Barriers and Facilitators to Psychologists’ Telepsychology Uptake during the Beginning of the COVID-19 Pandemic

Abstract

The COVID-19 pandemic transformed the delivery of psychological services as many psychologists adopted telepsychology for the first time or dramatically increased their use of it. The current study examined qualitative and quantitative data provided by 2619 practicing psychologists to identify variables facilitating and impeding the adoption of telepsychology in the U.S. at the beginning of the COVID-19 pandemic. The top five reported barriers were: inadequate access to technology, diminished therapeutic alliance, technological issues, diminished quality of delivered care or effectiveness, and privacy concerns. The top five reported facilitators were: increased safety, better access to patient care, patient demand, efficient use of time, and adequate technology for telepsychology use. Psychologists’ demographic and practice characteristics robustly predicted their endorsement of telepsychology barriers and facilitators. These findings provide important context into the implementation of telepsychology at the beginning of the pandemic and may serve future implementation strategies in clinics and healthcare organizations attempting to increase telepsychology utilization.

Development and validation of the Telepsychology Facilitators Scale: A national study.

“…The greater and more effective use of telepsychology can drastically improve access for a host of individuals, which may be limited due to circumstances (e.g., caregiving), disability, injury, or illness (Torous et al, 2020). Telepsychology use has a number of other benefits including reduced cost for patients and providers, more efficient use of time, and increased safety (particularly in the face of the pandemic; Watson et al, 2023). Further, telepsychology saw a significant increase in adoption during and immediately following the pandemic (Pierce et al, 2021) with drastically shifting norms, attitudes, and regulations (Watson et al, 2023).…”

“…Telepsychology use has a number of other benefits including reduced cost for patients and providers, more efficient use of time, and increased safety (particularly in the face of the pandemic; Watson et al, 2023). Further, telepsychology saw a significant increase in adoption during and immediately following the pandemic (Pierce et al, 2021) with drastically shifting norms, attitudes, and regulations (Watson et al, 2023).…”

“…This relationship is also bolstered by recent research on telepsychology use demonstrating that psychologists' attitudes toward and perceptions of telepsychology are key predictors of its uptake (Pierce et al, 2020b(Pierce et al, , 2021Watson et al, 2023). Similarly, the TFS-OS was moderately correlated with telepsychology use, indicating that organizational support for telepsychology (particularly supportive leadership and policies) is important for encouraging greater use (Watson et al, 2023). The TFS-FI and TFS-EP were weakly correlated with telepsychology use, suggesting that, while important, they may not be quite as vital to facilitating telepsychology use as either psychologists' own attitudes or the attitudes and policies of the organization at large.…”

“…Supportive infrastructure (or lack thereof) also played an important role in telepsychology use during the COVID-19 pandemic (see Appleton et al, 2021 for a review). Among a national group of psychologists, inadequate access to technology and insufficient training were frequently endorsed barriers to telepsychology use during the pandemic (Watson et al, 2023). Some psychologists continued to hold perceptions that telepsychology diminished the quality and/or effectiveness of care and had concerns about its negative impact on the therapeutic alliance (Watson et al, 2023).…”

“…Many of the most frequently endorsed barriers to telepsychology (e.g., inadequate access to technology, technological issues, and insufficient training) and facilitators (e.g., better access, improved quality of care, and positive leadership support; Watson et al, 2023) are covered by the TFS. The TFS-PA was most strongly associated with actual telepsychology use, supporting key elements of the TRA established by Fischbein and Ajzen (1975).…”