Table III. Open in new tab Identified...

Research Question 1: What factors influenced parents’ attitudes toward IBH services during the pandemic?
Parenting demands	Child emotions/behaviors	Q1	“She’s crying a lot more… the social worker at [clinic] thought it would be good for her to see a counselor because she’s been like, really just crying.” [P10]
Expanded roles	Q2	“It was tough because I was expected to be a teacher, I work full time, I was sick, and then I’m also in school. So it was… it was a lot to try to balance.” [P5]
Parenting capacity	Resources	Q3	“You have a hyperactive child. There are no parks open. There are no indoor places open in the winter… You can’t go out and interact with social groups. Overnight, everything is just gone.” [P3]
Parent mental health	Q4	“I had to increase my dose of depression medicine to maintain my ability to parent… If I can’t tolerate, then I’m getting angry and yelling and then the kids are upset by that, and then they’re fighting with each other. It’s like, one, horrible, snowball effect.” [P3]
Uncertainty	Child impact	Q5	“Will staying home all the time impact her mentally and socially? If it does, we still can’t really go out at this point, so what can we do at home to remedy that? Would more [video chatting] with others help? Would that not help?” [P16]
Healthcare ambiguity	Q6	“I don’t really know what type of sessions we could even book if we didn’t have an actual physical concern. One of my first questions would be, ‘Oh, is this only for people who have really bad behavior?’” [P14]

Research Question 1: What factors influenced parents’ attitudes toward IBH services during the pandemic?

Theme

Sub-theme

Representative quote

Parenting demands

Child emotions/behaviors

“She’s crying a lot more… the social worker at [clinic] thought it would be good for her to see a counselor because she’s been like, really just crying.” [P10]

Expanded roles

“It was tough because I was expected to be a teacher, I work full time, I was sick, and then I’m also in school. So it was… it was a lot to try to balance.” [P5]

Parenting capacity

Resources

“You have a hyperactive child. There are no parks open. There are no indoor places open in the winter… You can’t go out and interact with social groups. Overnight, everything is just gone.” [P3]

Parent mental health

“I had to increase my dose of depression medicine to maintain my ability to parent… If I can’t tolerate, then I’m getting angry and yelling and then the kids are upset by that, and then they’re fighting with each other. It’s like, one, horrible, snowball effect.” [P3]

Uncertainty

Child impact

“Will staying home all the time impact her mentally and socially? If it does, we still can’t really go out at this point, so what can we do at home to remedy that? Would more [video chatting] with others help? Would that not help?” [P16]

Healthcare ambiguity

“I don’t really know what type of sessions we could even book if we didn’t have an actual physical concern. One of my first questions would be, ‘Oh, is this only for people who have really bad behavior?’” [P14]

Research Question 1: What factors influenced parents’ attitudes toward IBH services during the pandemic?
Parenting demands	Child emotions/behaviors	Q1	“She’s crying a lot more… the social worker at [clinic] thought it would be good for her to see a counselor because she’s been like, really just crying.” [P10]
Expanded roles	Q2	“It was tough because I was expected to be a teacher, I work full time, I was sick, and then I’m also in school. So it was… it was a lot to try to balance.” [P5]
Parenting capacity	Resources	Q3	“You have a hyperactive child. There are no parks open. There are no indoor places open in the winter… You can’t go out and interact with social groups. Overnight, everything is just gone.” [P3]
Parent mental health	Q4	“I had to increase my dose of depression medicine to maintain my ability to parent… If I can’t tolerate, then I’m getting angry and yelling and then the kids are upset by that, and then they’re fighting with each other. It’s like, one, horrible, snowball effect.” [P3]
Uncertainty	Child impact	Q5	“Will staying home all the time impact her mentally and socially? If it does, we still can’t really go out at this point, so what can we do at home to remedy that? Would more [video chatting] with others help? Would that not help?” [P16]
Healthcare ambiguity	Q6	“I don’t really know what type of sessions we could even book if we didn’t have an actual physical concern. One of my first questions would be, ‘Oh, is this only for people who have really bad behavior?’” [P14]

