Abstract
BackgroundIn the context of the COVID-19 pandemic, many behavioral health services have transitioned to teletherapy to continue delivering care for patients with mental illness. Studies that evaluate the outcome of this rapid teletherapy adoption and implementation are pertinent.ObjectiveThis single-arm, nonrandomized pilot study aimed to assess the feasibility and initial patient-level outcomes of a psychiatric transitional day program that switched from an in-person group to a video teletherapy group during the COVID-19 pandemic.MethodsPatients with transdiagnostic conditions who were at risk of psychiatric hospitalization were referred to the Adult Transitions Program (ATP) at a large academic medical center in the United States. ATP was a 3-week intensive outpatient program that implemented group teletherapy guided by cognitive and behavioral principles delivered daily for 3 hours per day. Feasibility was assessed via retention, attendance rate, and rate of securing aftercare appointments prior to ATP discharge. Patients completed standardized patient-reported outcome measures at admission and discharge to assess the effectiveness of the program for improving quality of mental health, depression, anxiety, and suicide risk.ResultsPatients (N=76) started the program between March and August of 2020. Feasibility was established, with 70 of the 76 patients (92%) completing the program and a mean attendance of 14.43 days (SD 1.22); also, 71 patients (95%) scheduled at least one behavioral health aftercare service prior to ATP discharge. All patient-level reported outcomes demonstrated significant improvements in depression (95% CI –3.6 to –6.2; Cohen d=0.77; P<.001), anxiety (95% CI –3.0 to –4.9; Cohen d=0.74; P<.001), overall suicide risk (95% CI –0.5 to –0.1; Cohen d=0.41; P=.02), wish to live (95% CI 0.3 to 1.0; Cohen d=0.39; P<.001), wish to die (95% CI –0.2 to –1.4; Cohen d=0.52; P=.01), and overall mental health (95% CI 1.5 to 4.5; Cohen d=0.39; P<.001) from admission to discharge.ConclusionsRapid adoption and implementation of a group-based teletherapy day program for adults at risk of psychiatric hospitalization appeared to be feasible and effective. Patients demonstrated high completion and attendance rates and reported significant improvements in psychosocial outcomes. Larger trials should be conducted to further evaluate the efficacy and effectiveness of the program through randomized controlled trials.
Highlights
BackgroundDespite 50 years of research examining the utility of telehealth technologies, video teleconferencing has a poor record of implementation, with slow, uneven, and fragmented uptake into routine health care operations [1]
The quick adoption of telehealth was of particular relevance for transitional behavioral health programs, given that during times of crisis, intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) play a critical role in preventing psychiatric hospitalization and relapse among patients with serious mental illness (SMI) [2]
The present study evaluated the feasibility and initial effectiveness of the Adult Transitions Program (ATP), a group-based teletherapy IOP for adults with transdiagnostic conditions who are at risk for psychiatric hospitalization
Summary
BackgroundDespite 50 years of research examining the utility of telehealth technologies, video teleconferencing has a poor record of implementation, with slow, uneven, and fragmented uptake into routine health care operations [1]. Few studies have examined the feasibility and efficacy of delivering transitional video teleconferencing group programs to adults with SMI who were recently discharged from or are at high risk of psychiatric hospitalization. Objective: This single-arm, nonrandomized pilot study aimed to assess the feasibility and initial patient-level outcomes of a psychiatric transitional day program that switched from an in-person group to a video teletherapy group during the COVID-19 pandemic. Patients completed standardized patient-reported outcome measures at admission and discharge to assess the effectiveness of the program for improving quality of mental health, depression, anxiety, and suicide risk. Conclusions: Rapid adoption and implementation of a group-based teletherapy day program for adults at risk of psychiatric hospitalization appeared to be feasible and effective. Larger trials should be conducted to further evaluate the efficacy and effectiveness of the program through randomized controlled trials
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