Mental Health Providers Perceptions of Multimedia Technology with Custodial

Mental Health Providers Perceptions of Multimedia Technology with Custodial Grandparents

Claudine Allen

Counselor Education and Supervision – General specialization

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Mental Health Providers Perceptions of  Multimedia Technology with Custodial Grandparents

                                                          Problem Statement

Many grandparents opt to take custodial responsibility of their grandchildren as an act of love or failure of parents to take charge (Hadfield, 2014). It is estimated that about 2.4 to 2.8 million Americans, 200,000 British, and 46,680 Australian grandparents take care of their grandchildren on a full-time capacity. According to Vasel (2019), the responsibility not only strains the custodians physically, but also adds them financial obligations, which can be very expensive. Notably, the daily needs of these children place substantial financial strains on the custodial grandparents if they only depend on a fixed state pension or retirement benefits (Taylor, Marquis, Coal & Batten, 2015). Consequently, a combination of financial burden, daily challenges, and emotional stress caused by the parent’s failure to care for their kids can impel these grandparents into mental distress. According to Taylor, Marquis, Coal & Batten (2016), custodial grandparents experience higher levels of depression, anxiety, sadness, stress, and societal isolation  when compared to those who are non-custodial.

           This research seeks to identify mental healthcare providers’ perception concerning the use of technology amongst custodial grandparents. Today, the internet has revolutionized the way people interact through gadgets such as smartphones, Chrome book, and laptops. Some of the technologies that have effectively transformed the mental health field include Psych-educational applications and web pages. Personalized interactive cognitive behavioral-based self-help programs, blogging, professionally led online therapy, and video chat/conferencing have offered remarkable means of assisting mental health patients.

Although mental health professionals have continued to embrace the use of technology, it is not clear if they have done enough to share the information with custodial grandparents. According to the PEW Research Center, 86% of Americans use the internet at least regularly, but only 59% of the elderly do (Hadfield, 2014). Technology offers immense opportunities for addressing mental health treatment gaps concerning the lack of access to professional services, stigma, service costs, time constraints, and inadequate mental health literacy. The use of internet in training counselors and educating clients has expanded online counseling through a specific evidence-based treatment. Therefore, prospectus examine the underlying factors that have influenced the ineffective incorporation of technology by counselors working with custodial grandparents despite the benefits it offers.

Purpose

The purpose of this qualitative study is to analyze the relationship between independent variables and a single dependent variable in applying technology while dealing with custodial grandparents. Independent variables include the age and experience of a counselor, the size of the client’s city, and the cultural background of a counselor while the dependent variable is mental health provider. The outcome will establish the significance of  counselor’s perception on the use of technology amongst custodial grandparents and inform how they should work with specific groups in near future.

Significance

This study is significant because it focuses on the perception counselors have about custodial grandparents who are alienated in the provision of health services via technology and previous research. Notably, it also examines the relationship between demographics and the inclination of mental health providers towards using technology when working with custodial grandparents. Therefore, the research will help uncover the causes of a discreet application of multimedia interventions on grandparents taking care of their grandchildren. According to Loue (2016), online counseling can overcome geographic barriers to accessing mental health care services, promote instant disclosure of health information, and permit the establishment of therapeutic alliances. Although the use of technology has resulted in unrestricted provision of health services, there is an ongoing debate over the use of the internet in counseling due to information security concerns. However, several research findings have proved online therapy is a practical approach for offering mental healthcare interventions. Therefore, this research has sufficient literature reliable for exploring online therapy using a new paradigm to recommend technology for custodial grandparents. The study also recognizes the challenges grandparents experience when left to care for their grandchildren while offering reprieve on their mental stress and physical health.

Background

The literature reviewed in this research highlighted some aspects of online counseling versus face-to-face counseling. The sample population was African American counselors who work with African American children. Most of the research weighed the positives and negatives of each counseling method on the sample population. Therefore, the selection criteria for articles included in the study must have met the following requirements:

·         Should present a theoretical or conceptual framework on online therapy concerning grandparents.

·         Should have collected data, applied valid methodologies, analysis, and presented the results of the findings.

·         Must address the research question and hypothesis related to the use of technology, perception of caregivers, and the effectiveness of technology in providing mental health counseling.

