1
|
Clough BA, Alderson A, Savage S, Farrer L, Kebbell M. Can you tell me more about that? An examination of self-disclosure in videoconference and face-to-face psychological interviewing. Psychol Psychother 2024; 97:518-530. [PMID: 38923149 DOI: 10.1111/papt.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/28/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES Videoconference psychotherapy (VCP) is a crucial component of many health care systems, allowing for remote delivery of services. However, little is known about the mechanisms of change within VCP. Previous research has suggested that self-disclosure may be greater in VCP than face-to-face modalities and was investigated in the current study. DESIGN Young adults aged 18-25 years (N = 57) were randomly allocated to face-to-face or VCP interview conditions, with measures completed pre- and post-interview. METHODS Participants completed an autobiographical memory task, requiring them to describe specific memories in response to positive and negative valence cue words. Measures included self-reported self-disclosure, blind observer-rated self-disclosure, memory specificity, and mean number of words per response. RESULTS No significant differences were found between conditions with regard to self-reported self-disclosure, capacity to recall specific memories, or words uttered per response. However, observer-rated depth of self-disclosure was significantly higher for participants in the face-to-face than VCP condition. Self-disclosure and memory specificity were also significantly greater for negative than positive valence cue words, regardless of condition. CONCLUSIONS The findings indicate that whilst participants may be able to draw on memories with equal ease regardless of interview modality, in VCP, emotional processing of these memories may require increased support and guidance from the therapist.
Collapse
Affiliation(s)
- Bonnie A Clough
- School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
- Griffith Centre for Mental Health, Griffith University, Southport, Queensland, Australia
| | - Angie Alderson
- School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
| | - Stacey Savage
- School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
| | - Louise Farrer
- Centre for Mental Health Research, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mark Kebbell
- School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
| |
Collapse
|
2
|
Cho S, Kang J, Baek WH, Jeong YB, Lee S, Lee SM. Comparing counseling outcome for college students: Metaverse and in-person approaches. Psychother Res 2023:1-14. [PMID: 37848177 DOI: 10.1080/10503307.2023.2270139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
ABSTRACTObjective This study compared metaverse counseling with in-person counseling, using in-person counseling as a comparison group. To achieve this, we assessed whether metaverse counseling, a novel treatment approach, is comparable to traditional in-person counseling. Method: A total of 60 participants voluntarily participated in the study. Among the participants, 28 preferred in-person counseling, whereas 32 selected metaverse counseling as their preferred treatment option. Results and Conclusion: The findings indicated no statistically significant differences in the psychological symptom change patterns between the two counseling modalities. Both metaverse and in-person counseling demonstrated a common pattern of reduced symptom levels from pre-to post-session (Metaverse counseling Cohen's d = 1.04, In-person counseling Cohen's d = .62), which remained stable from post-session to follow-up regardless of the chosen counseling modality. Furthermore, the study revealed that the metaverse counseling group exhibited a higher level of working alliances than the in-person counseling group. Additionally, there was a slight tendency toward higher levels of counseling satisfaction in the metaverse counseling group than in the in-person counseling group. The results of this study support the use of synchronous metaverse programs to treat college students. The implications and limitations of this study are discussed. (195 words).
Collapse
Affiliation(s)
- Soohyun Cho
- Department of Education, Keimyung University, Daegu, Korea
| | - Jieun Kang
- Department of Education, Korea University, Seoul, Korea
| | - Woo Hyun Baek
- Department of Education, Korea University, Seoul, Korea
| | | | | | - Sang Min Lee
- Department of Education, College of Education, Korea University, Seoul, Korea
| |
Collapse
|
3
|
Greenup EP, Best D. Comparison of patient responses to telehealth satisfaction surveys in rural and urban populations in Queensland. AUST HEALTH REV 2023; 47:559-568. [PMID: 37635328 DOI: 10.1071/ah23116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
Objective Telehealth has for many years been identified as a potential contributor to reducing healthcare access inequality. For these benefits to be realised, patients must be accepting and satisfied with the delivery of healthcare in this manner. Measuring patient satisfaction across a large geographical area is important to ensure that investments in telehealth are delivering the benefits that are intended. Methods A brief survey was automatically issued on completion of a patient's telehealth appointment, requesting patient feedback on their experience and information on the location of where they participated in the appointment. These results were compared to an article review which sought examples of other patient satisfaction measures that compared rural and urban populations. Results No significant correlations between survey responses and established demographic indices were found. When stratified by the Modified Monash Model band from which the patient participated in their telehealth appointment from, an ANOVA test determined that rurality was not a predictor of survey response. A review of articles found four articles that compared rural and urban satisfaction responses. Conclusion No evidence of a patient's location influencing their satisfaction with telehealth was observed. This may be attributed to a variety of technical improvements introduced over the past 5-10 years that have made participating in telehealth appointments less technically demanding and more accessible. Telehealth is likely to be contributing to a reduction in healthcare access inequality in Queensland.
Collapse
Affiliation(s)
- Edwin Phillip Greenup
- Clinical Excellence Queensland, Queensland Health, Brisbane, Level 2, 15 Butterfield Street, Herston, Qld 4006, Australia
| | - Daniel Best
- Clinical Excellence Queensland, Queensland Health, Brisbane, Level 2, 15 Butterfield Street, Herston, Qld 4006, Australia
| |
Collapse
|
4
|
von Below C, Bergsten J, Midbris T, Philips B, Werbart A. It turned into something else: patients' long-term experiences of transitions to or from telepsychotherapy during the COVID-19 pandemic. Front Psychol 2023; 14:1142233. [PMID: 37251023 PMCID: PMC10213395 DOI: 10.3389/fpsyg.2023.1142233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction The shift from in-person therapy to telepsychotherapy during the COVID-19 pandemic was unprepared for, sudden, and inevitable. This study explored patients' long-term experiences of transitions to telepsychotherapy and back to the office. Methods Data were collected approximately two years after the declaration of COVID-19 as a pandemic. Eleven patients were interviewed (nine women and two men, aged 28 to 56, six in psychodynamic psychotherapy, five in CBT). Treatments switched between in-person and video/telephone sessions. Interview transcripts were analyzed applying the qualitative methodology of inductive thematic analysis. Results (1) The patients experienced the process in telepsychotherapy as impeded. Interventions were difficult to understand and lost impact. Routines surrounding the therapy sessions were lost. Conversations were less serious and lost direction. (2) Understanding was made more difficult when the nuances of non-verbal communication were lost. (3) The emotional relationship was altered. Remote therapy was perceived as something different from regular therapy, and once back in the therapy room, the patients felt that therapy started anew. The emotional presence was experienced as weakened, but some of the patients found expressing their feelings easier in the absence of bodily co-presence. According to the patients, in-person presence contributed to their security and trust, whereas they felt that the therapists were different when working remotely, behaving in a more easygoing and familiar way, as well as more solution-focused, supportive and unprofessional, less understanding and less therapeutic. Despite this, (4) telepsychotherapy also gave the patients an opportunity to take therapy with them into their everyday lives. Discussion The results suggest that in the long run, remote psychotherapy was seen as a good enough alternative when needed. The present study indicates that format alternations have an impact on which interventions can be implemented, which can have important implications for psychotherapy training and supervision in an era when telepsychotherapy is becoming increasingly common.
