Supporting survivors of child sexual abuse during the COVID-19 pandemic: An ecosystems approach to mobilizing trauma-informed telemental healthcare.

Abstract

The emergence of the COVID-19 global health pandemic and its associated adversities have had cascading and compounding effects on vulnerable children and families impacted by abuse and trauma. Mandated public health physical distancing measures necessitated an abrupt transition from traditional in-person mental healthcare to virtual mental healthcare. While ushering in new and unexpected opportunities, this shift presented significant challenges and unique implications for trauma-focused pediatric interventions. In this article, we (a) propose an ecological systems framework through which we can better understand the multilevel effects of child sexual abuse in the context of a pandemic;(b) describe our administrative and clinical processes for rapidly mobilizing a trauma-informed model of telemental healthcare for sexually abused children and families in a pediatric hospital setting;and (c) share our clinical observations and experiences delivering therapy via virtual platforms during the early stage of the pandemic through an ecosystems lens. Key learnings inform tailored teletherapy approaches that can be applied in present and future viral outbreaks and sustained in the postpandemic era. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (French) La pandemie de COVID-19 et ses repercussions ont eu des effets conjugues et en cascade sur les enfants et les familles vulnerables ayant subi de la violence et des traumatismes. Les mesures de distanciation physique imposees par la sante publique ont necessite une transition abrupte des soins de sante mentale en personne aux soins en mode virtuel. Tout en apportant son lot de possibilites nouvelles et inattendues, ce changement a comporte d'importantes difficultes et des implications uniques pour les interventions axees sur les traumatismes parmi la population pediatrique. Dans cet article, a) nous proposons un cadre de systemes ecologiques au moyen duquel nous pouvons mieux comprendre les effets multiniveaux de la violence sexuelle a l'endroit d'enfants dans le contexte de la pandemie;b) nous decrivons nos procedes administratifs et cliniques pour mobiliser rapidement un modele tenant compte des traumatismes pour des soins de telesante mentale destines aux enfants victimes de violence sexuelle et a leur famille dans un contexte d'hopital pediatrique;c) nous faisons part de nos observations et experiences de prestation de therapie par l'entremise de plateformes virtuelles au debut de la pandemie selon l'optique d'ecosystemes. Les lecons apprises eclairent les methodes de teletherapie personnalisee qui peuvent servir de nos jours et durant d'eventuelles eclosions virales, ainsi qu'apres la pandemie. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement The COVID-19 pandemic, physical distancing measures, and related challenges uniquely impact children and families with prior exposure to abuse and trauma. Ensuring mental health support during stay-at-home orders and social isolation is critical and requires special considerations. This article explores the intersection of the traumatic effects of child sexual abuse with the stressful conditions of the pandemic, presents one pediatric hospital's approach to implementing a trauma-informed model of telemental healthcare, and highlights clinical insights and applications of virtual therapy with abuse survivors and their families. (PsycInfo Database Record (c) 2021 APA, all rights reserved)