Taylor, Marquis, Coal & Batten (2015) describes caregiving as the physical and mental effort required to support, respond to, or look at a person who needs the care to perform routine duties or survive. Although many people find caregiving to be stressful, grandparents hardly perceive it as a burden. The trend is evident in cultures where caregiving is perceived as a family obligation rather than workload. However, Taylor et al. (2015) shows that there are subjective burdens that are likely to arise once a person assumes the role of professional caregiving. They include strain on personal financial resources, social identity, and anxiety. Another type is the objective custodial burden that is linked with physical aspects of caregiving and socio-cultural constraints. It affects the capacity to care for the caregiver.

Taylor, M., Marquis, B., Coall, D., Batten, R., &Werner, J. (2017). The physical health dilemmas facing custodial grandparent caregivers: Policy considerations. Cogent Medicine, 4(1). doi:10.1080/2331205x.2017.1292594.

Taylor, Marquis, Coall, Batten & Werner (2017) attribute the increasing number of grandparents becoming full-time caretakers of their grandchildren to child-neglect, death, or parental illness. Their study aimed at investigating the impact of raising grandchildren on the health of the custodial grandparents. The study, conducted on 49 custodial grandparents, revealed that the majority of the participants only depended on retirement/superannuation income to manage their grandchildren. Notably, they faced several constraints as the revenue did not cater for one or more dependents. Consequently, they seldom incur extra burdens, which forces them to make a hard decision regarding their health and continued support of the grandchildren (Taylor et a., 2017).  The authors propose that there is a need to offer financial and emotional assistance through support groups and government to offset the burden.

Lent, J., & and Otto, A. (2018). Grandparents, grandchildren, and caregiving: The impacts of America's substance use crisis. 1-3. Retrieved 19 November 2019, from http://www.grandsflourish.org/wp-content/uploads/2019/04/Impacts-of-Americas-Substance-USe-Crisis.pdf.

Lent & Otto (2018) claim that unlike parents who prepare in advance for their children, grandparents usually assume the role of caregivers unexpectedly. Immediately they take the caregiver role; they must start undergoing the complex experience to meet the cognitive, emotional, and physical health challenges that come with the role. Besides, they may struggle with mental health issues because of feeling guilt, loss, or shame about their children’s inability to parent (Lent & Otto, 2018). The authors indicate that most of the custodial grandparents end up prioritizing their grandchildren's needs over their own, which later leads to depression, chronic stress, or physical illness.

Bashshur, R., Bashshur, N., Shannon, G., & Yellowlees, P. (2016). The empirical evidence for telemedicine interventions in mental disorders. Telemedicine and E-Health, 22(2), 87-113. doi:10.1089/tmj.2015.0206.

Bashshur, Bashshur, Shannon, & Yellowlees (2016) evaluated the occurrence of a complex array of mental health challenges and the associated productivity loss to a particular population. Subsequently, it led to the development of telemedicine intervention that was aimed at countering mental health challenges. The study aimed at evaluating telemedicine interventions in terms of cost, health outcomes, acceptance/ feasibility, and adherence to medication effects. The systematic review of other scientific literature in their work showed that the medication was feasible and widely accepted by mental health patients (Bashshur et al., 2016). Therefore, the authors concluded that there is significant empirical evidence to support the use of telemedicine interventions on mental disorder patients.

Sumo, J., Wilbur, J., & Julion, W. (2017). Interventions to improve grandparent caregivers’ mental and physical health: An integrative review. Western Journal of Nursing Research, 40( 8), 1236-1264. doi: 10.1177/0193945917705376.

Sumo, Wilbur & Julion (2017) conducted a study to review the aged caregiver interventions designed to help in improving their mental and physical health. The systematic literature reviews of their work utilized thirteen articles related to psychological outcomes of caregiver grandparents. The study majorly focused on grandparents mental health outcomes with little emphasis on social relations and physical health. Nevertheless, the authors established that mental health interventions produced positive outcomes on the custodial grandparents. However, the study disregarded the parents or grandchildren's ages, or if the grandparent provided shared or primary care (Sumo et al., 2017). Therefore, the study requires further research to establish the variation in mental health outcomes on grandparents based on the above variables.

Wallin, E., Psych, L., Mattsson, S., & Olsson, E. (2016). The preference for internet-based psychological interventions by individuals without past or current use of mental health treatment delivered online: A survey study with mixed-methods analysis. JMIR Mental Health, 3(2), e25. JMIR Publications Inc., doi:10.2196/mental.5324.

