How to guide the underage family members through the labyrinth of the ICU? Development of the 'Ariadne', a psychological assessment and support protocol

Background: Critical illness and hospitalization in the Intensive Care Unit have been linked to adverse psychological effects for patients and their families. Although psychological support for adult family members gained growing research interest, studies regarding psychological support for the underage family members are still sporadic. Aim: The aim of this study was to develop a protocol for an innovative psychological assessment and support service (named “Ariadne”) for the underage family members (4 – 17 years old) of critically ill patients. Method: The following phases were implemented: a) Defining the needs of service’s users (underage family members and their guardians), b) Identifying potential assessment and intervention methods through semi-structured interviews with field experts and c) Consensus development with mental health professionals. Results: Users’ needs assessment phase highlighted the necessity for developing the service. Semi-structured interviews with field experts identified service implementation difficulties, psychological assessment, and intervention practices. The consensus meeting further specified the assessment and intervention practices that guided the development of the protocol. Limitations: The study was conducted at a single centre, limiting the generalization of findings. Furthermore, a possible recruitment bias should also be considered. Conclusion: This study introduces a novel methodology embedded in a complete protocol aiming to deliver in-vivo and tele-psychological services to children and adolescent family members of critically ill patients. The procedure implemented to develop the protocol, is expected to serve as gold-standard for the development of future psychological assessment and support protocols in under-investigated research areas.