Telepsychology Services Research Articles

How the COVID-19 pandemic reshaped telepsychology: Insights from an Italian survey

The coronavirus disease 2019 (COVID-19) pandemic rapidly boosted the introduction of certain changes in mental healthcare services, consequently driving up the adoption of remote care delivery options. We conducted an online Italian survey to evaluate telepsychology use, attitudes, acceptance, and training needs, as well as to understand patient-professional interactions in video-consultations, aiming to inform future mental healthcare practices and policies. The current study's survey responses were collected using an anonymous, self-reported questionnaire on the ‘REDCap’ platform from 25 October 2022 to 26 July 2023. In total, 128 mental health professionals and 113 patients completed the survey. In our sample, 69 % of patients and 79.7 % of mental health professionals reported having used telepsychology during COVID-19 pandemic; in particular, 84.6 % of patients and 95.1 % of professionals selected video-consultation modality. Data showed that participants expressed high satisfaction with this communication tool. The increase in satisfaction was directly proportional to increase in the quality of interactions and in relation to the quality of the experiences. The critical factors influencing the video-consultation experience include communication style, information completeness, patient-centredness, and the comfort underscoring the central role of the professional-patient relationship, which, substantially, remains a key element in the psychological treatment process. These findings reinforce the need for continued refinement and expansion of telepsychology services, thus highlighting the potential for integrating innovative technologies into mental health practise.

Barriers to accessing telepsychology services questionnaire: Structure and language-based performance in a sample of Latinx caregivers.

A lack of validated measures to examine barriers to youth telepsychology services among Latinx families limits research that could identify targets for reducing mental health disparities. We developed and validated the Latinx Barriers to Accessing Telepsychology Services (Latinx BATS) questionnaire, a brief multidimensional measure for caregivers of youths. Participants included 511 Latinx caregivers of youths Ages 6-18 (English n = 275, Spanish n = 236) who completed the Latinx BATS and reported on telepsychology service utilization and youth mental health problems. Caregivers whose youths had clinically elevated mental health problems were more likely to report barriers to accessing youth telepsychology services compared to nonclinical youths. Commonly endorsed barriers included concerns that the child would be distracted and not get much benefit, and that providers would be unfamiliar with the family's culture or would not pick up on nuances and emotions. Loadings from an exploratory graph analysis returned four-factors: relational, acceptability, quality, and access concerns. Network centrality measures identified provider knowledge regarding community resources and Latinx culture as important targets for reducing barriers to youth telepsychology services. Confirmatory factor analyses were then conducted and found that the four-factor structure outperformed a single-factor solution. The four-factor structure was similar for the English and Spanish versions of the Latinx BATS, but the strength of item loadings varied across languages. Implications for the use of the Latinx BATS in research and clinical practice are discussed including specific strategies for reducing these obstacles to care among Latinx families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Provision of Telepsychological Care Via Email during COVID-19 Confinement: An Exploratory Study.

Within teletherapy, email interventions have been studied scarcely. For this reason, this exploratory study aims to characterize the assistance provided by email in a university telepsychology service and to compare the data with the assistance provided by telephone in the same service and period. For this purpose, the records of 81 users assisted via email during the COVID-19 pandemic lockdown in Spain were analyzed. The data were compared with those of the 338 users assisted by telephone in the same period. Despite its many limitations, results indicate high satisfaction with the email modality. Users express that they prefer a preference for using email when they do not feel safe in other ways. We found a lot of variation between the number of emails exchanged and the days that each case was active. Additionally, differences were found with telephone users in aspects such as age (email users being younger) and in a depression screening (email users scoring more positively). This study concludes on the high potential of this channel for the application of certain techniques (e.g., psychoeducation) or for people with certain characteristics.

Supplemental Material for Barriers to Accessing Telepsychology Services Questionnaire: Structure and Language-Based Performance in a Sample of Latinx Caregivers

Supplemental Material for Barriers to Accessing Telepsychology Services Questionnaire: Structure and Language-Based Performance in a Sample of Latinx Caregivers

International Telepsychological Services for Latino Immigrants in the USA

International Telepsychological Services for Latino Immigrants in the USA

Clinicians' Attitudes Toward Telepsychology in Addiction and Mental Health Services, and Prediction of Postpandemic Telepsychology Uptake: Cross-sectional Study.