Wallin, Psych, Mattsson & Olsson (2016) note that enhancing evidence-based mental health services access was vital for strengthening global health. Achieving universal health, therefore, raises the need to utilize information technology to advance the well-being and self-care in the healthcare setting. According to the authors, the internet provides the best means through which the healthcare industry can offer its services globally at low costs. Similarly, other research has established that interventions have advantages over traditional face-to-face delivery (Wallin et al., 2016). In addition to enhancing fidelity to treatment through text-based materials and saving therapist time, internet-based interventions improve treatment acceptability in mental health patients.

Therefore, the study aimed at evaluating the preference of internet-based over face-to-face interventions for people without current or past online treatment (Wallin et al., 2016). The study revealed that most participants preferred face-to-face psychological intervention over internet-based intervention. The use of the Internet to search for and read health-related information was a significant predictor of treatment preference among all the participants. The perceived significance of internet-based treatment included credibility, anonymity, accessibility, minimum access effort, user empowerment, flexibility regarding location and time, and enhanced communication between client and therapist. The authors concluded that internet-based interventions were a preference for a minority of the participants. Nevertheless, the results showed that internet-based interventions have several advantages that could improve the delivery of mental health services to a larger population (Wallin et al., 2016). Therefore, the authors recommended the need to implement initiatives that enhance treatment acceptability by addressing the disadvantages and advantages identified in the study.

Loue, S. (2016). Ethical use of electronic media in social work practice. Revista Românească Pentru Educaţie Multidimensională, 8(2), 21-30. doi:10.18662/rrem/2016.0802.02.

Many people rely on the internet to access information and facilitate communication today; because majority use social media to get health-related information (Loue, 2016). Similarly, mental healthcare providers and practitioners use the internet to relay information to patient/clients, provide treatment, get client feedback, and conduct consultation or supervision. The author also highlights the importance of online counseling in overcoming geographical barriers to permit therapeutic alliances, facilitate information sharing, and access mental health care. Despite providing the opportunity to globalize the mental healthcare sector, internet-based interventions face several legal and ethical issues linked with the use of electronic media in the social work office (Loue, 2016). Other shortcomings include limited ability to monitor critical situations and potential breach of confidentiality.

Deslonde,V., & Becerra, M. (2018). The technology acceptance model: Exploring school counselors’ acceptance and use of naviance. The Professional Counselor, 369–382.

Overall, the article reviewed provide essential insight on the challenges that custodial grandparents may likely face during migration to a digital platform (Deslonde & Becerra, 2018). Notably, most of the research notes that financial constraints play a significant role in mental health for grandparents taking care of their grandchildren. The onset of financial problems comes along with other mental health issues like anxiety, stress, isolation, and so on. It is important to note that the majority of the research only highlighted the challenges mental health patients face while a few pointing out the necessary interventions to alleviate the problems. Besides, there is limited research on the use of technology by healthcare providers on custodial grandparents (Deslonde & Becerra, 2018). Therefore, the need for the current study is justified.

Conceptual Framework

The research employs the technology acceptance model (TAM) tool in the theoretical framework. Many researchers use this tool to examine the health professional’s behavior when using the internet for work purposes. Past research has used a modified version of TAM to gain insight on how internet use varies with participant's education, income earned, race, and participant’s age. However, the choice of the appropriate version to use will deter the success of this research. For instance, Surendran (2012) states that there is a need for future research to extend the application of the technology in e-recruitment. Therefore, there may be too many unknowns as to how the tool will produce desirable results in this research.

Research Question and Hypotheses

 The researcher will examine the relationship between mental health professional’s intention to use technology with custodial grandparents, purposes, and the predictors of demographic and confidence related influences. 

RQ1: Do counselors with varying degrees of experience have different Intentions to use modern technology with clients of different ages?

H1: There is a relationship between the independent variables (age, type of education received) and perception of custodial grandparents by counselors when using multimedia amongst custodial grandparents.

H0: There is no relationship between the independent variable (age, type of education received) and perception of custodial grandparents by counselors when using multimedia amongst custodial grandparents.

Nature of the Study

The study is a quantitative approach using a two-way ANOVA designed to assess the interrelationship of two independent variables on a dependent variable. Similarly, it involves a systematic review of scientific literature on the application of technology by mental healthcare providers for custodial grandparents. Particularly, the research will entail more of quantitative analysis of secondary data and less of qualitative analysis by reviewing various case studies in other research. The quantitative aspect involves comparison of  perceptions of custodial grandparents by counselor’s perception of the execution of  caregiver duties.  The approach helps to identify the elements of counseling that affect custodial grandparents and also uses empirical evidence to establish the truthfulness of the research hypothesis.

