There are major obstacles to the effective delivery of mental health services, particularly in rural areas. The need of rural families for mental health services is reaching crisis proportions due to the dearth of trained professionals. In addition, the meteoric rise of Internet use has created a new avenue for people to communicate and share ideas. These two trends are helping fuel the demand for mental health services and on-line support. Computer mediated interventions and assessment are feasible because of the wide penetration of Internet access. However, distal contact does not easily allow monitoring of intervention outcomes. The current proposal addresses the need for parent-child interaction data focused on treatment outcomes to tackle the issue of distal monitoring. Through the use of recent advances in multimedia technology and software and the nse of computer networking via the Internet, there now exists an opportunity to provide such monitoring of outcomes and remote contact for rural locations. This research will experimentally evaluate the psychometric characteristics of an innovative computer/Internet observation system to record parent-child behaviors as a means of monitoring important indicators of treatment outcomes in behavioral parent training. This system could potentially provide supplemental remote contact for parents of young children receiving therapy in rural areas. The current project will develop and test a computer-guided Parent-Child interaction task, automatically recorded with a digital camera and transferred over the Internet for coding. Ultimately, this system would enable professional providers to make treatment decisions with objective data, as well as provide researchers with a generalizable outcomes assessment from remote research sites. Central to this project is the use of multi-media technology to compress data (i.e., video and audio), and the transfer of that data via the Internet to observational coders. Once coded, the results will be analyzed via computer software and a report displayed on a secure website. Data can be presented on any targeted behavior or sequential interaction. If this study is successful, future therapists and researchers could be able to view dynamically created graphs of client progress toward goals (e.g. decreasing mother aggression following child aggression) on demand. The proposed system lends itself to dissemination in that it is not dependent on physical location and fits easily into existing HMO and EAP mental health service delivery models, bypassing distance and many of the current mental health and social service systems bamers.
