There is a current escalating need for telehealth (TH) options in family mental health services. In the absence of replicated evidence, TH guidelines from peak bodies are largely based on assumptions of the effectiveness of TH methods. New investments in TH would optimally be based in evidence of clinical efficacy. To this end, we conducted three studies in which we (1) systematically reviewed eight professional guidelines for TH family therapy, (2) examined replicated evidence for the efficacy of TH family therapy through systematic review of 20 studies and meta-analyses of 13 effects, and (3) synthesised clinical accommodations to TH methodology from a study of 12 experienced TH family therapists. The studies found (1) a predominant focus in existing TH guidelines on operational matters pertaining to TH and relative neglect of therapeutic process; (2) meta-analyses of efficacy for child behavioural problems (k = 8) and parental depression (k = 5) showed equivalent outcomes in TH and face-to-face therapy and enhanced outcomes in TH relative to treatment as usual, resource provision (i.e. written materials), or wait-list control. Narrative review of 20 studies for a range of relational and mental health outcomes aligned with these findings; and (3) therapists defined clear conditions for enhanced engagement and therapeutic process via TH and reflected on cautions and accommodations for purposes of rapport building and mitigating risk. Given moderate-strong evidence for the efficacy of TH methods of family therapy for a range of conditions, we offer recommendations for future implementation of TH for family therapy.

当前，家庭心理健康服务中对远程医疗 (TH) 选项的需求不断增加。在缺乏重复证据的情况下，高峰机构的 TH 指南主要基于对 TH 方法有效性的假设。对 TH 的新投资最好基于临床疗效的证据。为此，我们进行了三项研究，其中我们（1）系统回顾了 TH 家庭治疗的 8 项专业指南，（2）通过对 20 项研究的系统回顾和 13 项效应的荟萃分析，检查了 TH 家庭治疗有效性的重复证据，和 (3) 从对 12 位经验丰富的 TH 家庭治疗师的研究中综合临床适应 TH 方法。研究发现 (1) 现有的 TH 指南主要关注与 TH 相关的操作事项和对治疗过程的相对忽视；(2) 儿童行为问题疗效的荟萃分析 (k  = 8) 和父母抑郁症 ( k  = 5) 在 TH 和面对面治疗中显示出相同的结果，并且相对于常规治疗、资源提供（即书面材料）或等待名单控制，TH 的结果有所提高。对 20 项研究的叙述性回顾，涉及与这些发现一致的一系列关系和心理健康结果；(3) 治疗师通过 TH 为加强参与和治疗过程定义了明确的条件，并出于建立融洽关系和降低风险的目的考虑了注意事项和便利条件。鉴于 TH 家庭治疗方法对一系列疾病的有效性的中等强度证据，我们为未来实施 TH 家庭治疗提供建议。