“Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia

Abstract

Objective: Technology is changing how we behave, communicate, and process information, and this has significant implications for mental health care. Telepsychology has appeal as a solution to obstacles of distance and access in rural and regional areas; however, few services appear to provide telepsychology as a routine service component for psychotherapeutic exchanges. The primary research goal of a multi-year PhD project was to explore and explain the disconnect between research and practice in telepsychology, and to investigate, among other things, how telepsychology changes the clinician's usual practice or the client's behaviour. Methods: Eight adult participants were seen for 68 hours of direct videoconferencing telepsychology over 11 months, and 53 separate points of data for each client that included the perspectives of both the client and therapist were collected. Clients completed technical, process, and therapy-based satisfaction surveys after each session, in addition to standardised clinical symptom rating. Results: This manuscript will summarise some of the project's research findings in relation to specific practice techniques, with a particular focus on therapeutic alliance and satisfaction. Conclusions: In possible contrast to the opinions of those less familiar with telepsychology, we conclude that if telepsychology is not treated apologetically it can achieve therapeutic results, albeit via a different route, favourably comparable to those achieved in face-to-face encounters. What is already known on this topic1 Telepsychology is recognised as a potential solution to access to care barriers in rural and regional areas. 2 The results of telemental health studies indicate strong evidence for high patient satisfaction and therapeutic alliance for a range of health services, regardless of therapy orientation. 3 Despite positive satisfaction and effectiveness evidence, practitioners still appear to be reluctant to use telepsychology. What this paper adds1 The conditions of "artificiality" of transmissions, for example, from low bandwidth, poor camera resolution, and colour/picture or sound distortion, appear to not impede the client's satisfaction, or clinical outcomes. 2 Despite technical problems, there appeared little impact on participants' overall satisfaction or on the development of therapeutic alliance or clinical outcomes. 3 In some circumstances, the distancing provided by the telepsychology medium can also offer a sense of safety and sanctuary for clients who are dealing with shame-based issues.

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