Teletherapy: The New Norm?

Wiederhold, Brenda K.

doi:10.1089/cyber.2020.29196.editorial

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…Participants found it hard to build rapport with clients during telepractice sessions. This is consistent with findings by McCaslin (2021) and Wiederhold (2020) who point out that body language and non‐verbal cues on online platforms are not always easy to read. Although relationship building skills are important both in in‐person and telepractice sessions, in the online space SLTs need to work more explicitly on building rapport and creating ‘virtual presence’ with clients (Millstein & Chaiyachati, 2020).…”

Section: Discussionsupporting

confidence: 92%

Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

Gallant

Watermeyer

Sawasawa

2023

Intl J Lang & Comm Disor

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BackgroundThe COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs’ experiences of implementing telepractice in the Global South during this time is available.AimsTo explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic.Methods & ProceduresSLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles.Outcomes & ResultsWe describe participants’ reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online.Conclusions & ImplicationsTelepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs’ confidence in providing telepractice whilst delivering quality services in an accessible and safe manner.WHAT THIS PAPER ADDSWhat is already known on the subject Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs’ experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners.What this paper adds to existing knowledge Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic.What are the potential or actual clinical implications of this work? Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients.

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Section: Discussionsupporting

confidence: 92%

Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

Gallant

Watermeyer

Sawasawa

2023

Intl J Lang & Comm Disor

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“…Once adequate rapport has been established, the therapist can transition to in-person treatment or utilize other interventions via teletherapy to help clients confront such cognitions (Abramowitz, 2019 ). Lastly, in accordance with previous research, these results provide greater reasoning for therapists in rural areas to use telehealth and reach those that they might not have been able to if working strictly in-person (Wiederhold, 2020 ).…”

Section: Discussionsupporting

confidence: 90%

“…Therapists may also increase attendance for clients with specific diagnoses by having telehealth as an option. Those diagnosed with depressive disorders, panic disorder, social anxiety disorders, or other anxiety disorders could particularly feel more comfortable to begin services via telehealth as they can access such services while avoiding distressing circumstances such as social interactions or the outside environment (Wiederhold, 2020 ). Once adequate rapport has been established, the therapist can transition to in-person treatment or utilize other interventions via teletherapy to help clients confront such cognitions (Abramowitz, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 and Telehealth Services on Attrition Rates in Psychotherapy

Hellstern

Robinson

2023

Contemp Fam Ther

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Attrition in psychotherapy has been identified as a significant obstacle in the productive delivery of mental health services. Defined generally as the ending of a treatment prior to proper optimal benefit, attrition both hinders treatment efficacy and costeffectiveness in therapy. With the demands for quality mental health services increasing, resources must be identified to reduce barriers to such services. The COVID-19 pandemic has resulted in the emergence of one potential resources: telehealth services. The current study aims to identify how COVID-19 and telehealth services have influenced attrition by analyzing attrition rates from both before and during the pandemic in a community health center where a transition to telehealth was made at the start of the pandemic. In addition, the variables of age, gender, socioeconomic status, and insurance coverage were also tested as potential predictors of attrition. Using de-identified patient information, clients who had participated in therapy services within a six-month period at a community health center (N = 329) were selected. A survival analysis was used to assess the time taken from initial appointment to the point of attrition. Results indicated that those who attended therapy via telehealth were less likely to stop attending treatment than those who participated in therapy in person. Individuals who used both in-person and telehealth visits were the least likely to terminate treatment prematurely. Clinical implications include the need for therapists to offer both telehealth and in-person services in order to give clients more resources to reduce a large barrier to needed mental healthcare treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s10591-023-09661-0.

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“…Moreover, participants in this study reported feeling least comfortable completing a teletherapy session from home compared with the other technologies. This may be owing to concerns about privacy, outside interruptions (eg, from children, partners), or distractions from the computer or phone (eg, email notifications), as evidenced in several previous studies [70,71].…”

Section: Principal Findingsmentioning

confidence: 97%

Comparing the Feasibility and Acceptability of a Virtual Human, Teletherapy, and an e-Manual in Delivering a Stress Management Intervention to Distressed Adult Women: Pilot Study

Loveys¹,

Antoni²,

Donkin³

et al. 2023

JMIR Form Res

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Background Virtual humans (VHs), teletherapy, and self-guided e-manuals may increase the accessibility of psychological interventions. However, there is limited research on how these technologies compare in terms of their feasibility and acceptability in delivering stress management interventions. Objective We conducted a preliminary comparison of the feasibility and acceptability of a VH, teletherapy, and an e-manual at delivering 1 module of cognitive behavioral stress management (CBSM) to evaluate the feasibility of the trial methodology in preparation for a future randomized controlled trial (RCT). Methods A pilot RCT was conducted with a parallel, mixed design. A community sample of distressed adult women were randomly allocated to receive 1 session of CBSM involving training in cognitive and behavioral techniques by a VH, teletherapy, or an e-manual plus homework over 2 weeks. Data were collected on the feasibility of the intervention technologies (technical support and homework access), trial methods (recruitment methods, questionnaire completion, and methodological difficulty observations), intervention acceptability (intervention completion, self-report ratings, therapist rapport, and trust), and acceptability of the trial methods (self-report ratings and observations). Qualitative data in the form of written responses to open-ended questions were collected to enrich and clarify the findings on intervention acceptability. Results Overall, 38 participants’ data were analyzed. A VH (n=12), teletherapy (n=12), and an e-manual (n=14) were found to be feasible and acceptable for delivering 1 session of CBSM to distressed adult women based on the overall quantitative and qualitative findings. Technical difficulties were minimal and did not affect intervention completion, and no significant differences were found between the conditions (P=.31). The methodology was feasible, although improvements were identified for a future trial. All conditions achieved good satisfaction and perceived engagement ratings, and no significant group differences were found (P>.40). Participants had similar willingness to recommend each technology (P=.64). There was a nonsignificant trend toward participants feeling more open to using the VH and e-manual from home than teletherapy (P=.10). Rapport (P<.001) and trust (P=.048) were greater with the human teletherapist than with the VH. The qualitative findings enriched the quantitative results by revealing the unique strengths and limitations of each technology that may have influenced acceptability. Conclusions A VH, teletherapy, and a self-guided e-manual were found to be feasible and acceptable methods of delivering 1 session of a stress management intervention to a community sample of adult women. The technologies were found to have unique strengths and limitations that may affect which works best for whom and in what circumstances. Future research should test additional CBSM modules for delivery by these technologies and conduct a larger RCT to compare their feasibility, acceptability, and effectiveness when delivering a longer home-based stress management program. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620000859987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380114&isReview=true

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Teletherapy: The New Norm?

Cited by 5 publications

References 2 publications

Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

The Impact of COVID-19 and Telehealth Services on Attrition Rates in Psychotherapy

Comparing the Feasibility and Acceptability of a Virtual Human, Teletherapy, and an e-Manual in Delivering a Stress Management Intervention to Distressed Adult Women: Pilot Study

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