In view of the current COVID-19 pandemic which has had a major impact on the international community, there was a recent rise in telemedicine services and delivery of psychological interventions through phone and online technologies.

Through a collaboration with Queen Mary University of London, American University of Beirut, Médecins du Monde, Johns Hopkins University, and Medical School Hamburg, a guidance document was produced to set basic principles for the safe delivery of psychological therapy to children via telephone, based on the adaptation of an existing therapy for phone delivery among Syrian refugee children in Lebanon.

This effort is based on the work which was initiated in 2017 by Queen Mary University London, Médecins du Monde and IDRAAC (Dr. Elie Karam, Co-Principal Investigator and Dr. Georges Karam, Co-Investigator) in a study titled:

Biological Pathways of Risk and Resilience in Syrian Refugee Children BIOPATH, funded by The National Institutes of Health NIH -USA, which aims at investigating the biological underpinnings of individual differences in refugee children’s response to acute war-related trauma exposure. This project studies genetic moderations of interventions related to mental health wellbeing of Syrian and Lebanese children by measuring pre-post changes in psychological variables and identifying specific gene variants in children who are more/less responsive to interventions.

This project allows to understand the relationship between genetic, social, psychological and biological factors in relation to resilience.

Based on this study, a sample was selected for another study: Common Elements Treatment Approach (CETA), funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Program, which aims to adapt and evaluate this existing trans-diagnostic psychological treatment program for the delivery by trained counselors over phone to Syrian refugee children living in Lebanon.

The guidance document, produced as a result of this extensive research work, is aimed at mental health services that are adapting therapies to phone-delivery, and is especially relevant for those working in refugee or other low resource settings.

The complete guidance document (developed by Prof Michael Pluess and Dr. Fiona McEwen (Queen Mary University of London), Dr. Tania Bosqui (American University of Beirut), Nicolas Chehade (Médecins du Monde), and Dr. Laura Murray and Stephanie Skavenski (Johns Hopkins University)) can be downloaded on the following LINK.

Key points covered include:

• Developing safety protocols for managing risk over the phone
• Adapting therapy to maintain child engagement and using alternatives to workbooks or written materials
• Tips to manage specific practical and treatment-related challenges that can arise during therapy

Although this document proposes a number of specific solutions, it is important that each service adapts these further in order to create protocols that are appropriate to their specific setting, population, and type of therapy.