Types and Sources of Data

The research involves the collection of both primary and secondary data. Primary data will come from surveying mental health providers regarding their perception of the use of technology when dealing with custodial grandparents. The identified tool for this process is TAM. For distinction and clarity, mental health providers are categorized as counselors, social workers, marriage and family therapist, and Psychologists. The secondary will come from journals and book that meet the selection criteria on the application of technology in custodial grandparents.

Limitations, Challenges, and Barriers

The study aims to address the barriers that exist between mental healthcare providers and grandparents left to care for their grandchildren by applying multimedia interventions. Therefore, the research has identified its target population from urban, suburban, and remote providers and clients. However, there are limitations to the size of the people the study can reach out. Besides, the understanding of mental health interventions varies depending on the region, which could cause respondents to give inconsistent answers. The target participants, especially grandparents, compelled by court order or other circumstances to assume caregiver duties, may present a bias opinion of their experience. Although many studies have covered topics on the impact of online mental disorder interventions, there is limited research regarding the application of technology for custodial grandparents. Therefore, it is possible that the few available research materials making an inconclusive claim about the implementation of technology in custodial grandparents will limit this research.

It is also possible that most of the grandparents are more receptive to the traditional sources of knowledge and may express a strong desire to keep the status quo. If that is the case, then the outcome of this study may be reasonably limited or misleading. There are also possible low respondents due to insufficient knowledge on the use of internet-based information, especially among custodial grandparents. Another challenge that may emerge during actual data collection is the need for IRB application, which is time-consuming due to the bureaucracy involved. Lack of IRB may halt the research altogether. Generally, the success of the research design depends on a high number of participant's turnout regardless of other factors. A smaller gathering will make it harder to provide generalized results.

References

Bashshur, R., Bashshur, N., Shannon, G., & Yellowlees, P. (2016). The empirical evidence for telemedicine interventions in mental disorders. Telemedicine and E-Health, 22(2), 87-113. doi:10.1089/tmj.2015.0206.

Deslonde,V., & Becerra, M. (2018). The technology acceptance model: Exploring school counselors’ acceptance and use of naviance. The Professional Counselor, 369–382.

Hadfield, C. (2014). The health of grandparents raising grandchildren: A literature review. Journal of Gerontological Nursing, 40(4), 32-42. doi: 10.3928/00989134-20140219-01.

Lent, J., & and Otto, A. (2018). Grandparents, grandchildren, and caregiving: The impacts of America's substance use crisis. 1-3. Retrieved 19 November 2019, from http://www.grandsflourish.org/wp-content/uploads/2019/04/Impacts-of-Americas-Substance-USe-Crisis.pdf.

Loue, S. (2016). Ethical use of electronic media in social work practice. Revista Românească Pentru Educaţie Multidimensională, 8(2), 21-30. doi:10.18662/rrem/2016.0802.02.

Sumo, J., Wilbur, J., & Julion, W. (2017). Interventions to improve grandparent caregivers’ mental and physical health: An integrative review. Western Journal of Nursing Research, 40( 8), 1236-1264. doi: 10.1177/0193945917705376.

Surendran, P. (2012). Technology acceptance model: A survey of literature. International Journal of Business and Social Research, 175-179.

Taylor, M., Marquis, B., Coall, D., Batten, R., &Werner, J. (2017). The physical health dilemmas facing custodial grandparent caregivers: Policy considerations. Cogent Medicine, 4(1). doi:10.1080/2331205x.2017.1292594.

Taylor, M., Marquis, R., Coal, D., & Batten, R. (2015). Understanding the occupational issues faced by custodial grandparents endeavoring to improve scholastic outcomes for their grandchildren. Journal of Occupational Therapy, Schools, & Early Intervention, 8(4), 319-335. doi:10.1080/19411243.2015.1105169.

Taylor, M., Marquis, R., Coall, D., & Batten, R.(2016). Understanding the mental health travails of custodial grandparents. Occupational Therapy in Mental Health, 32(3), 259-280. doi:10.1080/0164212x.2015.1136255.

Vasel, K. (2019). It Costs $233,610 To Raise A Child. Cnn money.

Wallin, E., Psych, L., Mattsson, S., & Olsson, E. (2016). The preference for internet-based psychological interventions by individuals without past or current use of mental health treatment delivered online: A survey study with mixed-methods analysis. JMIR Mental Health, 3(2), e25. JMIR Publications Inc., doi:10.2196/mental.5324.