Videoconferencing at home for psychotherapy in the postpartum period: Identifying drivers of successful engagement and important therapeutic conditions for meaningful use

Abstract

Purpose: Virtual care has almost become the norm since COVID-19 mandated social distancing. Prior, the use of personal videoconferencing was being explored as an appealing option to overcome barriers to care, but little was studied about how we should do it and for whom. This study aimed to answer these questions for women receiving psychotherapy in the postpartum period when there are significant barriers to attending office-based care.Methods: Twelve postpartum women who had the option to attend their psychotherapy sessions for the treatment of mood and/or anxiety symptoms via videoconferencing over a 3-month time period were interviewed about their experience. The three therapists providing care were also interviewed early in adoption of the virtual treatment and at the end of the study. Thematic analysis was conducted to identify themes for the initial and ongoing engagement with videoconferencing, which were triangulated with therapist input. Findings: Major themes which emerged related to (a) initial willingness to engage with videoconferencing, (b) technological compatibility, and (c) a good patient fit, with positive and negative influencers for each. Therapeutic considerations were identified, including (a) an initial in-person meeting when possible, (b) matching the therapy format to the clinical situation, (c) attention to the home environment, and (d) a clear therapy frame. Conclusions: Therapists should consider that videoconferencing might not be appropriate for every patient; but in the right context and with appropriate therapeutic considerations, offering this treatment format may actually facilitate an individual's recovery. These findings can help to inform the future delivery of videoconferencing psychotherapy.

Healthcare Professionals’ Experience of Performing Digital Care Visits—A Scoping Review

“…In which a patient and a healthcare professional are present, on a clinical site or in the home, and together they are consulted by an included specialist from another clinical site [ 7 , 8 ]. So, the consultation may be referred to as video-conferencing [ 9 , 10 ], even though it is broader than just patient-to-healthcare professional consultations. In this review, a narrower concept of video-conferencing is considered central, which is video consultations initiated by patients consulted by health care professionals.…”

Patients' experiences of home-based psychotherapy via videoconference: A qualitative study

“…Some had the option of flexible scheduling that permitted patients to take less time off from work (Ashwick et al, 2019), and some benefitted from more frequent contact with their therapist, which enhanced the patients' engagement with their treatment (Christensen, Wilson et al, 2020). Others could choose for each session whether they wanted to use videoconferencing or attend in person, which eased access and enhanced the patients' sense of control (Tarp & Nielsen, 2017;Hensel et al, 2020). Patients also felt more comfortable being in their own homes (Ashwick et al, 2019;Christensen, Wilson et al, 2020;Tarp & Nielsen, 2017).…”

“…Patients also felt more comfortable being in their own homes (Ashwick et al, 2019;Christensen, Wilson et al, 2020;Tarp & Nielsen, 2017). In general, patients found J o u r n a l P r e -p r o o f that it was possible to create a good therapeutic relationship, but some found it more impersonal and that communication was less intense than in-person sessions (Ashwick et al, 2019;Christensen, Wilson et al, 2020;Frank et al, 2017;Hensel et al, 2020;Tarp & Nielsen, 2017). The studies included adult patients who were diagnosed with post-traumatic stress disorder (Ashwick et al, 2019), alcohol abuse disorder (Tarp & Nielsen, 2017), postpartum women with mood or anxiety symptoms (Hensel et al, 2020) and elderly patients diagnosed with depression (Christensen, Wilson et al, 2020;Frank et al, 2017).…”

Healthcare professionals' experience of performing digital care visits - a scoping review

“…(7,8) In this review a narrower concept of videoconferencing is considered central -video consultations initiated by patients in which they are consulted by health care professionals. This type of consultation is referred to differently in the literature -sometimes as videoconferencing (9,10) despite that it is broader than just patient-to-healthcare professional consultations, virtual visits, (11) telehealth which can mean both telephone and video consultations, (12,13) digital visits, or video consultations (13) to name a few.…”