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Online behavioural therapy could improve young children’s functioning, a study has shown.


The study from University of NSW (UNSW) School of Psychology focused on rural and regionally-based families with children aged between 1.5 and 4 years of age across NSW.

The results found that of the 17 mother-child combinations that completed treatment, almost 90% “rated in the normal range of functioning by the end of the program.”

“This online intervention was powerful for improving child behaviour,” said the study lead Dr Georgette Fleming.

In addition Dr Fleming said parents could also benefit from training and support provided by the supervising therapist.

An average of 10 sessions were run with each participating family across the study. A therapist watching on a video call would observe a child and mother play together, and advise the parent (wearing a wireless headset) on strategies to help shift their child’s behaviour.

The participating children (and their mothers) had been referred to the program by medical professionals or a community parent service, after displaying persistent tantrums, defiance, and aggressive behaviour.

The sessions were run in consultation with service provider Karitane, with the results published in the journal Behavior Therapy.

However, while Dr Fleming was pleased with the initial results, she acknowledged there were shortcomings, with 10 of the 27 initial participants failing to complete the program, while the current level of government support for psychological treatment has created questions about the potential accessibility of these treatments for some patients.

One of the issues that Dr Fleming was concerned about was the availability of the sessions under the existing Medicare scheme.

“Medicare only offers 10 subsidised sessions per calendar year,” Dr Fleming said.

“Many psychological interventions, including the intensive one we delivered, exceed this number… With limited subsidised funding, many people might stop intervention prematurely.”

Additionally, COVID-19 solutions such as the temporary subsidisation of some “online psychological programs” in metropolitan areas, similarly means there are possible future obstacles that may prevent the wider application of Dr Fleming and her team’s work in everyday settings.

“While this [the subsidy] is a promising step forward, it’s currently unclear whether the improvement to the accessibility of online mental health services will last beyond the pandemic,” Dr Fleming said.

“This is unfortunate, because treating problematic behaviours in the place where they actually happen – the home – is likely to be more powerful than treating them in artificial clinic settings.”

Nevertheless, with plans to expand the scope of the research further into bigger and more comparative-based studies, as well as follow up with those from the initial research, Dr Fleming is clear-minded about the potential importance of her team’s efforts.

“While families in metropolitan areas are currently facing barriers in accessing face-to-face mental health services, geographical barriers make this a constant challenge for those in regional and rural NSW,” she explained.

“We hope our research lays the groundwork for integrating online parent management training into community services-as-usual in the long term.”