Continuation of Teletherapy After the COVID-19 Pandemic: Survey Study of Licensed Mental Health Professionals

Abstract

Background The use of teletherapy has exponentially increased in the context of the ongoing COVID-19 pandemic. Studies on teletherapy documented substantial benefits of accessibility and convenience even before the start of the pandemic. Although recent studies show that this modality of therapy delivery is here to stay, few have studied who will most benefit from this trend. Objective In this paper, we report predictors of continued teletherapy usage in a sample of licensed mental health professionals in the United States during a time period when pandemic-related restrictions began diminishing. As such, it is one of the first studies to examine factors related to continued benefits of teletherapy postpandemic. Methods Participation from licensed mental health professionals was sought on listservs of national organizations of multiple mental health organizations. Data were collected via an anonymous link to a survey on Qualtrics between January 2021 and April 2021. Participants responded to questions on therapist demographics, practice setting, experiences of shifting to teletherapy, perspectives on continued use of teletherapy, and their client characteristics. Findings related to client characteristics that predicted continued teletherapy usage are presented here. Results A total of 186 individuals consented to participate in the survey, with a final sample of 114 with complete data. A majority of participants identified as female (92/114, 80.7%), White (94/114, 82.5%), and having a master's degree (75/114, 65.5%) from a nationally accredited program (106/114, 93%). Data were analyzed using heteroskedastic regression modeling with client-related factors as predictors. Two models were run with and without distance travelled by clients as a control variable. Model estimates from both models showed that continued use of teletherapy postpandemic was predicted by the following factors: higher percentage of clients from rural areas, younger and older adult clients, clients with Medicare, and clients with marginalized gender and religious/spiritual identities. Significantly, having a higher percentage of clients from lower socioeconomic status, a higher percentage of those with Medicaid coverage, and a higher percentage of couples and families as clients predicted decreased use of teletherapy postpandemic. Conclusions Findings from the study suggest that while some groups of clients are more likely to continue to receive benefits of teletherapy, vulnerable groups such as those in lower socioeconomic conditions, Medicaid beneficiaries, and those who seek couple and family therapy may be less likely to be served by it. These differences point to a need to address factors driving telehealth care disparities such as access to technology, housing, and childcare issues, as well as the need for continued training for licensed professionals.

Tele-psychotherapy during the COVID-19 pandemic: a mini-review

“…Two studies show difficulties in accessing mental health services for ethnic minority and socioeconomically disadvantaged individuals with Adverse Childhood Experiences ( 46 ), and challenges for vulnerable groups (lower socioeconomic conditions, Medicaid beneficiaries, and those who seek couple and family therapy) as well as access to technology, housing, childcare, and need for training for professionals ( 47 ).…”

“…There are difficulties in cases of family conflict, where there is a duty to report child abuse and suicidality in minor patients and geriatric populations. It is also difficult to identify neglect or abuse if someone is only treated through teletherapy, especially in cases of, for example, physically impaired and vulnerable populations ( 36 , 47 , 53 ). Family therapy and therapy for psychotic symptoms, severe anxiety, trauma, or individuals in crisis is less suited to online sessions ( 12 ).…”

Evaluation of Online Counseling through the Working Experiences of Mental Health Therapists Amidst the COVID-19 Pandemic

“…According to the APA guidelines for online counseling, therapists must make sure that they have adequate knowledge of the technology required and that online counseling is beneficial to their clients [11]. This is even more evident in the post-COVID-19 era in that online counseling is expected to have an increased utility for people who face health issues requiring systematic monitoring, for elderly people, and for people who experience all kinds of exclusion due to gender, religion, or spiritual peculiarities [40]. The readiness of the therapist to use online counseling should also be underlined.…”