PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

Knowlton, Charlie N.; Nelson, Karl G.

doi:10.1037/rmh0000190

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…The study results indicate, compared to PCPs, social workers, nutritionists, and pharmacists were more likely to use any virtual care (mostly telephone), whereas mental health care providers were more likely to provide video-based care. Previous research has shown that mental health providers have a long tradition of using video visits, which may help explain the study findings [ 61 , 62 ]. Furthermore, social workers have a long history of conducting case management, which might explain their preference for using telephone vs. video.…”

Section: Discussionmentioning

confidence: 92%

Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic

et al. 2022

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Background At the onset of COVID-19, there was a rapid expansion of telehealth (video/telephone) visits to maintain delivery of primary care (PC) services at the Veterans Health Administration (VA). This study examines patient, provider, and site-level characteristics of any virtual and video-based care in PC. Methods Interrupted time series (ITS) design was conducted using VA administrative/clinical, electronic healthcare data, 12-months before and 12-months after COVID-19 onset (set at March 2020) at the VA Greater Los Angeles Healthcare System (GLA), between 2019 and 2021. Patients with at least one visit to a VA PC clinic at GLA (n = 547,730 visits) were included in the analysis. The two main outcomes for this study were 1) any telehealth (versus in-person), as well as 2) video-based care (versus telephone). For the ITS analysis, segmented logistic regression on repeated monthly observations of any telehealth and video-based care was used. Results Percent telehealth and video use increased from 13.9 to 63.1%, and 0.3 to 11.3%, respectively, before to after COVID-19 onset. According to adjusted percentages, GLA community-based clinics (37.7%, versus 29.8% in hospital-based clinics, p < .001), social workers/pharmacists/dietitians (53.7%, versus 34.0% for PC clinicians, p < .001), and minority groups, non-Hispanic African Americans (36.3%) and Hispanics (34.4%, versus 35.3% for Whites, p < .001) were more likely to use telephone than video. Conversely, mental health providers (43.3%) compared to PC clinicians (15.3%), and women (for all age groups, except 75+) compared to men, were more likely to use video than telephone (all p’s < .001). Conclusions Since telehealth care provision is likely to continue after COVID-19, additional research is needed to identify which PC outpatient services are better suited for telephone (e.g., case management) versus video-based care (e.g., integrated mental health visits). Additionally, it is important to understand how all clinics can systematically increase access to both telephone- and video-based PC services, while ensuring equitable care for all patient populations.

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Section: Discussionmentioning

confidence: 92%

Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic

et al. 2022

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“…Given the already small population sizes inherent in rural areas, compounded with the barriers to accessing care even when made available through telehealth, studying the effectiveness of teletherapy in rural areas can be challenging. Nevertheless, this has not prevented continued contributions including telephone (Dwight-Johnson et al, 2011; Heckman et al, 2018; Ransom et al, 2008) and videoconference (Gonzalez & Brossart, 2015; Griffiths et al, 2006; McCord et al, 2011) teletherapy interventions for a variety of populations such as veterans (Knowlton & Nelson, 2021; Morland et al, 2014) and children/families (Kohlhoff et al, 2020; Rooks-Ellis et al, 2020; Ryan et al, 2005) and presenting concerns such as depression (Openshaw et al, 2012; Ransom et al, 2008; Trombello et al, 2020; Tutty, 2008), psychosis (Lecomte et al, 2021), grief (Chang et al, 2016; Supiano et al, 2021), and substance use (Baca et al, 2007).…”

Section: Research Questionsmentioning

confidence: 99%

Assessing depression outcomes in teletherapy for underserved residents in Central Texas: Telehealth’s move to treatment-as-usual.

Armstrong¹,

McCord²,

Stickley³

et al. 2022

Journal of Rural Mental Health

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Telehealth is a flexible and cost-effective solution for providing psychotherapy services. The present study examines teletherapy outcomes data using two methodological frameworks: a categorical outcome approach, clinically significant change (CSC), and a continuous outcome approach, latent growth mixture modeling (LGMM). Archival data from 424 rural-residing clients were analyzed. Kaplan-Meier survival curves were fitted in two ways of comparison. The level of change was also explored and was modeled at five points as well as six points. A latent growth mixture model was fitted to assess depression severity over time. Clients achieved either CSC or overall improvement on the Patient Health Questionnaire-9 after three-seven sessions. Session-to-session results indicated that change took longer (10-11 sessions). Reliable deterioration was infrequently experienced and, thus, difficult to model. The LGMM fit best with three classes, of which two started clinically and varied in their improvement rates. The third class started nonclinically and showed little improvement over time. This study advances the literature regarding outcomes for rural clients by utilizing the frame of treatment-as-usual psychotherapy effectiveness and providing more generalizability to this specific population.

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Advances in Psychotherapy for Older Adults Using Video-to-Home Treatment

Freytag¹,

Touchett²,

Bryan³

et al. 2022

Advances in Psychiatry and Behavioral Health

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PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

Cited by 6 publications

References 33 publications

Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic

Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic

Assessing depression outcomes in teletherapy for underserved residents in Central Texas: Telehealth’s move to treatment-as-usual.

Advances in Psychotherapy for Older Adults Using Video-to-Home Treatment

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