Virtual care delivery of whole family assessment and intervention with infants and preschoolers: a thematic analysis of clinician and family experiences

In this study, we explore family and clinician experiences with virtual care delivery of whole family assessment and therapy developed for infant and preschool-aged children and adapted during the COVID-19 pandemic. A clinical case study is also presented. Between September and November 2020, semi-structured interviews were conducted with four clinicians working with families with children in the 0 to 5 population and with four caregivers with children aged 4–6 years (M = 5.3) involved in whole family assessment and intervention (i.e., Lausanne Trilogue Play [LTP]; Reflective Family Play [RFP]) at a community mental health facility. Clinicians represented various mental health disciplines. Qualitative data were analysed using inductive thematic analysis with intercoder reliability established. Analysis of interviews generated nine themes organised within two conceptual frameworks, accessibility and efficacy. Accessibility included the themes: (1) flexibility, (2) privacy, and (3) resources. Efficacy comprised: (4) effects of technology, (5) home environment, (6) feasibility of therapy tasks, (7) parent alliance, (8) clinician fatigue, and (9) overall evaluation. Home environment was further divided into three subthemes: (5.1) disruptions, (5.2) boundaries, and (5.3) naturalistic observation. While participants reported benefits and challenges uniquely related to virtual care, both caregivers and clinicians expressed overall satisfaction with virtual whole family assessment and therapy. This study provides a rich exploration of the perspectives of caregivers and clinicians engaged in virtual whole family mental health care during the COVID-19 pandemic. With adequate technology and privacy, whole family assessment and therapy, such as the LTP and RFP, provided via video teleconferencing facilitated accessible and effective care for families of young children with moderate to severe mental health challenges. Evidence suggests in-person and hybrid approaches to whole family assessment and therapy could be further tailored to meet the needs of families with young children and infants.