry. Tele-behavioral health coaching and tele-psychotherapy/psychiatry were both associated with significant improvements in overall behavioral health symptoms (average change in PSC-17 total: 3.37, P<.0001 for tele-coaching and 3.16, P<.0001 for tele-psychotherapy/psychiatry) and internalizing behaviors (average change in PSC-17-internalizing subscore: 1.58, P<.0001 and 1.66, P<.0001 respectively). Caregiver strain also improved in both groups (average change in CGSQ-SF7 1.02, P<.0001 and 1.06, P< .0001 respectively). Children receiving tele-psychotherapy/psychiatry significantly decreased symptoms of anxiety (average GAD-7 change: 2.97, P<.0001) and depression (average PHQ-8 change: 2.92, P<.0001).
Conclusions:
A tele-behavioral health offering can provide clinically meaningful care to children and their families across a spectrum of acuity.
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