Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment
Date
2019
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Abstract
Mental health systems need scalable solutions that can reduce the efficacy–effectiveness gap and
improve mental health outcomes in community mental health service settings. Two major
challenges to delivery of high-quality care are providers’ fidelity to evidence-based treatment
models and children’s and caregivers’ engagement in the treatment process. We developed a novel,
tablet-based application designed to enhance via technology the quality of delivery of trauma focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility
of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27
families. Provider fidelity and child engagement in treatment were observationally measured via
session audio recording. Parent and child perceptions of the tablet application were assessed using
structured interviews and mixed-method analyses. Providers actively and appropriately used tablet
TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with
its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions
reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is
accepted by providers and families and may be integrated into mental health treatment with
minimal training. Further study is needed to examine the extent to which technology-based
applications may enhance the reach, quality, and clinical outcomes of mental health treatment
delivered to children and families.
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Keywords
telemental health, treatment, technology, TF-CBT, research
Citation
Davidson, T. M., Bunnell, B. E., Saunders, B. E., Hanson, R. F., Danielson, C. K., Cook, D., ... & Walker, J. H. (2019). Pilot evaluation of a tablet-based application to improve quality of care in child mental health treatment. Behavior therapy, 50(2), 367-379.