Table 2.
Describing and characterizing virtual implementation strategies
| Independent variables: virtual implementation strategies | |||
|---|---|---|---|
| Name of support | % of families whose therapist participated | Description | Created internally or externally? |
| Strategy 1: web conference trainings from outside agencies | 43.02% | Webinars and recorded trainings released by psychologists in the American Psychological Association (APA), Division 53, PCIT International, etc. Content varied from trainings specific to PCIT, to more general discussions of how to conduct virtual services successfully, including how to establish rapport and maintain privacy virtually | External |
| Strategy 2: recorded trainings developed by PCIT team | 56.98% | The team shared recorded trainings created previously internally for conferences and training new therapists in I-PCIT | Internal |
| Strategy 3: one-on-one consultation | 73.26% | Four therapists on the team who had previously conducted I-PCIT created a schedule of available “office hours” (approximately 10 h per therapist) each week for on-call consultation. Consultants helped therapists troubleshoot with families about both clinical and technological difficulties until therapists felt comfortable leading the troubleshooting on their own. After 1 month, this was discontinued, as therapists expressed confidence working through pitfalls on their own | Internal |
| Strategy 4: skills practice | 41.86% | Therapists were given the opportunity to practice specific scenarios in a role-play with another therapist before needing to coach a client through the same scenario. Scenarios included unique difficulties that would occur in a virtual setting, including the parent having difficulty hearing the clinician, the call dropping unexpectedly, the child leaving the room, etc. | Internal |
| Strategy 5: shadowing cases | 1.16% | Therapists new to virtual services shadowed the cases of experienced clinicians to observe the strategies they used to successfully complete PCIT virtually | Internal |
| Strategy 6: reviewing cases | 26.74% | Videos of previous cases who received services virtually were available for therapists to review | Internal |
| Strategy 7: FAQ document | 70.93% | As therapists reported the technological difficulties they encountered, consultants (the three clinic therapists with more than 5 h of prior training in virtual service delivery) recorded these problems and the corresponding solutions on a Google document accessible to the rest of the team | Internal |
| Strategy 8: online community of practice | 80.23% | The clinic’s therapists met as a group to discuss common challenges encountered during I-PCIT, as well as ways to increase the strength of virtual PCIT. This group met weekly at the beginning of the stay-at-home order, and then biweekly. All trainees were encouraged to participate, both in the reporting of difficult therapeutic scenarios and in the generation of potential strategies for addressing the situations | Internal |
| Strategy 9: live observation and feedback | 37.20% | For particularly difficult cases, or challenging sessions, therapists could request that a supervisor or I-PCIT consultant shadow them, joining them for the session | Internal |
| Strategy 10: virtual training materials (I-PCIT Guide) | 69.77% | I-PCIT-experienced therapists on this team compiled and distributed a 53-page manual for transitioning PCIT successfully to virtual services | Internal |
| Strategy 11: in-session co-therapist support | 31.40% | This clinic utilizes a co-therapy model to train new clinicians in PCIT. During the transition to I-PCIT, clinicians used this co-therapy structure to scaffold the training of new clinicians to become comfortable with I-PCIT as well | Internal |