Clinical and Ethical Considerations for Delivering Couple and Family Therapy via Telehealth

Abstract

Studies have generally supported telehealth as a feasible, effective, and safe alternative to in-office visits. Telehealth may also be of particular benefit to couples/families interested in relational treatments, as it addresses some of the barriers that may be more prominent for families, such as childcare and scheduling difficulties. Therapists interested in expanding their practice to include telehealth should understand ethical and practical considerations of this modality. This article discusses areas unique to the delivery of telehealth to couples and families. Each broad domain is then elaborated upon with case examples from actual clinical practice and specific recommendations for addressing potential difficulties. Authors recommend further empirical research examining differences in modality outcome, as well as feasibility of the suggestions proposed here.

Expectations and Experiences of Couples Receiving Therapy Through Videoconferencing: A Qualitative Study

“…However, despite this growing need, few online interventions for couples exist, and this area remains under researched, with a scarcity of studies qualitatively exploring the experience of couples who have undergone online couples therapy, particularly via videoconferencing (Backhaus et al, 2012;Wrape and McGinn, 2018). This presents a significant gap in the literature, with a strong need for research directly exploring the unique dyadic relationship experienced by a couple when working with a therapist through videoconferencing.…”

“…This highlights the importance of having safety procedures in place, which couples are notified of prior to beginning therapy (Fenichel et al, 2002). Therapists are able to access best practice guidelines to assist them with implementing these safeguards (Wrape and McGinn, 2018).…”

“…Efficacy studies of videoconferencing have consistently reflected favorable outcomes in the areas of: client satisfaction, efficacy as compared to face-to-face therapy, clinical measures and the therapeutic alliance (Frueh et al, 2007;Richardson et al, 2009;Backhaus et al, 2012;Duncan et al, 2014). However, despite evidence of efficacy and increased awareness of this medium, few studies have examined the applicability of videoconferencing to couple's therapy and the literature in this area is largely quantitative or theoretical (Backhaus et al, 2012;Doss et al, 2017;Wrape and McGinn, 2018). For this reason it remains essential to explore the lived experiences of those who have received couple's therapy through videoconferencing (Elliott, 2008).…”

Digital privacy in mental healthcare: current issues and recommendations for technology use

“…Despite the benefits, TMHT services present unique risks to client confidentiality [31 ,32]. TMHT sessions may be unintentionally overheard or even maliciously observed by outside parties [33 ]. Barnett [31 ] recommended that TMHT practitioners 'safeguard' client confidentiality through encryption, HIPAA-compliant software, and protections against adware, malware, and firewalls (p. 424).…”

Terapia On-line com Casais e Famílias: Prática e Formação na Pandemia de Covid-19

“…Nesse contexto, terapeutas de casal e família têm referido preocupações quanto à relação terapêutica, à efetividade dos atendimentos remotos bem como aos recursos mais apropriados e seguros para realizá-los (Lebow, 2020;Wade et al, 2020). As fragilidades na formação em terapia on-line com casais e famílias se associam também a dúvidas quanto a indicações e contraindicações dessa modalidade, inclusive entre profissionais com experiência em terapia on-line individual (Wrape & McGinn, 2019). Assim, capacitações profissionais e supervisões têm se mostrado relevantes para a qualificação da terapia on-line com casais e famílias (Pickens et al, 2020), podendo ser realizadas por meio das TICs (Borcsa & Pomini, 2018;Pennington, Patton, Ray, & Katafiasz, 2017).…”