Research Question 2: How did the pandemic affect preferences for how IBH services are delivered?
Proactive communication	Service availability	Q7	“Forgive my language, but parents are losing their shit. They don’t know which way is up, which way is down… So, send out resources. Somewhere in there, connecting and saying, ‘Did you know this resource was available? Did you know there was a behavioral health specialist available?” [P6]
Mitigating pandemic impact	Q8	“How can I better protect my child? You know, keeping her at home but then also at the same time, providing her the social skills. You know, because I wanted to provide that for her, but I can’t because I want to protect her.” [P4]
Practical strategies	Q9	“At the start of the pandemic, they could have sent out an email. Maybe activities to do with kids at home. Little things of how to work on their behaviors and being stuck at home.” [P20]
Ease of use	Comfort with technology	Q10	“I use technology more than I did before. I’ve become more knowledgeable… It’s made me have to come out my little bubble of not wanting to learn how to do new things.” [P10]
Same-day access	Q11	“If we’re already there, I’m going to take [IBH]. Having to come back with young kids, would just be kind of a hassle… I’d have to take more time out of my schedule.” [P8]
Perceived utility	–	Q12	“If the clinic thinks it’s safe, I’d be happy to meet in person. I think that would give the provider the richest information about our kiddo.” [P21]

Research Question 2: How did the pandemic affect preferences for how IBH services are delivered?

Theme

Sub-theme

Representative quote

Proactive communication

Service availability

“Forgive my language, but parents are losing their shit. They don’t know which way is up, which way is down… So, send out resources. Somewhere in there, connecting and saying, ‘Did you know this resource was available? Did you know there was a behavioral health specialist available?” [P6]

Mitigating pandemic impact

“How can I better protect my child? You know, keeping her at home but then also at the same time, providing her the social skills. You know, because I wanted to provide that for her, but I can’t because I want to protect her.” [P4]

Practical strategies

“At the start of the pandemic, they could have sent out an email. Maybe activities to do with kids at home. Little things of how to work on their behaviors and being stuck at home.” [P20]

Ease of use

Comfort with technology

Q10

“I use technology more than I did before. I’ve become more knowledgeable… It’s made me have to come out my little bubble of not wanting to learn how to do new things.” [P10]

Same-day access

Q11

“If we’re already there, I’m going to take [IBH]. Having to come back with young kids, would just be kind of a hassle… I’d have to take more time out of my schedule.” [P8]

Perceived utility

–

Q12

“If the clinic thinks it’s safe, I’d be happy to meet in person. I think that would give the provider the richest information about our kiddo.” [P21]

Research Question 2: How did the pandemic affect preferences for how IBH services are delivered?
Proactive communication	Service availability	Q7	“Forgive my language, but parents are losing their shit. They don’t know which way is up, which way is down… So, send out resources. Somewhere in there, connecting and saying, ‘Did you know this resource was available? Did you know there was a behavioral health specialist available?” [P6]
Mitigating pandemic impact	Q8	“How can I better protect my child? You know, keeping her at home but then also at the same time, providing her the social skills. You know, because I wanted to provide that for her, but I can’t because I want to protect her.” [P4]
Practical strategies	Q9	“At the start of the pandemic, they could have sent out an email. Maybe activities to do with kids at home. Little things of how to work on their behaviors and being stuck at home.” [P20]
Ease of use	Comfort with technology	Q10	“I use technology more than I did before. I’ve become more knowledgeable… It’s made me have to come out my little bubble of not wanting to learn how to do new things.” [P10]
Same-day access	Q11	“If we’re already there, I’m going to take [IBH]. Having to come back with young kids, would just be kind of a hassle… I’d have to take more time out of my schedule.” [P8]
Perceived utility	–	Q12	“If the clinic thinks it’s safe, I’d be happy to meet in person. I think that would give the provider the richest information about our kiddo.” [P21]

Table III.

Open in new tab

Identified Themes, Sub-Themes, and Representative Quotes

Research Question 1: What factors influenced parents’ attitudes toward IBH services during the pandemic?
Theme	Sub-theme	Representative quote
Parenting demands	Child emotions/behaviors	Q1	“She’s crying a lot more… the social worker at [clinic] thought it would be good for her to see a counselor because she’s been like, really just crying.” [P10]
Parenting demands	Expanded roles	Q2	“It was tough because I was expected to be a teacher, I work full time, I was sick, and then I’m also in school. So it was… it was a lot to try to balance.” [P5]
Parenting capacity	Resources	Q3	“You have a hyperactive child. There are no parks open. There are no indoor places open in the winter… You can’t go out and interact with social groups. Overnight, everything is just gone.” [P3]
Parenting capacity	Parent mental health	Q4	“I had to increase my dose of depression medicine to maintain my ability to parent… If I can’t tolerate, then I’m getting angry and yelling and then the kids are upset by that, and then they’re fighting with each other. It’s like, one, horrible, snowball effect.” [P3]
Uncertainty	Child impact	Q5	“Will staying home all the time impact her mentally and socially? If it does, we still can’t really go out at this point, so what can we do at home to remedy that? Would more [video chatting] with others help? Would that not help?” [P16]
Uncertainty	Healthcare ambiguity	Q6	“I don’t really know what type of sessions we could even book if we didn’t have an actual physical concern. One of my first questions would be, ‘Oh, is this only for people who have really bad behavior?’” [P14]

