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.

中文翻译：

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对婴儿和学龄前儿童进行全家庭评估和干预的虚拟护理：临床医生和家庭经验的主题分析

在这项研究中，我们探讨了家庭和临床医生在为婴儿和学龄前儿童开发并在 COVID-19 大流行期间进行调整的全家庭评估和治疗的虚拟护理交付经验。还提供了临床案例研究。2020 年 9 月至 11 月期间，对四名从事 0 至 5 岁儿童家庭工作的临床医生和四名 4-6 岁儿童（M  = 5.3）的护理人员进行了半结构化访谈，参与整个家庭评估和干预（即，在社区心理健康机构进行的洛桑三部曲游戏 [LTP]；反思家庭游戏 [RFP]）。临床医生代表了不同的心理健康学科。使用归纳主题分析对定性数据进行分析，并建立了内部编码器的可靠性。对访谈的分析产生了九个主题，这些主题组织在两个概念框架内：可访问性和有效性。可访问性包括以下主题：(1) 灵活性、(2) 隐私和 (3) 资源。功效包括：（4）技术效果，（5）家庭环境，（6）治疗任务的可行性，（7）家长联盟，（8）临床医生疲劳，以及（9）总体评估。家庭环境进一步分为三个子主题：（5.1）破坏，（5.2）边界和（5.3）自然观察。虽然参与者报告了与虚拟护理独特相关的好处和挑战，但护理人员和临床医生都对虚拟全家庭评估和治疗表示总体满意。这项研究对 COVID-19 大流行期间从事虚拟全家庭心理保健的护理人员和临床医生的观点进行了丰富的探索。凭借足够的技术和隐私，通过视频电话会议提供的整个家庭评估和治疗（例如 LTP 和 RFP）有助于为患有中度至重度心理健康问题的幼儿家庭提供方便且有效的护理。有证据表明，可以进一步定制针对整个家庭评估和治疗的面对面和混合方法，以满足有幼儿和婴儿的家庭的需求。