Collapse
|
5
|
Bechtold S, Hall M, Scherner PV, Kaven L, Rubel J. [Therapists' Perspectives on Changes in the Therapeutic Relationship after Switching from in-Person to Online Video Therapy Due to Corona: A Qualitative Analysis]. Psychother Psychosom Med Psychol 2023; 73:221-230. [PMID: 36878308 DOI: 10.1055/a-2017-5338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the extent to which the therapeutic relationship changed as a result of the COVID-19-related switch from face-to-face to video therapy. METHOD Twenty-one psychotherapists, who had changed the setting of therapy from face-to-face to video therapy were interviewed. The interviews were then transcribed, coded and superordinate themes were created in the context of a qualitative analysis. RESULTS More than half of the therapists reported that the therapeutic relationship with their patients remained stable. In addition, the majority of therapists described uncertainties in dealing with and responding to non-verbal signals, as well as maintaining an appropriate distance to their patients. Overall, both an improvement and a deterioration of the therapeutic relationship was reported. DISCUSSION The stability of the therapeutic relationship was mainly attributed to the therapists' previous face-to-face contact with their patients. The uncertainties expressed could be interpreted as risk factors for the therapeutic relationship. Although the sample represented only a small portion of working therapists, the findings from this study represent an important milestone in understanding how psychotherapy has changed as a result of the COVID-19 pandemic. CONCLUSION The therapeutic relationship remained stable despite the change from face-to-face to video therapy.
Collapse
Affiliation(s)
- Sara Bechtold
- Abteilung für Psychotherapieforschung, Justus Liebig Universität Giessen
| | - Mila Hall
- Abteilung für Psychotherapieforschung, Justus Liebig Universität Giessen
| | | | - Leonie Kaven
- Professur für Klinische Psychologie und Psychotherapie, Universität Greifswald
| | - Julian Rubel
- Abteilung für Psychotherapieforschung, Justus Liebig Universität Giessen
| |
Collapse
|
6
|
Winter S, Jesser A, Probst T, Schaffler Y, Kisler IM, Haid B, Pieh C, Humer E. How the COVID-19 Pandemic Affects the Provision of Psychotherapy: Results from Three Online Surveys on Austrian Psychotherapists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1961. [PMID: 36767327 PMCID: PMC9915415 DOI: 10.3390/ijerph20031961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to assess patient numbers and the format in which psychotherapy was delivered by Austrian psychotherapists during different time points of the COVID-19 pandemic and to explore psychotherapists` experiences on pandemic-associated changes in their psychotherapeutic work as well as their wishes for support in their professional activities. Three cross-sectional online surveys were conducted between March 2020 and May 2022. The total number of participating psychotherapists was n = 1547 in 2020, n = 238 in 2021, and n = 510 in 2022. The number of patients treated was highest in 2022 and lowest at the beginning of the pandemic (p < 0.001). During the lockdown in 2020, only 25.0% of patients were treated in personal contact. This proportion increased in the following years, reaching 86.9% in 2022 (p < 0.001). After a substantial increase in the proportion of patients treated via the telephone and internet during the first lockdown, both proportions decreased during the pandemics' second and third year (p < 0.001). However, a larger proportion of patients were treated via the internet in 2022 compared to pre-pandemic times (p < 0.001). Psychotherapists reported that the pandemic affected mainly the setting in which psychotherapy was provided (29.6%), the working conditions and workload (27.1%), as well as the demand for psychotherapy (26.9%). About one-third of psychotherapists expressed support wishes for their psychotherapeutic work. Results suggest that the pandemic went along with a partial shift in the provision of psychotherapy towards psychotherapy via the internet but not the telephone. The increase in patient numbers and psychotherapists` reports of increased workload suggest a rise in the demand for mental health care during and in the aftermath of the pandemic.
Collapse
Affiliation(s)
- Stefanie Winter
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Andrea Jesser
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Yvonne Schaffler
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | | | - Barbara Haid
- Austrian Federal Association for Psychotherapy, 1030 Vienna, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| |
Collapse
|
7
|
van Kessel K, de Pont S, Gasteiger C, Goedeke S. Clients' experiences of online therapy in the early stages of a COVID‐19 world: A scoping review. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Kirsten van Kessel
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
| | - Sarita de Pont
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
| | - Chiara Gasteiger
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
- Department of Psychological Medicine, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
| | - Sonja Goedeke
- Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand
| |
Collapse
|
8
|
Rodgers B, Tudor K, Sutherland A. An integrative review of the person‐centred and experiential therapy literature on delivering individual video counselling and psychotherapy. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Brian Rodgers
- The University of Auckland Auckland Aotearoa New Zealand
| | - Keith Tudor
- Auckland University of Technology Auckland Aotearoa New Zealand
| | | |
Collapse
|
9
|
Preminger TJ. Telemedicine in pediatric cardiology: pros and cons. Curr Opin Pediatr 2022; 34:484-490. [PMID: 35983842 DOI: 10.1097/mop.0000000000001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The aim of this article is to review recent uses of telemedicine in pediatric cardiology, highlighting merits, challenges, and future directions. RECENT FINDINGS The COVID-19 pandemic accelerated telemedicine use, which has had a positive impact with respect to providers, patients, and their caregivers. Recent data have demonstrated the feasibility and effectiveness of telemedicine through expediting needed care and reducing healthcare utilization, including unnecessary emergency department visits, transports, and hospitalizations. With increasing complexity of cardiac care, telecardiology allows for establishing a medical home, improving access, and continuity of care. Great potential also exists for telecardiology to permit more consistent preventive care, possibly resulting in improved health equity, reduced morbidity and mortality, and associated costs. Challenges to optimal implementation of telecardiology, which are all surmountable, include the currently unaccounted additional workload and administrative burden, licensing restrictions, disparities in access to care, insurance reimbursement, and potential fraud and abuse. SUMMARY Telecardiology allows for efficient, quality, effective, collaborative care and is foundational to creating innovative, high-value care models. Through integration with accelerating technology and in-person visits, a sustainable hybrid model of optimal care can be achieved. Addressing barriers to progress in telecardiology is critical.