BackgroundThe COVID-19 pandemic has resulted in unprecedented uptake of telepsychology services; however, clinicians have mixed attitudes toward virtual technologies.ObjectiveThis study (1) explored clinicians’ experiences of and intentions to use video, telephone, and in-person services, and (2) tested the utility of the unified theory of acceptance and use of technology (UTAUT) to predict clinicians’ intentions to offer telepsychology after the COVID-19 pandemic.MethodsClinician satisfaction and therapeutic alliance were compared across in-person, video, and telephone services, while technology attitudes and intention to use after the pandemic were compared across video and telephone services among 118 addiction and mental health clinicians during the COVID-19 pandemic.ResultsClinicians reported more positive experiences with in-person services than both virtual technologies; further, clinicians reported greater positive experiences, attitudes, and intentions to use video services than telephone services across measures. Based on the UTAUT, performance expectancy positively predicted concurrent intentions to use video services (β=0.46; P<.001) and telephone services (β=0.35; P<.001) after the pandemic. Social influence (β=0.24; P=.004) and facilitating conditions (β=0.19; P=.03) additionally predicted the intention to use telephone services.ConclusionsClinicians rated in-person services more positively than virtual technologies, with video services perceived more positively than telephone services. Performance expectancy was the primary facilitator of the uptake of both virtual modalities.

The Transition to Telepsychology during the COVID-19 Pandemic: College Student and Counselor Acceptability Perceptions and Attitudes

ABSTRACT The COVID-19 pandemic forced univaersity and college counseling and psychological service centers to swiftly switch to telepsychology service delivery to meet the continuing needs of student clients. This study was conducted at the onset and peak periods of the COVID-19 outbreak. We explored student client and counselor acceptability, attitudes, perceptions, experiences, barriers, and facilitators to remote telepsychology services using Qualtrics survey methodologies. Student clients and counselors were sent, via e-mail, two separate, but parallel anonymous questionnaires developed for purposes of this study. Results revealed that most student clients agreed that mental health service delivery via telepsychology was an adequate alternative to face-to-face therapy, there were few challenges with telepsychology with ease of access a key benefit. Student clients also felt that the therapeutic alliance was commensurate with face-to-face therapy while identifying lack of privacy in the home as the most problematic aspect of telepsychology. Counselors and student clients both identified convenience as the most important characteristic of telepsychology. Limitations are discussed as well as directions for future research.

Modified Training Experiences for Psychology Interns and Fellows During COVID-19: Use of Telepsychology and Telesupervision by Child and Adolescent Training Programs.

Coronavirus (COVID-19) has affected opportunities available to psychology interns and postdoctoral fellows completing capstone training experiences during culminating training years. While research supports COVID-19 has increased the use of telepsychology services amongst psychologists, there is a paucity of research regarding how COVID-19 has altered training and use of telepsychology by psychology trainees. The current study includes survey responses from 59 psychology training directors and 58 psychology internship and postdoctoral fellowship trainees at pediatric sites throughout the United States. Results support changes in telepsychology training provided during COVID-19, including increased use of telepsychology for clinical service delivery and increased use of telesupervision for training. As expected, findings suggest novel training experiences in telepsychology for trainees within the last two years as a result of COVID-19. Given ongoing need for telepsychology services to assure access to psychological care during the pandemic and beyond, results provide support for graduate and advanced training programs to provide formal training in best-practices for utilization of telepsychology and telesupervision.

Latinx caregivers’ perceived need for and utilization of youth telepsychology services during the coronavirus pandemic.

Latinx caregivers’ perceived need for and utilization of youth telepsychology services during the coronavirus pandemic.

Addressing concerns and adapting psychological techniques for videoconsultations: a practical guide

ABSTRACT Objective: The 2020 coronavirus pandemic required many psychologists to rapidly transition to telehealth services to reduce virus exposure. Telepsychology services expanded quickly in Australia. This article seeks to provide simple and practical recommendations for clinicians who are changing their practice. Method: A narrative literature review focusing on psychologists’ concerns regarding telehealth-facilitated psychology or telepsychology was undertaken. Results: Research literature and guidelines from peak professional bodies such as The Australian Psychological Society and the American Psychological Association, inform two sections of the article: Common Concerns about Videoconsultations and; Practical Considerations for Effective Videoconsultations. Telepsychology, has numerous benefits, especially during emergency situations. However, concerns regarding efficacy, therapeutic alliance, and the digital divide have contributed to psychologists’ unwillingness to use telepsychology. Evidence suggests that efficacy and therapeutic alliance is comparable between telepsychology and in-person services. Simple evidence-based adjustments to therapeutic practice can optimise videoconsultations and increase the effectiveness of telepsychology. Despite the rapid change to videoconsultations, evidence suggests that Australian psychologists need not be concerned about clinical efficacy or therapeutic alliance related to telepsychology. However, it is acknowledged that transitioning to telehealth models of care is disruptive. Conclusion: This paper can assist clinicians in selecting appropriate clients for telepsychology, increase effectiveness and mitigate risks. KEY POINTS What is already known about this topic: Research supports the clinical efficacy and establishment of therapeutic alliance related to telepsychology services and highlights that concerns regarding the digital divide need to be evidence-based, not based on assumptions. As outlined in this paper, it is important to consider client suitability and ethical considerations prior to delivering telepsychology services. The adaptations to psychological techniques, as highlighted in this paper, can increase the effectiveness of videoconsultations. What this topic adds: An examination of common concerns related to videoconsultations including: efficacy, therapeutic alliance and the digital divide. A practical evidence-based checklist for pre-therapy videoconsultation considerations. An evidence-based checklist of practice adaptations that can increase effectiveness in videoconsultation.

