Therapeutic Alliance in Family-Based Treatment of Anorexia Nervosa: In-Person Versus Telehealth.

OBJECTIVE: The therapeutic alliance is broadly linked with positive outcomes. However, nearly all research in this area involves in-person therapy, whereas teletherapy has grown increasing common since the COVID-19 pandemic. There is now a pressing need to establish whether the nature and importance of the therapeutic alliance is impacted by teletherapy. This study examined therapeutic alliance in families of youth with anorexia nervosa who were participating in a randomized controlled trial that transitioned from in-person to telehealth visits during the COVID-19 pandemic. METHOD: We analysed data from 53 adolescents and their parents (20 began in-person, 33 began with telehealth). Both parents, youth and therapist completed the Working Alliance Inventory-Short Revised after 4 weeks of treatment. RESULTS: We found no significant differences across telehealth and in-person treatment for paternal or therapist reported data. However, both adolescents and mothers reported higher bond and goal-related alliance for in-person sessions compared to telehealth. CONCLUSIONS: Findings regarding alliance across telehealth and in-person sessions were mixed, with some preference among mothers and youth for in-person treatment. Future studies should determine whether possible adaptations can improve working alliance during family-based treatment for anorexia nervosa via telehealth.

The importance of including Long COVID outcomes when developing novel treatments for acute COVID-19.

The ongoing COVID-19 pandemic continues to present surges in infections demonstrating the persistent threat posed by COVID-19. Amidst efforts to develop effective treatments for acute COVID-19, there is a growing recognition of the need to address Long COVID. This manuscript reviews the current landscape of acute COVID-19 treatments and highlights the opportunity to incorporate Long COVID as a key outcome measure in clinical trials. Our analysis includes a review of current US clinical trials investigating acute COVID-19 treatments. Of the 19 studies that met our inclusion criteria, only one study currently incorporates Long COVID measurements. In our review, we argue there are 7 compelling reasons to include Long Covid measurements, including: (1) Long COVID is not rare (2) Long COVID is debilitating to individuals and has a high societal cost (3) Those at high risk of severe COVID-19 are also at higher risk of developing Long COVID if they are infected with COVID-19 (4) Treatments for acute COVID-19 may reduce the risk of Long COVID (5) Measures exist to track Long COVID (6) Long COVID considerations are potentially important for acute COVID-19 treatment decision-making (7) Deaths and hospitalizations due to COVID-19 are increasingly rare, creating an opportunity for other important clinical endpoints to be considered In conclusion, while not every trial needs to include assessments of Long COVID, it is worth the research burden to include assessments where possible as this could facilitate the uptake of acute COVID-19 treatments that lessen the societal burden of Long COVID.

Impact of the Learn to Play program on play, social competence and language for children aged 5-8 years who attend a specialist school.

INTRODUCTION: The aim of this study was to investigate the change in the relationship between play, language and social skills of children aged 5-8 years pre and post participation in the 'Learn to Play' program. The Learn to Play program is a child led play based intervention aimed at developing self-initiated pretend play skills in children. METHODS: All 19 participants attended a specialist school, with 10 of the 19 children having a diagnosis of autism. The play, language and social skills of the children were assessed at baseline and at follow up. Children were assessed using the Child-Initiated Pretend Play Assessment, the Preschool Language Scale and the Penn Interactive Peer Play Scale. Follow up data collection occurred after the children had been participating in the Learn to Play program for 1 hour twice a week for 6 months. RESULTS: After 6 months in the program, typical indicators of play accounted for an increase of 47.3% in shared variance with social interaction and an increase of 36% in shared variance for social connection. For language, object substitution ability accounted for 50% of the shared variance, which was an increase of 27% from baseline. CONCLUSION: The 'Learn to Play' program was associated with increases in children's language and social skills over a 6-month period within a special school setting, indicating the Learn to Play program is an effective intervention for children with developmental disabilities. This paper presents an example of how the Learn to Play program can be adapted into a classroom setting.

Play, behaviour, language and social skills: the comparison of a play and a non-play intervention within a specialist school setting.

The aim of the present study was to investigate the play, behaviour, language and social skills of children aged 5-8 years participating in a play intervention (based on the 'Learn to Play' program) compared to a group of children participating in traditional classroom activities within a specialist school over a six month period. Thirty-five children participated in the study, 19 participated in the play intervention group and 16 participated in the comparison group. Fourteen staff members at the special school were involved. A quasi-experimental design was used with pre and post data collection. Children in the play intervention and the comparison group were assessed using the Child-Initiated Pretend Play Assessment (play), Goal Attainment Scaling (behaviour), the Preschool Language Scale (language) and the Penn Interactive Peer Play Scale (social skills) at baseline and at follow up. Findings revealed that children participating in the play intervention showed a significant decrease in play deficits, became less socially disruptive and more socially connected with their peers. Both groups improved in their overall language skills and significantly improved in their goal attainment. This study supports the use of a play intervention in improving a child's play, behaviour, language and social skills.