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Internet-Based Support and Coaching for Adolescents and Young Adults with Neuropsychiatric Disorders – a Follow-up of an Intervention from an Organizational Studies Perspective

Saturday, 4 May 2013: 09:00-13:00
Banquet Hall (Kursaal Centre)
N. M. Gillberg1 and E. Wentz2, (1)Institute of Neuroscience and Physiology, Gillberg Neuropsychiatry Centre, Gothenburg, Sweden, (2)Gillberg Neuropsychiatry Centre, Institute of Neruoscience and Physiology, Gothenburg, Sweden
Background:  In a pilot study, internet-based support with a personal coach was offered to adolescents and young adults with autism spectrum disorder and/or ADHD. This article summarizes the evaluation of the trial from an organizational perspective, focusing on future implementation of the intervention.

Objectives:  Difficulty with social interaction is a trait shared by many neuropsychiatric patients. Particularly face-to-face communication can be problematic. Significant initiation difficulties and impairments in executive function can further complicate visits at clinics i.e. traditional treatment. Internet presents an opportunity to design support measures to a group of patients who often find face-to-face meetings in a clinic stressful. The aims of the project were 1) to develop a model for internet-based support and coaching for adolescents and young adults with neuropsychiatric disorders (NPD) and 2) to validate the model. Upon completion of the trial, the intervention was evaluated by the participants. The evaluation of the intervention showed improvement of the participants’ self-esteem and sense of coherence, indicating that the internet-based support and coaching can be an important complement to other interventions for young people with ASD and/or ADHD.

Methods:  The organizational evaluation consisted of semi-structured group interviews with coaches and project managers at the three treatment units involved in the study. Guided by existing implementation research and the collected data, the intervention was evaluated from the following parameters: 1) whether the method could be said to have relative advantages to other methods 2) to what degree the method is in keeping with the values, norms and work practices at the implementation sites 3) how easy the method is to use and 4) to what degree the method could be adapted to local conditions and recipients’ needs.

Results:  It was concluded that the intervention had quantitative and qualitative advantages relative to other interventions. Organizational culture posed a problem as the intervention was met by negative attitudes among some staff. Insufficient awareness was identified as another issue compromising successful implementation. Gate-keepers on treatment entry levels and management were identified as two groups of key importance to successful implementation. Technical difficulties were reported to affect the quality of the intervention negatively.

Conclusions: The intervention has benefits in terms of both quantity (by reaching individuals that would otherwise not receive any support) and quality (by providing a qualitatively better suited intervention to a group for which traditional interventions are less well suited). The intervention also meets goals of achieving a high level of equality in the patient-caregiver relationship.  Further work on staff awareness and attitudes in relation to the intervention will be needed for future implementation of the intervention. Technical issues will also have to be addressed.

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