Telepsychology and the COVID-19 pandemic: the experiences of psychologists in South Africa

The emergence of the COVID-19 pandemic has drawn renewed attention to telepsychology. This study reports on the experiences of psychologists in response to the implications of the COVID-19 pandemic pertaining to the provision, application, and accessibility of telepsychology services in the South African context. The findings highlight the direct and indirect implications of the pandemic and its impact on both practitioners and clients. The core themes comprise an increase in mental health care needs, challenges pertaining to therapeutic modalities in response to crises, as well as contextual considerations. The latter include barriers to telepsychology, such as the costs of data, as well as limitations to confidentiality and privacy.

Incorporating telehealth into health service psychology training: A mixed-method study of student perspectives.

ObjectiveTelehealth is increasingly recognized as an avenue for enhancing psychologists’ capacities to meet the mental health needs of a diverse and underserved (due to barriers e.g., distance, transportation) public. The present study sought to inform training in telepsychology (i.e., telehealth delivery of psychological services) by using both quantitative and qualitative methods to explore the perspectives of doctoral students who have already been involved in such training.MethodA total of 19 predoctoral students from two universities, with at least some experience in telepsychology training, provided their perspectives on two complementary research questions: (1) How do students perceive their level of competence in various domains of telepsychology?; and (2) What are students’ perspectives on the process of telepsychology competency development during their doctoral training?ResultsThe results of our study provide early evidence that doctoral trainees are able to develop telepsychology competencies and suggest that a supportive, training-oriented environment and fit between telepsychology and existing programmatic areas of emphasis are likely key to success.ConclusionsContinued efforts to enhance training in providing telepsychology services should focus on how to best define, measure, and promote competency development in this emerging specialty area.

Toward establishing telepsychology guideline. Turning the challenges of COVID-19 into opportunity

IntroductionThe COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19.AimThis document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities.MethodA professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices.ResultsThe practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples.ConclusionTelepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.

Caring for women with substance use disorders through pregnancy and postpartum during the COVID-19 pandemic: Lessons learned from psychology trainees in an integrated OBGYN/substance use disorder outpatient treatment program

ObjectiveThis article presents a brief overview of the challenges and facilitators to the provision of substance use disorder (SUD) treatment for pregnant and parenting women during the COVID-19 pandemic. Specifically, we highlight the deployment of telepsychology services during the pandemic by an integrated, trainee-based women & addictions program that provides care via a multidisciplinary team, including an obstetrician, addiction medicine fellow, nurse, behavioral health trainees, violence prevention advocates, and pediatric provider. MethodsWe outline unique adaptations that the program made to shift from in-person psychology trainee services to telepsychology. Additionally, we describe supporting factors and barriers to success for continued treatment planning, service provision, and educational training. ResultsThe program identified and addressed numerous opportunities for improvement to implement and continue telepsychology within an integrated women & addictions program during the COVID-19 pandemic. The program maintained the unique components of care integration with the proliferation of digital resources for patients and providers, as well as the flexibility of attending physicians and supervising psychologists. ConclusionsProvision of telepsychology services within an integrated women & addictions program employing trainees is crucial during the COVID-19 pandemic. The program addressed barriers to care in creative ways, through the use of various technologies, to meet patients where they are. Continuing to have this option available requires adaptation to the maturing needs of the clinic.

Psychological Practice at Six Months of COVID-19: A Follow-Up to the First National Survey of Psychologists During the Pandemic.

We conducted a survey of licensed psychologists at two weeks and again at six months after the declaration of a national emergency related to the COVID-19 pandemic. This article describes the results of the second survey conducted approximately six months after the crisis began. The rapid shift to telepsychological services seen in the first survey in the pandemic has solidified in the second survey. More providers reported delivering a larger percentage of services via telepsychology than early in the pandemic. The majority of respondents do not anticipate resuming in-person services until after a vaccine is made available, although a consistent minority reports ongoing in-person service provision. A majority reported their patients had appropriate access to internet and telepsychological service platforms, although one-fifth of respondents reported their patients had difficulty accessing such services. Early concerns about technological or regulatory problems involved in telepsychology are no longer evident. Most respondents indicated they will continue to use telepsychological services for the delivery of some of their psychological services after the pandemic ends. Forty-five percent knew of individuals who contracted the disease, 13% knew someone who died of the disease, and 2% reported contracted the disease themselves.

