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AF-CBT Adaptations During the COVID-19 Pandemic

General Suggestions

  1. Find and ensure that your patient has the most private setting they can.
    1. Have client use headphones
    2. Ask most closed ended questions to minimize disclosure of sensitive info.
  2. Do a general check in to see how the person is doing with the COVID situation.
    1. Address any anxiety or need for info
    2. Encourage safe forms of self-care and activity/exercise
  3. Clarify how long the participant wants the session to last
    1. Make it shorter than usual
    2. AF-CBT does not prescribe a session length or the frequency of sessions
  4. Do separate Weekly Safety Check-In with each participant when you speak to each one.
    1. Decide whether you need to bring them together for a discussion to process the info.
  5. Make handouts available to all participants – information on accessing these can be found below.
  6. For families that need to complete our assessment forms, information can be found below.
  7. Make AF-CBT website address available to each family:
    1. Families can send us a question via our “Ask a Question” button

Accessing Caregiver and Child Handouts

Needed Programs

Before you use these, make sure you and your clients have Adobe Reader or another program that can open .pdf files.

Caregiver Handouts

Caregiver handouts are outlined below in order of appearance. Handouts marked with an asterisk* are not fillable.

  1. Weekly Safety Check-In (WSCI)
  2. Stressful Life Experiences
  3. Decisional Balance Sheet
  4. My Goals for Treatment
  5. Alternatives for Families Plan
  6. ABC Model*
  7. Reaction Triangle
  8. The Body's Response to Anger and Anxiety
  9. Feelings Thermometers
  10. Anger/Anxiety Warning Signs
  11. How to Relax Using Controlled Breathing*
  12. How to Relax Using Progressive Muscle Relaxation*
  13. Relaxation Practice
  14. ABC Model Pathway
  15. Patterns of Personal Thinking*
  16. Matching Parenting Technique with Type of Behavior*
  17. Attending to Your Child
  18. Praise Statements*
  19. Types of Rewards
  20. "When-Then" Statements
  21. Giving Effective Instructions*
  22. Natural and Logical Consequences
  23. Positive Opposites
  24. Active Ignoring
  25. Removing Privileges Plan
  26. Time Out from Positive Reinforcement Plan
  27. Contracts
  28. Clarification Letter Sections
  29. Common Communication Obstacles
  30. Communication Alternatives
  31. Problem Solving Skills

Child Handouts

Child handouts are outlined below in order of appearance.

  1. Learning About Each Other
  2. Goal Setting
  3. Weekly Safety Check-In
  4. Look, Listen, Ask*
  5. Identifying Feelings*
  6. My Positive Experiences at Home
  7. My Upsetting Experiences at Home
  8. Alternatives for Families Plan
  9. ABC Model*
  10. Reaction Triangle
  11. The Body's Response to Anger and Anxiety
  12. Feelings Thermometers
  13. Anger/Anxiety Warning Signs
  14. How to Relax Using Controlled Breathing*
  15. How to Relax Using Progressive Muscle Relaxation*
  16. Relaxation Practice
  17. ABC Model Pathway
  18. Ways to be Nice to Friends and Family
  19. If I Need Help
  20. SUDS Graph*
  21. Common Communication Obstacles
  22. Communication Alternatives
  23. Problem Solving Skills

Accessing Assessments

There are three ways to make use of the AF-CBT assessment measures remotely via the AF-CBT website: downloading fillable measures and completing them on a shared screen with the client, downloading fillable measures and e-mailing those measures to the client, or completing the measure by phone and scoring the measure online.

Fillable Assessment Measures

To use fillable measures, save the measures that you would like to send to a client below to a folder that you can easily access later. Instructions for use of these measures can be found here.

  1. APQ SF+CP
    1. English
    2. Spanish
  2. BCAP
    1. English
    2. Spanish
  3. Trauma Screen/CPSS-V
    1. English
    2. Spanish (without CPSS-V)
  4. SDQ
    1. English
    2. Spanish

Send the Measures to your Client

Include the PDFs of the assessments and instructions as an attachment to an e-mail that you send to your client's e-mail address. Alternatively, you can ask the client to download the assessment PDFs directly from this page.

Client Steps

Ask that the client does the following:

  1. Download the assessment PDFs to a location that they can easily access later.
  2. Open them in Adobe Reader (or another program) and complete the measure(s).
  3. Save a copy of their completed measures by another name or to another location.
  4. Include the completed measures as an attachment to an e-mail to you.

Assessment by Phone

To complete assessment by phone, you can use the AF-CBT Online Assessment Scoring Tool via your browser.

  1. Call your client.
  2. Select an assessment from the Assessment Scoring Tool's menu.
  3. Enter a client ID and your e-mail address in the appropriate fields.
  4. Go through each item with your client, marking the appropriate answer for each and clicking the "Next" button to proceed through each set of items.
  5. You will be given a table of scores that you can print on your PC. To print, click on the Menu/Settings button (this will look different for each browser; Chrome: 3 vertical dots, Firefox: 3 horizontal bars, Internet Explorer: gear icon) in the upper right-hand corner of the screen next to the address bar. Select Print from the menu.
  6. Return to the main menu and repeat this process for each measure you would like to complete.

Topic Tracker

This form is used to document the delivery of key AF-CBT topical content and the level of participation/progress shown by the family after each treatment session/contact.  It should also be shared with your supervisor to support conversations about who to enhance the delivery of AF-CBT with each case.

Download the Topic Tracker

Audio Recording Options

Below are some options for audio recording while not seeing clients in person. We are always open to other ideas. All options assume that permission ahve been obtained from the client and that agency policies are being followed.

  1. Use the method of telehealth to record (for example, 2 agencies that are using Zoom and recording their sessions using the record feature in Zoom. One agency uploads the audio file to the AF-CBT secure server, the other sends me a link and password to access the recording on their server.
  2. Record the therapist’s end of a phone call or video call using a phone, recorder, tablet, or computer. We have had a therapist upload to our secure server a recording in which only the therapist side of the recording is audible, which is fine; that's what we're rating for fidelity.
  3. Postpone recording until another time.

General References

Sharma, R., Nachum, S., Davidson, K. W., & Nochomovitz, M. (2019). It's not just FaceTime: core competencies for the Medical Virtualist. International journal of emergency medicine, 12(1), 8. DOI: 10.1186/s12245-019-0226-y

Nochomovitz M, Sharma R. Is It Time for a New Medical Specialty? The Medical Virtualist. JAMA. 2018;319(5):437–438. DOI: 10.1001/jama.2017.17094

APA Telepsychiatry Practice Guidelines

APA Media Communication Skills


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Dr. Barbara Baumann to Present at NCA 2021 Leadership Conference: Empowering Caregivers to Help Children Manage Anger and Aggression


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