Providers’ Perspectives on Telemental Health Usage After the COVID-19 Pandemic: Retrospective Analysis

Wilczewski, Hattie; Paige, Samantha R.; Ong, Triton; Soni, Hiral; Barrera, Janelle F.; Welch, Brandon M.; Bunnell, Brian E.

doi:10.2196/39634

Cited by 10 publications

(4 citation statements)

References 40 publications

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“…First, participants were recruited from the Doxy.me platform. While the demographics of Doxy.me users have been consistent with overall mental health care industry statistics ( American Psychological Association, 2022 ; Vogt et al, 2022 ; Wilczewski et al, 2022 ), future studies should aim to recruit from larger participant pools, ideally from across a variety of telehealth platforms. Second, most therapists in this study had used VR in casual settings, but none had used VR clinically.…”

Section: Discussionmentioning

confidence: 95%

Therapist perspectives on telehealth-based virtual reality exposure therapy

Ong¹,

Wilczewski²,

Soni³

et al. 2023

Preprint

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Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists’ perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, perceptions of VR in therapy, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16/18), enhanced therapy (61.1%, 11/18), and improved access to clients (38.9%, 7/18), but entailed problems with technology (61.1%, 11/18), uncontrolled settings (55.6%, 10/18), and communication difficulties (50%, 9/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12/18), preparing client expectations (55.6%, 10/18), and adjusting workflows (27.8%, 5/18). Most therapists had used VR before (72.2%, 13/18) and had positive impressions (55.6%, 10/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14/18) and customizable interventions components (55.6%, 10/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14/18), costs (50%, 9/18), side effects and privacy (22.2%, 4/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3/18). These results show how designing for telehealth may extend VRET and can help inform collaborative development of health technologies.

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Section: Discussionmentioning

confidence: 95%

Therapist perspectives on telehealth-based virtual reality exposure therapy

Ong¹,

Wilczewski²,

Soni³

et al. 2023

Preprint

Self Cite

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“…Previous studies have reported that a majority of mental health practitioners reported at least one practice adjustment during the PHE, such as providing additional therapeutic services [ 22 ] and that both the process and content of therapy often changed [ 23 ]. Changes in the service type likely resulted from a mix of other factors, including patient availability and preferences, changed provider preferences, and changed provider schedules or demands during the pandemic [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Telehealth and In-Person Behavioral Health Services in Rural Communities Before and During the COVID-19 Pandemic: Multisite Prospective Cohort Study

Ward,

Ullrich,

Bhagianadh

et al. 2023

JMIR Ment Health

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Background The COVID-19 pandemic triggered widespread adjustments across the US health care system. Telehealth use showed a substantial increase in mental health conditions and services due to acute public health emergency (PHE) behavioral health needs on top of long-standing gaps in access to behavioral health services. How health systems that were already providing behavioral telehealth services adjusted services and staffing during this period has not been well documented, particularly in rural areas with chronic shortages of behavioral health providers and services. Objective This study investigates patient and treatment characteristic changes from before the COVID-19 PHE to during the PHE within both telehealth and in-person behavioral health services provided in 95 rural communities across the United States. Methods We used a nonrandomized, prospective, multisite research design involving 2 active treatment groups. The telehealth cohort included all patients who initiated telehealth treatment regimens during the data collection period. A comparison group included a cohort of patients who initiated in-person treatment regimen. Patient enrollment occurred on a rolling basis, and data collection was extended for 3 months after treatment initiation for each patient. Chi-square tests compared changes from pre-PHE to PHE time periods within telehealth and in-person treatment cohorts. The dependent measures included patient diagnosis, clinicians providing treatment services, and type of treatment services provided at each encounter. The 4780 patients in the telehealth cohort and the 6457 patients in the in-person cohort had an average of 3.5 encounters during the 3-month follow-up period. Results The encounters involving anxiety, dissociative, and stress-related disorders in the telehealth cohort increased from 30% (698/2352) in the pre-PHE period to 35% (4632/12,853) in the PHE period (P<.001), and encounters involving substance use disorders in the in-person cohort increased from 11% (468/4249) in the pre-PHE period to 18% (3048/17,047) in the PHE period (P<.001). The encounters involving treatment service codes for alcohol, drug, and medication-assisted therapy in the telehealth cohort increased from 1% (22/2352) in the pre-PHE period to 11% (1470/13,387) in the PHE period (P<.001); likewise, encounters for this type of service in the in-person cohort increased from 0% (0/4249) in the pre-PHE period to 16% (2687/17,047) in the PHE period (P<.001). From the pre-PHE to the PHE period, encounters involving 60-minute psychotherapy in the telehealth cohort increased from 8% (190/2352) to 14% (1802/13,387; P<.001), while encounters involving group therapy in the in-person cohort decreased from 12% (502/4249) to 4% (739/17,047; P<.001). Conclusions The COVID-19 pandemic challenged health service providers, and they adjusted the way both telehealth and in-person behavioral therapy services were delivered. Looking forward, future research is needed to explicate the interaction of patient, provider, setting, and intervention factors that influenced the patterns observed as a result of the COVID-19 pandemic.

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“…A significant portion expressed commitment to ongoing telemedicine utilization, indicating a potential long-term trend. Enhanced intention correlated with factors like social influence, perceived usefulness, telemedicine caseload, ease of use perception, and facilitating conditions (Wilczewski et al, 2022).…”

Section: Digital Healthcare Solutions and Chronic Diseases: Evidence ...mentioning

confidence: 97%

Navigating Chronic Disease Management with Digital Healthcare Solutions amidst the COVID-19 Pandemic: A Systematic Literature Review

Vratimos,

Champilomatis,

Farantos

2024

ESJ

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Purpose: The purpose of this paper is to critically evaluate data collected from various studies on Chronic Disease Management during the COVID-19 pandemic and the emergence of Digital Healthcare as a means of providing innovative approaches to manage chronic diseases. Methodology: A systematic literature review was applied. Studies were found after a search in the Pubmed database with no publication date time limit, given that COVID–19 emerged in 2019. A Prisma diagram was created to record the way and the criteria by which we included and excluded studies for our research. Out of the 567 records identified through various sources 85 were used for a qualitative synthesis. Results: During the first wave of the pandemic, a significant reduction or complete cancellation of scheduled health appointments was observed. Shortages of medication used to manage chronic conditions were also observed at the beginning of the COVID-19 pandemic due to global supply chain disruptions. Governments acted rapidly at the beginning of the pandemic to promote the use of teleconsultations by introducing enabling legislation and revising laws ensuring continuity of care for people with chronic diseases, thus transitioning rapidly to remote care and monitoring. Conclusion: Telemedicine and involving community pharmacists in chronic patient management are key for sustained adherence. Long-term policies are vital to prevent pandemic-driven health disparities. Lessons should be derived for future preparedness, managing subsequent waves, and ensuring testing in primary care.

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Providers’ Perspectives on Telemental Health Usage After the COVID-19 Pandemic: Retrospective Analysis

Cited by 10 publications

References 40 publications

Therapist perspectives on telehealth-based virtual reality exposure therapy

Therapist perspectives on telehealth-based virtual reality exposure therapy

Telehealth and In-Person Behavioral Health Services in Rural Communities Before and During the COVID-19 Pandemic: Multisite Prospective Cohort Study

Navigating Chronic Disease Management with Digital Healthcare Solutions amidst the COVID-19 Pandemic: A Systematic Literature Review

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