APA calls for telecommunications use to prevent virus spread

The American Psychological Association (APA) on March 24 called on states and insurers to move quickly to allow people to connect with their mental health providers remotely using telehealth as the need for mental health services rises during the COVID‐19 pandemic. “We are asking state policymakers to temporarily suspend state licensing requirements for telepsychological services, which would allow patients greater access to their providers and ensure continuity of care during this crisis,” Arthur C. Evans Jr., Ph.D., APA's CEO, said in a statement. “The federal government has just identified psychologists as critical, essential workers in the U.S. response to COVID‐19. But this does not mean that psychologists and psychology trainees must do work in person,” he said. “Essential psychological services can, and in many cases, should be delivered through telehealth. It is critically important that psychologists are able to meet the needs of their patients and communities during this difficult time, without further increasing the risk of contagion.”

A Telepsychology Primer

Psychologists may be hesitant to use telepsychology to increase patient care access not only due to unfamiliarity with technological platforms and their utilization, but also due to uncertainty of additional telepsychology requirements. Telepsychology, the provision of psychological services using telecommunication technology, is a burgeoning area and increasingly part of mainstream practice. The following article outlines core aspects of ethical telepsychology service provision. The author operationalizes terms, outlines key ethical and legal considerations, and discusses various aspects of implementation and logistics (e.g., inclusion criteria, technology selection, documentation, and emergency planning). The author focuses on specific aspects of videoconferencing and telephone service provision.

Efficacy, Efficiency, and Ethics in the Provision of Telepsychology Services: Emerging Applications for International Workers

Computers and the Internet ushered humanity into a new era in the late 1900s—information on a variety of topics became widely available to the general public, and it became suddenly possible for individuals to communicate with one another instantaneously regardless of each person's geographical location. According to some, the evolution of technology has outpaced humanity's ability to learn how to manage technology properly, and this appears particularly true in the field of psychology. Instant messaging, social media sites, and video conferencing have all influenced the ways in which counselors and clients can interact. Questions remain, however, about the use of this technology. This paper addresses some of those questions by considering whether or not telepsychology is effective when it is used to conduct therapy and the circumstances under which a counselor might use a technological medium to provide such services. A review of some ethical considerations related to the use of technology in the service of providing therapeutic services is also included, as well as a discussion regarding the specific applicability of telepsychology services to international workers, specifically missionaries, serving abroad.

Videoconference Grief Group Counseling in Rural Texas: Outcomes, Challenges, and Lessons Learned

Disparities in access to mental health care, especially in rural areas, demand continued attention from practitioners, researchers, and community stakeholders. Telehealth, or the use of long distance technology to provide mental health services, is one well-recognized solution for reducing mental health disparities. At the Telehealth Counseling Clinic, advanced doctoral students provide telepsychology services to low-income and uninsured individuals living in a rural region in Texas. In response to an identified community need for grief counseling services, an 8-week grief group utilizing videoconference technology was conducted. This article discusses clinical and methodological challenges and lessons learned that are unique to delivering group counseling services over videoconference technology in a rural area, as well as preliminary data of the group’s effectiveness as measured by a satisfaction survey, the Patient Health Questionnaire–9, the CORE–B, and the Complicated Grief Assessment are presented.

Telepsychological services with criminal justice and substance abuse clients: A systematic review and meta-analysis.

Recent years have seen the incorporation of telepsychology into poorly accessed, rural, and underserved settings, including criminal justice and substance abuse treatment. A systematic search of the literature on telepsychological and related services with justice-involved and substance abuse clients revealed numerous descriptive reports, but few empirical studies. The results of 3 studies of criminal justice participants and 2 studies of substance-abuse participants were subjected to a series of 5 outcome-specific meta-analyses (mental health symptoms, therapeutic processes, program engagement, program performance, and service satisfaction). These 5 studies, all of which utilized a comparison group, contributed a total of 342 participants and 14 total effect sizes. Summary data on 3 additional uncontrolled studies are also presented. Results indicated that telepsychological outcomes were at least comparable with in-person outcomes. This review serves as an initial reference for clinicians and policymakers working with criminal justice and substance abuse clients, but also highlights the need for more rigorous scientific investigation into the nuances of telepsychological practice.