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. 2022 Nov 28:8:20552076221129733.
doi: 10.1177/20552076221129733. eCollection 2022 Jan-Dec.

Establishing therapeutic and supportive relationships throughout delivery of a school-based group parenting program via telehealth: Exploring causal pathways

Dorothy Drabarek  1   2 , Rebecca Hammond  1 , Michelle Mitchell  1 , Hannah Colton  1 , John Dean  3 , Kimberley Stirling  1 , Leonie Wainwright  1 , Suzanne Davies  1 , Sharon Haarsma  4 , Cherie Puckett  5 , Darya McCann  1 , Danielle Blaydon  1 , Daniel Zandberg  1 , Jessica Harris  6 , Alexandra Martiniuk  2   7   8
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Establishing therapeutic and supportive relationships throughout delivery of a school-based group parenting program via telehealth: Exploring causal pathways

Dorothy Drabarek et al. Digit Health. .

Abstract

Background: Access to specialised early intervention mental health services for children, including group counselling for parents/carers, is still a challenge in non-metropolitan areas of Australia.

Aim: To gain understanding of the acceptability of a school-based targeted parenting group program delivered via telehealth by exploring the experiences of parents/carers, clinicians and school staff, and asking what works, how, why and in what circumstances.

Methods: Caregivers, clinicians and school staff involved in the delivery of a mental health program via telehealth into primary schools in two rural Local Health Districts (LHDs) in southern New South Wales (NSW) were invited to participate in interviews and/or focus group discussions. Thematic analysis of the data was conducted with reference to realist theory.

Findings: We conducted semi-structured interviews with 12 caregivers, five semi-structured interviews and two focus group discussions with school staff from six participating schools, and three focus groups with seven clinicians who delivered the intervention. We found that the intervention and micro contexts interacted to influence acceptability by initiating or enhancing cohesion among caregivers, establishing channels of communication between caregivers and teachers, and connection between caregivers and clinicians despite geographic distance. Several adaptations were made to strengthen the therapeutic alliance between caregivers and clinicians.

Conclusion: Relationships crucial to the success of delivering psychological group counselling were established. Regional community contexts can facilitate acceptability of parenting group counselling delivered into schools via telehealth. Implementation of the program was flexible enough to allow clinicians to adjust their approach and materials to better suit the telehealth modality.

Keywords: Telehealth; early intervention; group; mental health; realist, school.

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Conflict of interest statement

Royal Far West delivers specialist paediatric and allied health care for children in rural and remote Australia in-person and through real-time telehealth. Royal Far West provided in-kind resources and time towards this project. DD and AM declare no conflict of interest with this research. AM was funded by a National Health and Medical Research Council of Australia (NHMRC) Translating Research into Practice Fellowship for the initial phase of this research, by the NSW Translational Research Grants Scheme (TRGS) in the middle phases and by an NHMRC Investigator Grant for the final phases of this research. RH declares no conflict of interest. RH was employed by RFW as this study's Project Manager and played the roles of service delivery coordinator and an evaluator.

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