Tilley, Jacqueline L.

Amidst the COVID-19 pandemic, prolonged periods of physical and social isolation imposed significant challenges on parents and children, disrupting their socioeconomic stability and psychological well-being. This study examined the effects of parenting stress on aspects of parents’ and children’s functioning during the COVID-19 pandemic. A comprehensive search of studies from eight electronic sources, including the World Health Organization’s COVID-19 database, yielded 42 studies focusing on the associations between parenting stress, as measured by standardized scales, and child and parental outcomes. Multilevel random-effect models were used to analyze weighted effect sizes. Our findings revealed medium-to-large effect sizes (ranging from r = .29 to .55) in the associations between parenting stress and (a) externalizing child behaviors (r = .41), (b) internalizing child behaviors (r = .48), (c) negative parents’ behavioral engagements (r = .29), (d) parents’ mental health (r = .46), and (e) poor parent–child relationship quality (r = .55). These results underscore the significance of addressing parenting stress during a pandemic. Practice implications suggest that governmental or community support, along with tangible assistance, can alleviate parenting stress and positively impact the well-being and functioning of parents and children in the pandemic and postpandemic era, especially in light of the current global mental health crisis. Furthermore, considering the influence of parenting stress on treatment engagement and motivation, family- or parent-oriented interventions that address parenting stress can be more effective at reducing the negative consequences of a pandemic on children and their parents.

Background: The role of working alliance remains unclear for many forms of internet-based interventions (IBIs), a set of effective psychotherapy alternatives that do not require synchronous interactions between patients and therapists. Objective: This study examined the conceptual invariance, trajectories, and outcome associations of working alliance across an unguided IBI and guided IBIs that incorporated clinician support through asynchronous text messaging or video messaging. Methods: Adults with high education attainment (n=145) with subclinical levels of anxiety, stress, or depressive symptoms were randomized to 1 of 3 treatment conditions for 7 weeks. All participants received treatments from MyCompass, an unguided IBI using cognitive behavior therapy. Participants in condition 2 and 3 received supplemental, asynchronous clinician support through text and video, respectively. Working alliance with the IBIs was measured weekly using select items from the 12-item version of the Agnew Relationship Measure. Symptom and functional outcomes were assessed at baseline, at the end of treatment, and 1-month follow-up. Results: Working alliance with the IBIs was conceptually invariant across the 3 conditions. Working alliance followed a quadratic pattern of change over time for all conditions and declined significantly only in the text-support condition. After controlling for baseline symptoms, higher baseline levels of working alliance predicted less depression and less functional impairment at follow-up, whereas faster increases in working alliance predicted less worry at the end of treatment and at follow-up, all of which only occurred in the video-support condition. Conclusions: Working alliance with the IBIs was generally established in the initial sessions. Although working alliance is conceptually invariant across IBIs with or without clinician support, the associations between working alliance and treatment outcomes among IBIs may differ depending on clinician involvement and the modalities of support.