Online support services 'less effective' than face-to-face sessions

A report by the Early Intervention Foundation (EIF) finds that despite services “rapidly mobilising” to provide online interventions to replace services such as counselling for children with mental health issues, participants are more likely to drop out of programmes than if they were seeing a professional face-to-face.

The results of a “rapid response survey” carried out by the EIF in the first few weeks of lockdown measures in the UK, found that of 88 providers of intervention services for young people 76 per cent were forced to make “major adaptations” to their programmes because of coronavirus.

Just three in 10 providers (32 per cent) delivered their programme “predominantly through remote methods” prior to the Covid-19 crisis.

• Youth work services move online to protect vulnerable children

• How one youth organisation is coping with lockdown

EIF’s research found just three per cent of remotely delivered programmes were carried out on a one-to-one basis.

Most had no direct practitioner input or contact, with 84 per cent instead involving self-guided or unguided content, such as quizzes, games, videos and apps, the report states.

“The evidence also highlights that participant drop-out, a challenge usually, may be worse with video and digital programmes. This reduces the likelihood that an intervention will work for those taking part, and undermines the robustness of any evaluation or testing of these interventions,” it adds, saying: “Many effective traditional interventions rely on a strong relationship and regular contact between a practitioner and participant.”

Of the 116 existing digital interventions identified by EIF, only 22 per cent showed evidence of having been effective, researchers said.

The report states: “All others were found to have only preliminary evidence of working, no evidence, or evidence of having no effect or a negative impact. While this doesn’t mean that these programmes won’t or can’t deliver benefits for children, it provides a significant note of caution on the effectiveness of existing remotely delivered interventions.”

• Latest coronavirus news

• Topic hub: Mental health

The report also highlighted a lack of online programmes focused on children’s mental health and wellbeing and even fewer resources on subjects including substance misuse and teenage pregnancy.

Some 73 per cent of the programmes identified by the EIF focus on children’s education or aspects of physical health, leaving just 31 programmes focused on child maltreatment, crime, violence and antisocial behaviour, mental health and wellbeing, substance misuse, and risky sexual behaviour and teen pregnancy.  

Recommendations made to commissioners in the report, which also looked at studies on digital and video intervention dating back to 2000, include: 

• Providers should work with experts in digital delivery to ensure content is appropriate and engaging for the participants it’s aimed at. 
• Those developing and adapting video and digital interventions should have frequent contact with a trained practitioner.  
• Services need to consider how to develop strong engagement strategies for their interventions and to monitor engagement so they can detect if interventions are struggling to reach recipients. 
• Given the limited evidence base – especially on the long-term impacts – providers, developers and commissioners should work with the research community to design evaluations that will improve the evidence base on effective approaches to remote delivery of interventions for children and young people. 

Tom McBride, director of evidence at the EIF said: “Covid-19 is likely to increase both the number of vulnerable children and the severity of the challenges they are facing. It’s important that these children and young people continue to receive effective support and it’s encouraging to see that the sector is rapidly adapting to deliver services remotely. 

“However, achieving this rapid adaptation to remote and digital delivery isn’t going to be straightforward. It’s important not to assume that face-to-face support can simply be moved online and produce the same level of benefits as before. It’s also important that those involved in adapting services can access what is currently known about different virtual delivery methods and the evidence about what has and hasn’t been shown to be effective. What we don’t want to see is the most disadvantaged being left further behind by virtual or digital services that aren’t as widely available or effective as possible.” 

The report comes after children’s charity the NSPCC said it is “increasingly concerned” about the number of children suffering abuse and neglect during lockdown.

Last week, the organisation’s Childline service delivered 363 counselling sessions where children had experienced physical, sexual, emotional abuse or neglect – almost a fifth more than in the previous week.