Collapse
Affiliation(s)
- Tamar J Preminger
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| |
Collapse
|
10
|
Rutter N, Hall K, Westmarland N. Responding to child and adolescent-to-parent violence and abuse from a distance: Remote delivery of interventions during Covid-19. CHILDREN & SOCIETY 2022; 37:CHSO12622. [PMID: 36247928 PMCID: PMC9538484 DOI: 10.1111/chso.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 07/26/2022] [Accepted: 08/04/2022] [Indexed: 06/16/2023]
Abstract
Working with families living with child and adolescent-to-parent violence raises a number of challenges which were compounded during the Covid-19 pandemic. In this article, UK umbrella organisation 'Respect' is used as a case study to explore how 10 practitioners navigated social, emotional and safeguarding concerns that occurred when transitioning to remote working. Engagement with children and young people proved difficult, especially for those with special education needs and/or disabilities. However, parental engagement with services increased. Practitioners were quick to adapt to the changing landscape of remote working; continually adapting their practice to otherwise unforeseen safeguarding and/or practical challenges.
Collapse
Affiliation(s)
- Nikki Rutter
- Department of SociologyDurham UniversityDurhamUnited Kingdom
| | - Kirsten Hall
- Department of SociologyDurham UniversityDurhamUnited Kingdom
| | | |
Collapse
|
11
|
Sagui-Henson SJ, Welcome Chamberlain CE, Smith BJ, Li EJ, Castro Sweet C, Altman M. Understanding Components of Therapeutic Alliance and Well-Being from Use of a Global Digital Mental Health Benefit During the COVID-19 Pandemic: Longitudinal Observational Study. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:439-450. [PMID: 35855977 PMCID: PMC9278317 DOI: 10.1007/s41347-022-00263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/15/2022] [Accepted: 06/07/2022] [Indexed: 01/23/2023]
Abstract
Digital mental health services leverage technology to increase access to care, yet less is known about the quality of therapeutic relationships in a virtual setting. This study examined components of therapeutic alliance (a mechanism underlying successful treatment) and its association with beneficial treatment outcomes in a real-world, virtual setting. The objective is to examine (1) participant ratings of components of therapeutic alliance with providers in a virtual setting, (2) changes in subjective well-being and depressive symptoms among participants who began care with elevated depressive symptoms, and (3) the association between components of alliance and changes in participants’ well-being. Adults (N = 3,087, M age = 36 ± 9 years, 54% female) across the world with access to digital mental health benefits who engaged in videoconference sessions with a licensed therapist (18%, 555/3,087), certified coach (65%, 2,003/3,087), or both (17%, 529/3,087) between Sept. 29, 2020 and Oct. 12, 21. Participants completed 2 adapted items from the Working Alliance Inventory (goals and bonds subscales) after each session, and ratings were averaged across visits (Cronbach’s ɑ = .72). Participants’ World Health Organization-Five (WHO-5) Well-Being Index scores at the start and end of the study period were used to measure changes in subjective well-being. Descriptive and inferential statistics were conducted to examine average alliance ratings across demographics and utilization types and the association between alliance and well-being. The median adapted therapeutic alliance score was 4.8 (range: 1–5) and did not differ by age, country, or baseline well-being (Ps > .07). Females reported higher components of alliance than males (4.88 vs. 4.67, P = .01). Participants utilizing telecoaching reported higher components of alliance than those utilizing teletherapy or both telecoaching and teletherapy (4.83 v. 4.75, P = .004), though effect sizes were negligible. Among those with elevated baseline depressive symptoms (n = 835), participants reported an average WHO-5 increase of 15.42 points (95% CI 14.19–16.65, P < .001, Cohen d = 1.06) with 58% (485/835) reporting clinical recovery and 57% (481/835) reporting clinical improvement in depressive symptoms. Higher components of therapeutic alliance scores predicted greater well-being at follow-up (b = 2.04, 95% CI 0.09–3.99, P = .04) after controlling for age, sex, baseline WHO-5, and number of days in care (R2 = .06, P < .001). Exploratory analyses indicated this association did not differ by utilization type, baseline well-being, or session utilization (Ps > .34). People with access to one-on-one videoconferencing care via a digital mental health benefit formed a strong bond and sense of alignment on goals with both coaches and therapists. Higher components of alliance scores were associated with improvements in subjective well-being among participants who began care with elevated depressive symptoms, providing evidence that a positive bond and goal alignment with a provider are two of many factors influencing virtual care outcomes. Continued focus on the quality of therapeutic relationships will ensure digital mental health services are patient-tailored as these platforms expand equitable access to evidence-based care.
Collapse
|
12
|
Novella JK, Ng KM, Samuolis J. A comparison of online and in-person counseling outcomes using solution-focused brief therapy for college students with anxiety. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1161-1168. [PMID: 32703092 DOI: 10.1080/07448481.2020.1786101] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 05/21/2020] [Accepted: 06/12/2020] [Indexed: 05/20/2023]
Abstract
ObjectiveThis study compared online, synchronous video counseling to in-person counseling using solution-focused brief therapy for college students with mild to moderate anxiety. Participants: Participants were 49 undergraduate students who were seeking counseling for mild to moderate anxiety. The study was conducted from November, 2017 to December 2018. Methods: In a randomized, non-inferiority design, undergraduate participants were randomly assigned to online, synchronous video counseling or in-person treatment for anxiety using solution-focused brief therapy (SFBT). Participants completed the Beck's Anxiety Inventory (BAI) and College Counseling Assessment of Psychological Symptoms (CCAPS) to assess outcomes. Results: The results showed significant changes in scores on the BAI and the CCAPS Generalized Anxiety and Social Anxiety subscales for participants in both study conditions, and no significant differences in effectiveness of the two delivery methods. Conclusions: The findings provide support for the treatment of college students with anxiety with SFBT through online, synchronous video counseling. Limitations related to sample size and diversity are discussed.
Collapse
Affiliation(s)
| | - Kok-Mun Ng
- Counseling, Oregon State University, Corvallis, OR, USA
| | | |
Collapse
|
13
|
Werbart A, Byléhn L, Jansson TM, Philips B. Loss of Rituals, Boundaries, and Relationship: Patient Experiences of Transition to Telepsychotherapy Following the Onset of COVID-19 Pandemic. Front Psychol 2022; 13:835214. [PMID: 35401368 PMCID: PMC8988038 DOI: 10.3389/fpsyg.2022.835214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022] Open
Abstract
Telepsychotherapy is an increasingly common way of conducting psychotherapy. Previous research has shown that patients usually have positive experiences of online therapy, however, with large individual differences. The aim of this study was to explore patients’ experiences of transition from in-person psychotherapy sessions to telepsychotherapy during the COVID-19 pandemic, as well as variation in the experiences with regard to the patients’ personality orientation. Seven psychotherapy patients in Sweden were interviewed and the transcripts were analyzed using thematic analysis. Additionally, the participants were asked to rate their dissatisfaction/satisfaction with the transition, how hindering/helpful the transition was, and how unsafe/safe they felt after the transition in comparison to before. Personality orientation on relatedness or self-definition was assessed applying a self-assessment instrument (Prototype Matching of Anaclitic-Introjective Personality Configuration; PMAI). The participants experienced telepsychotherapy as qualitatively different from in-person psychotherapy. They reported several essential losses: the rituals surrounding therapy sessions were lost, including the transitional time and space between their every-day life and the therapy sessions, less therapeutic work was done, the therapists could lose their therapeutic stance, the sense of rapport was impaired, and the patients felt less open and emotionally available. On the other hand, some patients could feel freer online. As six of the participants had an anaclitic personality orientation, the present study could especially contribute to the understanding of how patients with strong affiliative needs and fear of abandonment experience the transition to meeting their therapists via communication technology. The participants’ self-ratings showed that they were only marginally dissatisfied with the transition and experienced the transition as slightly hindering, whereas they felt rather safe after the transition, indicating low concordance between qualitative and quantitative evaluations. New studies are needed to explore the introjective patients’ experiences of the transition. An essential topic is also to collect evidence and to test how the impaired sense of rapport when using communication technology can be remedied by adequate, patient-tailored interventions, a topic that has to be included in psychotherapy education and training.
Collapse
|
14
|
Patients’ and therapists’ experiences of CBT videoconferencing in anxiety disorders. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Cognitive behavioural therapy (CBT) videoconferencing has been demonstrated to be an effective treatment for anxiety disorders and an equal alternative to face-to-face CBT. However, qualitative patient and therapist experiences of CBT videoconferencing have been less researched. Due to COVID-19, mental health services have shifted to remote therapy methods; thus, understanding patient and therapist experiences are crucial to better inform service policies and best practices. The current study focused on patient and therapist experiences of CBT videoconferencing at the Centre for Anxiety Disorders and Trauma (CADAT). Researchers used qualitative content analysis to explore patients’ (n = 54) and therapists’ (n = 15) responses to an online survey. Results yielded four themes: behavioural experiments work well if the problem lends itself to videoconferencing, overall practicalities but some home environment implications, privacy and technical issues, high telepresence and the negative impact on the therapeutic alliance, and COVID-19 influences attitude positively. The findings have clinical implications for CBT videoconferencing, including a need for specific training in assessment and intervention for therapists using videoconferencing.
Key learning aims
Readers of this paper will be able to:
(1)
Describe patient and therapist qualitative experiences of CBT videoconferencing.
(2)
Identify areas to consider when delivering CBT videoconferencing in anxiety disorders.
(3)
Understand therapist training needs for CBT videoconferencing in anxiety disorders.
(4)
Inform own service protocols and best practices for the delivery of CBT videoconferencing.
Collapse
|
15
|
Kysely A, Bishop B, Kane RT, McDevitt M, De Palma M, Rooney R. Couples Therapy Delivered Through Videoconferencing: Effects on Relationship Outcomes, Mental Health and the Therapeutic Alliance. Front Psychol 2022; 12:773030. [PMID: 35185681 PMCID: PMC8855148 DOI: 10.3389/fpsyg.2021.773030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/22/2021] [Indexed: 11/18/2022] Open
Abstract
Changing technology, and the pervasive demand created by a greater need in the population for access to mental health interventions, has led to the development of technologies that are shifting the traditional way in which therapy is provided. This study investigated the efficacy of a behavioral couples therapy program conducted via videoconferencing, as compared to face-to-face. There were 60 participants, in couples, ranging in age from 21 to 69 years old. Couples had been in a relationship for between 1 to 49 years. The 30 couples were randomly allocated to the face-to-face or videoconferencing group. They all took part in Couple CARE—a couples behavioral education program which promotes self-change in order to increase relationship satisfaction. The six session manualized intervention was offered in an identical manner to all clients, in each condition. Data analysis was based on several questionnaires completed by each couple at pre, post and 3-months follow-up. Results showed that therapeutic alliance ratings did not differ between groups, but increased significantly over time for both groups. Additionally, the results indicated improvements in relationship satisfaction, mental health, and all other outcome scores over time, which did not differ based on condition. This study uniquely contributes to the literature exploring the use of technology to provide therapy. Specifically, the study provides evidence for couples therapy via videoconferencing as a viable alternative to face-to-face interventions, especially for those couples who may not have access to the treatment they require. It is anticipated that the results of this study will contribute to the field of online therapy, and add to fostering confidence in agencies to allow expansion of services conducted via videoconferencing.
Collapse
|
16
|
Cephas AS, Sofield S, Millstein A. Embracing Technological Possibilities in the Telehealth Delivery of Interactive Music Therapy. NORDIC JOURNAL OF MUSIC THERAPY 2022; 31:214-227. [PMID: 35846834 PMCID: PMC9282720 DOI: 10.1080/08098131.2022.2040579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Given how many music therapists have shifted their practice to telehealth in accordance with COVID-19 public safety precautions, it is essential for clinicians not only to adjust to the virtual platform, but to embrace the therapeutic potential of technological tools. Just as music is considered a therapeutic agent in music therapy sessions, the authors assert that technology may also be conceptualized and utilized as a means of enhancing therapeutic outcomes. METHOD Referencing an interactive music therapy protocol adapted for telehealth as part of a pain management study, the authors examine ways in which different aspects of telehealth technology can be used by music therapists to support client goals and bolster the therapeutic relationship. Generalized clinical examples drawn from virtual sessions are incorporated to demonstrate the unique therapeutic possibilities for client agency, client self-efficacy, and the client-therapist relationship afforded by the telehealth platform. RESULTS Among the possibilities afforded by telehealth are enriched opportunities for client choice, reinforcement of learning and implementing new transferrable skills, and enhancing the therapeutic relationship through collaborative troubleshooting and adapted interactive music experiences. DISCUSSION Specific recommendations for music therapists are included to advance the conversation around best practices regarding telehealth. The authors discuss actionable items for music therapists such as utilizing screen-sharing options to enhance musical interactions, validating and exploring clients' use of technology for self-disclosure, and other strategies for harnessing the therapeutic potential of technology in virtual music therapy sessions.
Collapse
|
17
|
Thomas N, McDonald C, de Boer K, Brand RM, Nedeljkovic M, Seabrook L. Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems. Psychol Psychother 2021; 94:854-883. [PMID: 33620133 PMCID: PMC8451850 DOI: 10.1111/papt.12332] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/02/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE The COVID-19 pandemic has resulted in a widespread adoption of videoconferencing as a communication medium in mental health service delivery. This review considers the empirical literature to date on using videoconferencing to deliver psychological therapy to adults presenting with mental health problems. METHOD Papers were identified via search of relevant databases. Quantitative and qualitative data were extracted and synthesized on uptake, feasibility, outcomes, and participant and therapist experiences. RESULTS Videoconferencing has an established evidence base in the delivery of cognitive behavioural therapies for post-traumatic stress disorder and depression, with prolonged exposure, cognitive processing therapy, and behavioural activation non-inferior to in-person delivery. There are large trials reporting efficacy for health anxiety and bulimia nervosa compared with treatment-as-usual. Initial studies show applicability of cognitive behavioural therapies for other anxiety and eating disorders and obsessive-compulsive spectrum disorders, but there has yet to be study of use in severe and complex mental health problems. Therapists may find it more difficult to judge non-verbal behaviour, and there may be initial discomfort while adapting to videoconferencing, but client ratings of the therapeutic alliance are similar to in-person therapy, and videoconferencing may have advantages such as being less confronting. There may be useful opportunities for videoconferencing in embedding therapy delivery within the client's own environment. CONCLUSIONS Videoconferencing is an accessible and effective modality for therapy delivery. Future research needs to extend beyond testing whether videoconferencing can replicate in-person therapy delivery to consider unique therapeutic affordances of the videoconferencing modality. PRACTITIONER POINTS Videoconferencing is an efficacious means of delivering behavioural and cognitive therapies to adults with mental health problems. Trial evidence has established it is no less efficacious than in-person therapy for prolonged exposure, cognitive processing therapy, and behavioural activation. While therapists report nonverbal feedback being harder to judge, and clients can take time to adapt to videoconferencing, clients rate the therapeutic alliance and satisfaction similarly to therapy in-person. Videoconferencing provides opportunities to integrate therapeutic exercises within the person's day-to-day environment.
Collapse
Affiliation(s)
- Neil Thomas
- National eTherapy CentreSwinburne University of TechnologyMelbourneVictoriaAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
- Alfred HospitalMelbourneVictoriaAustralia
| | - Caity McDonald
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Kathleen de Boer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Rachel M. Brand
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
- School of Health and Behavioural SciencesUniversity of the Sunshine CoastSippy DownsQldAustralia
| | - Maja Nedeljkovic
- National eTherapy CentreSwinburne University of TechnologyMelbourneVictoriaAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Liz Seabrook
- National eTherapy CentreSwinburne University of TechnologyMelbourneVictoriaAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| |
Collapse
|
18
|
Venville A, O'Connor S, Roeschlein H, Ennals P, McLoughlan G, Thomas N. Mental Health Service User and Worker Experiences of Psychosocial Support Via Telehealth Through the COVID-19 Pandemic: Qualitative Study. JMIR Ment Health 2021; 8:e29671. [PMID: 34182461 PMCID: PMC8362804 DOI: 10.2196/29671] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/03/2021] [Accepted: 06/17/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, we saw telehealth rapidly become the primary way to receive mental health care. International research has validated many of the benefits and challenges of telehealth known beforehand for specific population groups. However, if telehealth is to assume prominence in future mental health service delivery, greater understanding of its capacity to be used to provide psychosocial support to people with complex and enduring mental health conditions is needed. OBJECTIVE We focused on an Australian community-managed provider of psychosocial intervention and support. We aimed to understand service user and worker experiences of psychosocial support via telehealth throughout the COVID-19 pandemic. METHODS This study was jointly developed and conducted by people with lived experience of mental ill health or distress, mental health service providers, and university-based researchers. Semistructured interviews were conducted between August and November 2020 and explored participant experiences of receiving or providing psychosocial support via telehealth, including telephone, text, and videoconferencing. Qualitative data were analyzed thematically; quantitative data were collated and analyzed using descriptive statistics. RESULTS Service users (n=20) and workers (n=8) completed individual interviews via telephone or videoconferencing platform. Service users received psychosocial support services by telephone (12/20, 60%), by videoconferencing (6/20, 30%), and by both telephone and videoconferencing (2/20, 10%). Of note, 55% (11/20) of service user participants stated a future preference for in-person psychosocial support services, 30% (6/20) preferred to receive a mixture of in-person and telehealth, and 15% (3/20) elected telehealth only. Two meta-themes emerged as integral to worker and service user experience of telehealth during the pandemic: (1) creating safety and comfort and (2) a whole new way of working. The first meta-theme comprises subthemes relating to a sense of safety and comfort while using telehealth; including trusting in the relationship and having and exercising choice and control. The second meta-theme contains subthemes reflecting key challenges and opportunities associated with the shift from in-person psychosocial support to telehealth. CONCLUSIONS Overall, our findings highlighted that most service users experienced telehealth positively, but this was dependent on them continuing to get the support they needed in a way that was safe and comfortable. While access difficulties of a subgroup of service users should not be ignored, most service users and workers were able to adapt to telehealth by focusing on maintaining the relationship and using choice and flexibility to maintain service delivery. Although most research participants expressed a preference for a return to in-person psychosocial support or hybrid in-person and telehealth models, there was a general recognition that intentional use of telehealth could contribute to flexible and responsive service delivery. Challenges to telehealth provision of psychosocial support identified in this study are yet to be fully understood.
Collapse
Affiliation(s)
- Annie Venville
- Social Work, College of Health and Biomedicine, Victoria University, Footscray, Australia
| | | | | | | | | | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| |
Collapse
|
19
|
Zhou X, Bambling M, Edirippulige S. A mixed-method systematic review of text-based telehealth interventions in eating disorder management. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-03-2021-0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose
Eating disorders (EDs) is a major health condition affecting 9% of the global population and 10% of those with EDs lost their lives as a result. Text-based telehealth interventions (TTIs) seem to provide a low-cost and convenient treatment option; however, the evidence is scarce. This study aimed to synthesize evidence relating to the use of TTIs for the management of EDs.
Design/methodology/approach
Five databases were searched published between January 2020 and May 2019. The authors used keywords relating to telehealth and EDs. The authors used Joanna Briggs Institute's (JBI's) critical appraisal instrument to assess the methodology quality of included studies.
Findings
Fifteen studies were included in this mix-method systematic review and assessed for methodology quality. Email, web-based texting, text-messaging and online chat room were used as mode for deliver healthcare for patients with EDs. In the treatment phase, all studies (nine studies; n = 860 participants) showed effectiveness (for RCTs) and usefulness (for non-RCT studies). In the aftercare phase (six studies; n = 364 participants), the results regarding the effectiveness of TTIs were mixed. Two studies showed effectiveness whilst four studies did not find statistically significant change of ED outcomes.
Research limitations/implications
The qualities of these studies varied; firstly, 66% (n = 10) of the studies were non-randomized studies (e.g. single-arm trial, case report) with small samples. Moreover, one-fourth (n = 4) of the studies did not use validated instruments or indicate the instrument. Also, half (n = 7) of the studies used TTIs as adjunct to face-to-face treatment or bigger online treatment, it is hard to make conclusion that the changes were due to TTIs' effect. In addition, follow-up rate is not satisfactory, thus results should be interpreted cautiously.
Practical implications
TTIs seem to be promising for management of EDs, particularly in the treatment phase. This provides an important treatment option for health practitioners and people with EDs as an alternative or in adjunct with face-to-face services.
Originality/value
This is the first review to synthesis the use of TTIs for ED management.
Collapse
|
20
|
Barker GG, Barker EE. Online therapy: lessons learned from the COVID-19 health crisis. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1889462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Gina G. Barker
- School of Behavioral Sciences, Liberty University, Lynchburg, VA, USA
| | - Edgar E. Barker
- School of Behavioral Sciences, Liberty University, Lynchburg, VA, USA
| |
Collapse
|
21
|
The Research on Patient Satisfaction with Remote Healthcare Prior to and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105338. [PMID: 34067818 PMCID: PMC8156025 DOI: 10.3390/ijerph18105338] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 02/08/2023]
Abstract
The issue of research on patient satisfaction with healthcare services took on a completely new dimension due to the COVID-19 pandemic and the developing telehealth services. This results from the fact that during the pandemic, remote healthcare was often the only possible form of care provision to the patient. The COVID-19 pandemic has substantially accelerated the implementation of remote healthcare in healthcare institutions and made it an essential tool for providing healthcare services. The objective of the literature review was to study the research on patient satisfaction with remote healthcare services prior to and during the pandemic. The study featured a literature review of electronic databases, such as: Medline, ProQuest, PubMED, Ebsco, Google Scholar, WoS. The identified empirical papers were classified in two groups concerning the research on patient satisfaction prior to and during the COVID-19 pandemic, and were divided and descriptively synthesised. Certain limitations to the methodical quality of the research were demonstrated as result of the conducted analyses. It was also ascertained that researchers lack clarity on the method of defining and measuring satisfaction prior to and during the COVID-19 pandemic.
Collapse
|
22
|
Marcotte-Beaumier G, Bouchard S, Gosselin P, Langlois F, Belleville G, Marchand A, Dugas MJ. The Role of Intolerance of Uncertainty and Working Alliance in the Outcome of Cognitive Behavioral Therapy for Generalized Anxiety Disorder Delivered by Videoconference: Mediation Analysis. JMIR Ment Health 2021; 8:e24541. [PMID: 33720024 PMCID: PMC8077936 DOI: 10.2196/24541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/23/2020] [Accepted: 01/03/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Previous meta-analyses have shown a significant relationship between working alliance and treatment outcome in general. Some studies have examined the relationship between working alliance and treatment outcome during telepsychotherapy, but to the best of our knowledge, no study has examined the mediating role of individual components of the working alliance. OBJECTIVE As part of a clinical trial of cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) delivered by videoconference (VC), the aim of this study is to examine the mediating role of intolerance of uncertainty on the relationship between the components of the working alliance and treatment outcome. METHODS A sample of 46 adults with primary GAD received 15 sessions of CBT for GAD delivered over VC. Participants completed the measure of working alliance immediately after the fifth therapy session. The degree of change in intolerance of uncertainty (a key psychological process) was assessed from pre- to posttreatment. Treatment outcome was assessed via changes in GAD symptoms from pretreatment to the 6-month follow-up. RESULTS The results revealed that the therapeutic bond did not predict treatment outcome (r=-0.23; P=.12). However, agreement on therapeutic goals and tasks did predict treatment outcome (r=-0.42; P=.004 and r=-0.37; P=.01, respectively). In addition, the relationship between consensus on therapeutic tasks and treatment outcome was completely mediated by changes in intolerance of uncertainty (unstandardized β=-0.03; r2=0.12), whereas consensus relative to treatment goals had a direct impact on treatment outcome. CONCLUSIONS These results provide a better understanding of the differential role of the components of the working alliance in telepsychotherapy as a facilitative factor for changes in key cognitive processes, leading to therapeutic change. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 12662027; http://www.isrctn.com/ISRCTN12662027.
Collapse
Affiliation(s)
- Gabrielle Marcotte-Beaumier
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, QC, Canada
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Stéphane Bouchard
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, QC, Canada
- Centre de recherche du Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Gatineau, QC, Canada
| | - Patrick Gosselin
- Département de psychologie, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédéric Langlois
- Département de psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | | | - André Marchand
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Michel J Dugas
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, QC, Canada
- Centre de recherche du Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Gatineau, QC, Canada
| |
Collapse
|
23
|
Record JD, Ziegelstein RC, Christmas C, Rand CS, Hanyok LA. Delivering Personalized Care at a Distance: How Telemedicine Can Foster Getting to Know the Patient as a Person. J Pers Med 2021; 11:137. [PMID: 33671324 PMCID: PMC7922915 DOI: 10.3390/jpm11020137] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 12/14/2022] Open
Abstract
The promise of precision medicine is based on the use of new technologies to better characterize patients by defining individuals in the areas of genomics, proteomics, metabolomics and other aspects of biologic variability. Wise application of modern technology can similarly transform health visits with patients, allowing for better characterization of the patient's individual life circumstances than possible in a traditional office visit. The use of, and experience with, telemedicine have increased significantly during the COVID-19 pandemic. Patients and clinicians report high satisfaction with telemedicine, and the quality of communication and patient-centeredness experienced in this setting are both rated highly. In this article, we explore the benefits offered by telemedicine in facilitating personalized care with particular focus on telemedicine delivered by video platforms. We propose strategies and skills specific to the effective implementation of personalized telemedicine, drawing on literature in patient-centered communication and home visits. While traditional in-person office visits continue to offer important opportunities such as thorough physical examination and the potential for enhanced non-verbal communication, telemedicine offers many important advantages that can facilitate the process of getting to know the patient as a person.
Collapse
Affiliation(s)
- Janet D. Record
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (R.C.Z.); (C.C.); (C.S.R.); (L.A.H.)
| | | | | | | | | |
Collapse
|
24
|
Norwood C, Sabin-Farrell R, Malins S, Moghaddam NG. An explanatory sequential investigation of the working alliance as a change process in videoconferencing psychotherapy. J Clin Psychol 2021; 77:1330-1353. [PMID: 33482015 DOI: 10.1002/jclp.23112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/07/2020] [Accepted: 12/20/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVES AND DESIGN Debate exists as to patient experience, and the importance, of the working alliance (WA) in videoconferencing psychotherapy (VCP). This study used a two-phase explanatory sequential design to investigate the WA as a change process in VCP. METHODS Phase I: sessional VCP outcome and WA data were analysed using multilevel modelling (n = 46). Phase II: participants (n = 12) from Phase I were recruited to semi-structured interviews, analysed using thematic framework analysis. RESULTS AND CONCLUSIONS Results demonstrate: (1) a significant correlation between WA and outcome (F(1, 15.19) = 25.01, p < 0.001), (2) previous session WA significantly predicted outcome in the next session (F(1, 355.61) = 4.47, p < 0.05), and (3) previous session outcome significantly predicted next session WA (F(1, 55.3) = 15.19, p < 0.001), with three core themes explaining patient experience (engaging with the medium, connection with the therapist, and working via the medium). Results are discussed and future research recommended.
Collapse
Affiliation(s)
- Carl Norwood
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Rachel Sabin-Farrell
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Sam Malins
- Institute of Mental Health, CLAHRC EM, University of Nottingham, Nottingham, UK
| | | |
Collapse
|
25
|
Vuillier L, May L, Greville-Harris M, Surman R, Moseley RL. The impact of the COVID-19 pandemic on individuals with eating disorders: the role of emotion regulation and exploration of online treatment experiences. J Eat Disord 2021; 9:10. [PMID: 33436064 PMCID: PMC7802411 DOI: 10.1186/s40337-020-00362-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The Covid-19 pandemic has wrought disruption to everyday life and services, and emerging evidence suggests that those with eating disorders (EDs) are likely to experience marked distress and exacerbation of their symptoms. However, little is known around the most relevant factors to symptom change; whether certain emotion regulation and coping strategies are linked to better outcomes; and how people with EDs are adjusting to psychological interventions moving online. METHOD In a mixed-method design, we collected qualitative and quantitative data from 207 (76 males) self-selected UK residents with self-reported ED, who described and ranked impacts of the pandemic on their symptoms. Regression analysis examined whether emotion regulation strategies were associated with self-reported symptom change, ED symptomatology, and negative emotional states. Thematic analysis explored participants' experiences of the pandemic, particularly factors affecting their ED, coping strategies used, and experiences of psychological intervention. RESULTS Most participants (83.1%) reported worsening of ED symptomatology, though factors affecting symptom change differed between specific EDs. Emotion regulation, such as having fewer strategies, poorer emotional clarity, and non-acceptance of emotions, explained nearly half of the variance in emotional distress during the pandemic. Qualitative findings indicated that difficult emotions (such as fear and uncertainty), changes to routine, and unhelpful social messages were triggering for participants during the pandemic. While some participants described employing positive coping strategies (such as limiting social media exposure), many reported using ED behaviours (among other maladaptive strategies, like alcohol use) to cope with the pandemic. Finally, loss of treatment support, feeling underserving of support and experiencing a 'detached connection' online were further exacerbating factors for these participants. DISCUSSION While our sample was self-selected and may not represent all people with EDs, our results suggest that people with EDs have been strongly affected by the pandemic. Some aspects of online treatment were found to be beneficial but our findings suggest it also needs some improvement. Our paper discusses implications for online treatment such as taking into account personal circumstances and, in a time where people have limited control over the antecedents of negative emotion, the need to develop skills to manage emotions when they arise.
Collapse
Affiliation(s)
- L Vuillier
- Department of Psychology, Bournemouth University, Poole, UK.
| | - L May
- Department of Psychology, Bournemouth University, Poole, UK
- Dorset Healthcare University NHS Foundation Trust, Poole, UK
| | | | - R Surman
- Department of Psychology, Bournemouth University, Poole, UK
| | - R L Moseley
- Department of Psychology, Bournemouth University, Poole, UK
| |
Collapse
|
26
|
Batastini AB, Paprzycki P, Jones ACT, MacLean N. Are videoconferenced mental and behavioral health services just as good as in-person? A meta-analysis of a fast-growing practice. Clin Psychol Rev 2020; 83:101944. [PMID: 33227560 DOI: 10.1016/j.cpr.2020.101944] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/19/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
The use of videoconferencing technologies (VCT) is on the rise given its potential to close the gap between mental health care need and availability. Yet, little is known about the effectiveness of these services compared to those delivered in-person. A series of meta-analyses were conducted using 57 empirical studies (43 examining intervention outcomes; 14 examining assessment reliability) published over the past two decades that included a variety of populations and clinical settings. Using conventional and HLM3 meta-analytical approaches, VCT consistently produced treatment effects that were largely equivalent to in-person delivered interventions across 281 individual outcomes and 4336 clients, with female clients and those treated in medical facilities tending to respond more favorably to VCT than in-person. Results of an HLM3 model suggested assessments conducted using VCT did not appear to lead to differential decisions compared to those conducted in-person across 83 individual outcomes and 332 clients/examinees. Although aggregate findings support the use of VCT as a viable alternative to in-person service delivery of mental healthcare, several limitations in the current literature base were revealed. Most concerning was the relatively limited number of randomized controlled trials and the inconsistent (and often incomplete) reporting of methodological features and results. Recommendations for reporting the findings of telemental health research are provided.
