Medical University of South Carolina, Charleston, SC, United States.
University of California, Irvine, United States.
Curr Probl Pediatr Adolesc Health Care. 2021 Jan;51(1):100949. doi: 10.1016/j.cppeds.2021.100949. Epub 2021 Jan 8.
Considerable efforts over the last decade have been placed on harnessing technology to improve access to behavioral health services. These efforts have exponentially risen since the outbreak of the Coronavirus disease 2019 (COVID-19), which has prompted a move to novel systems of care, largely based on telehealth delivery. This article aims to provide a broad review of evidence for telehealth assessment and treatment of externalizing disorders and internalizing disorders in children and discuss practice considerations and established guidelines for telehealth delivery. Existing literature supports the promise of behavioral health interventions including behavioral parent training and combination approaches for externalizing disorders as well as cognitive-behavioral based interventions for internalizing disorders. There is a scarcity of work on assessment via telehealth compared with the available treatment literature. While treatment may be most pressing given the COVID-19 circumstances to continue delivery of care, movement toward establishing evidence-based assessment via telehealth will be of increased importance. Lastly, practice guidelines have been set forth by national associations, professional societies, and supported by the development of national Telehealth Centers of Excellence. These guidelines and practice considerations are discussed within the context of COVID-19.
在过去十年中,人们付出了大量努力来利用技术来改善获得行为健康服务的机会。自 2019 年冠状病毒病(COVID-19)爆发以来,这些努力呈指数级增长,促使人们转向以远程医疗为基础的新型护理系统。本文旨在广泛回顾远程医疗评估和治疗儿童外化障碍和内化障碍的证据,并讨论远程医疗提供的实践注意事项和既定准则。现有的文献支持行为健康干预措施的前景,包括行为家长培训和外化障碍的联合方法,以及针对内化障碍的基于认知行为的干预措施。与现有的治疗文献相比,通过远程医疗进行评估的工作相对较少。虽然鉴于 COVID-19 的情况,治疗可能是最紧迫的,但通过远程医疗建立基于证据的评估将变得更加重要。最后,国家协会、专业协会制定了实践指南,并得到了国家远程医疗卓越中心的发展的支持。这些指南和实践注意事项是在 COVID-19 的背景下讨论的。