Research Question 1: What factors influenced parents’ attitudes toward IBH services during the pandemic?
Theme	Sub-theme	Representative quote
Parenting demands	Child emotions/behaviors	Q1	“She’s crying a lot more… the social worker at [clinic] thought it would be good for her to see a counselor because she’s been like, really just crying.” [P10]
Parenting demands	Expanded roles	Q2	“It was tough because I was expected to be a teacher, I work full time, I was sick, and then I’m also in school. So it was… it was a lot to try to balance.” [P5]
Parenting capacity	Resources	Q3	“You have a hyperactive child. There are no parks open. There are no indoor places open in the winter… You can’t go out and interact with social groups. Overnight, everything is just gone.” [P3]
Parenting capacity	Parent mental health	Q4	“I had to increase my dose of depression medicine to maintain my ability to parent… If I can’t tolerate, then I’m getting angry and yelling and then the kids are upset by that, and then they’re fighting with each other. It’s like, one, horrible, snowball effect.” [P3]
Uncertainty	Child impact	Q5	“Will staying home all the time impact her mentally and socially? If it does, we still can’t really go out at this point, so what can we do at home to remedy that? Would more [video chatting] with others help? Would that not help?” [P16]
Uncertainty	Healthcare ambiguity	Q6	“I don’t really know what type of sessions we could even book if we didn’t have an actual physical concern. One of my first questions would be, ‘Oh, is this only for people who have really bad behavior?’” [P14]

Research Question 2: How did the pandemic affect preferences for how IBH services are delivered?
Theme	Sub-theme	Representative quote
Proactive communication	Service availability	Q7	“Forgive my language, but parents are losing their shit. They don’t know which way is up, which way is down… So, send out resources. Somewhere in there, connecting and saying, ‘Did you know this resource was available? Did you know there was a behavioral health specialist available?” [P6]
	Mitigating pandemic impact	Q8	“How can I better protect my child? You know, keeping her at home but then also at the same time, providing her the social skills. You know, because I wanted to provide that for her, but I can’t because I want to protect her.” [P4]
	Practical strategies	Q9	“At the start of the pandemic, they could have sent out an email. Maybe activities to do with kids at home. Little things of how to work on their behaviors and being stuck at home.” [P20]
Ease of use	Comfort with technology	Q10	“I use technology more than I did before. I’ve become more knowledgeable… It’s made me have to come out my little bubble of not wanting to learn how to do new things.” [P10]
Ease of use	Same-day access	Q11	“If we’re already there, I’m going to take [IBH]. Having to come back with young kids, would just be kind of a hassle… I’d have to take more time out of my schedule.” [P8]
Perceived utility	–	Q12	“If the clinic thinks it’s safe, I’d be happy to meet in person. I think that would give the provider the richest information about our kiddo.” [P21]

Research Question 2: How did the pandemic affect preferences for how IBH services are delivered?
Theme	Sub-theme	Representative quote
Proactive communication	Service availability	Q7	“Forgive my language, but parents are losing their shit. They don’t know which way is up, which way is down… So, send out resources. Somewhere in there, connecting and saying, ‘Did you know this resource was available? Did you know there was a behavioral health specialist available?” [P6]
	Mitigating pandemic impact	Q8	“How can I better protect my child? You know, keeping her at home but then also at the same time, providing her the social skills. You know, because I wanted to provide that for her, but I can’t because I want to protect her.” [P4]
	Practical strategies	Q9	“At the start of the pandemic, they could have sent out an email. Maybe activities to do with kids at home. Little things of how to work on their behaviors and being stuck at home.” [P20]
Ease of use	Comfort with technology	Q10	“I use technology more than I did before. I’ve become more knowledgeable… It’s made me have to come out my little bubble of not wanting to learn how to do new things.” [P10]
Ease of use	Same-day access	Q11	“If we’re already there, I’m going to take [IBH]. Having to come back with young kids, would just be kind of a hassle… I’d have to take more time out of my schedule.” [P8]
Perceived utility	–	Q12	“If the clinic thinks it’s safe, I’d be happy to meet in person. I think that would give the provider the richest information about our kiddo.” [P21]

Note. IBH = integrated behavioral health; [P#] = participants in the order they were interviewed.

This Feature Is Available To Subscribers Only