Collapse
Affiliation(s)
- Ashley B Batastini
- University of Southern Mississippi, USA; University of Mississippi Medical Center Department of Psychiatry, USA.
| | - Peter Paprzycki
- University of Southern Mississippi, USA; Mississippi Center for Clinical and Translational Research, USA; University of Toledo, USA
| | | | - Nina MacLean
- Michigan Department of Health & Human Services - Center for Forensic Psychiatry, USA
| |
Collapse
|
27
|
Simpson S, Guerrini L, Rochford S. Telepsychology in a University Psychology Clinic Setting: A Pilot Project. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12131] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Shirley Rochford
- Rural and Remote Network, Country Health SA Mental Health Service,
| |
Collapse
|
28
|
Richardson L, Reid C, Dziurawiec S. “Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12126] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Lisa Richardson
- School of Psychology and Exercise Science, Murdoch University,
| | - Corinne Reid
- School of Psychology and Exercise Science, Murdoch University,
| | | |
Collapse
|
29
|
Simpson SG, Rochford S, Livingstone A, English S, Austin C. Tele‐web Psychology in Rural South Australia: The Logistics of Setting Up a Remote University Clinic Staffed by Clinical Psychologists in Training. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12049] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Shirley Rochford
- Rural and Remote Network, Country Health SA Mental Health Service,
| | | | | | - Carly Austin
- Psychology Clinic, University of South Australia,
| |
Collapse
|
30
|
Sansom‐daly UM, Wakefield CE, Mcgill BC, Patterson P. Ethical and Clinical Challenges Delivering Group‐based Cognitive‐Behavioural Therapy to Adolescents and Young Adults with Cancer Using Videoconferencing Technology. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12112] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ursula M Sansom‐daly
- Kids Cancer Centre, Sydney Children's Hospital,
- School of Women's and Children's Health, University of New South Wales,
- Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital,
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital,
- School of Women's and Children's Health, University of New South Wales,
| | - Brittany C Mcgill
- Kids Cancer Centre, Sydney Children's Hospital,
- School of Women's and Children's Health, University of New South Wales,
| | - Pandora Patterson
- Research, Evaluation and Social Policy, CanTeen Australia,
- Cancer Nursing Research Unit, Sydney Nursing School, The University of Sydney,
| |
Collapse
|
31
|
Reid C, Campbell C, Locke V, Charlesworth R. Australian Men's Hockey Team: Virtually There. Telepsychology in Olympic Sport. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Corinne Reid
- School of Psychology and Exercise Science, Murdoch University,
- Australian Men's Hockey Team, Hockey Australia,
| | | | - Vance Locke
- School of Psychology and Exercise Science, Murdoch University,
- Australian Men's Hockey Team, Hockey Australia,
| | | |
Collapse
|
32
|
Stubbings DR, Rees CS, Roberts LD. New Avenues to Facilitate Engagement in Psychotherapy: The Use of Videoconferencing and Text–Chat in a Severe Case of Obsessive‐compulsive Disorder. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12111] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel R Stubbings
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University of Technology,
| | - Clare S Rees
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University of Technology,
| | - Lynne D Roberts
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University of Technology,
| |
Collapse
|
33
|
Richards P, Simpson S, Bastiampillai T, Pietrabissa G, Castelnuovo G. The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist's perspective. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12102] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Penelope Richards
- Psychology Clinic, School of Psychology, Social Work & Social Policy, University of South Australia, Adelaide, South Australia, Australia,
| | - Susan Simpson
- Psychology Clinic, School of Psychology, Social Work & Social Policy, University of South Australia, Adelaide, South Australia, Australia,
| | - Tarun Bastiampillai
- Department of Psychiatry, University of Adelaide School of Medical Sciences, Adelaide, South Australia, Australia,
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, Milan, Italy,
- Ospedale San Giuseppe, Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy,
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy,
- Ospedale San Giuseppe, Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy,
| |
Collapse
|
34
|
Simpson S, Richardson L, Pietrabissa G, Castelnuovo G, Reid C. Videotherapy and therapeutic alliance in the age of COVID-19. Clin Psychol Psychother 2020; 28:409-421. [PMID: 33037682 PMCID: PMC7675483 DOI: 10.1002/cpp.2521] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 12/17/2022]
Abstract
The arrival of the coronavirus (COVID‐19) pandemic has confronted us with a global and unprecedented challenge of community‐wide psychological distress alongside reduced access to therapeutic services in the traditional face‐to‐face format, due to the need to self‐isolate. This previously unimagineable set of circumstances provides a unique opportunity, and indeed an imperative, for videotherapy to fulfil its potential in addressing mental health and well‐being needs from a distance. Historically, the uptake of videotherapy has been hindered by psychotherapist expectations of inferior therapeutic alliance and outcomes, in spite of considerable research evidence to the contrary. Research suggests that videotherapy provides a powerful pathway for clients to experience enhanced opportunities for self‐expression, connection and intimacy. This more neutral therapeutic ‘space’ provides clients with multifarious opportunities for self‐awareness, creative experience and collaboration, with potentially a greater sense of agency over their own experience. This paper explores ways in which videotherapy can lead to a revitalisation of the concept of the therapeutic relationship, in order to meet the challenges associated with COVID‐19. A number of specific considerations for videotherapy adaptations and etiquette in the midst of COVID‐19 are described.
Collapse
Affiliation(s)
- Susan Simpson
- NHS Lothian, St. John's Hospital, Livingston, UK.,Department of Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Lisa Richardson
- North Metropolitan Health Service, MHPHDS, Perth, WA, Australia
| | - Giada Pietrabissa
- Psychology Research Laboratory, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Corinne Reid
- Deputy Vice Chancellor, Research, Victoria University, Melbourne, VIC, Australia
| |
Collapse
|
35
|
Woo H, Dondanville A, Jang H, Na G, Jang Y. A Content Analysis of the Counseling Literature on Technology Integration: American Counseling Association (ACA) Counseling Journals between 2000 and 2018. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2020; 42:319-333. [PMID: 32836577 PMCID: PMC7363684 DOI: 10.1007/s10447-020-09406-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This content analysis provides an overview of articles specific to technology integration in the field of counseling published in American Counseling Association (ACA) journals between the years 2000 and 2018. In addition to the number of articles on this topic published during this time period, the study identified other aspects such as authors and institutional affiliations; methodology, study locations, and application settings; target populations and sample characteristics; and areas and types of technology integration. Recommendations are provided for counseling research in general and for future research extending from specific circumstances such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Hongryun Woo
- Department of Counseling and Human Development, University of Louisville, 326 Woodford R. and Harriett B. Porter Building, Louisville, KY 40292 USA
| | - Ashley Dondanville
- Department of Counseling and Human Development, University of Louisville, 326 Woodford R. and Harriett B. Porter Building, Louisville, KY 40292 USA
| | | | - GoEun Na
- School of Education, Hunter College, New York, NY USA
| | - Yoojin Jang
- College of Education, Hanyang, University, Seoul, Republic of Korea
| |
Collapse
|
36
|
Kysely A, Bishop B, Kane R, Cheng M, De Palma M, Rooney R. Expectations and Experiences of Couples Receiving Therapy Through Videoconferencing: A Qualitative Study. Front Psychol 2020; 10:2992. [PMID: 32038380 PMCID: PMC6985577 DOI: 10.3389/fpsyg.2019.02992] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022] