| Children and families residing in rural areas face barriers to accessing mental healthcare. Telemental health is a fast advancing field that can bridge service barriers by allowing for long distance delivery of mental healthcare services. Internet-based televideoconferencing (TVC) technology enables providers to deliver real time face-to face psychological services to clients located miles away. The telemental health literature is encouraging; telemental health is efficacious as well as satisfying for clients. Despite this, a recent review pointed out a paucity of research for telemental health for children. Telemental health research is especially needed for trauma-exposed children as there is presently only one TVC telemental health study examining a child trauma-related psychological treatment. Sleep disturbances, such as posttraumatic nightmares, are prevalent among children who have experienced trauma. Exposure, Relaxation, and Rescripting therapy for children (ERRT-C) is a promising treatment for the reduction of posttraumatic nightmares and associated distress. The current study aimed to document and describe the feasibility of adapting ERRT-C to be delivered via televideoconferencing (i.e., Tele-ERRT-C). Additionally, this study sought to examine the preliminary effectiveness of Tele-ERRT-C for the reduction of posttraumatic nightmares and improvement of related psychopathology. Using a multiple-baselines design, families (N = 3) participated in: a pre-treatment assessment, a varied length of baseline monitoring, five weeks of Tele-ERRT-C, a one week post-treatment assessment and a one-month follow up. Prior to treatment participants reported experiencing chronic nightmares for an average of six years (SD = 3.46 years). Following treatment, participants' reported reductions in nightmare frequency, distress, and severity. Reported reductions of nightmares per night as compared to pre-treatment values ranged from small to large at the post treatment and one-month follow up (d = -.36 to d = -2.69). Notably, at the one-month follow up assessment, 100% of participants indicated they had not experienced nightmares in the previous month. Moreover, all three participants reported statistically reliable and clinically significant improvements in sleep quality, moving from the "poor" sleep category to the "good" sleep category post treatment. Although across varying timelines, all three participants also reported statistically reliable improvements in PTSD severity from the pre-treatment to post-treatment and follow up assessments. Children and families reported satisfaction with the telemental health services as well as indicated a strong working alliance. Feasibility, clinical implications, strengths, limitations and areas for future research are discussed. |
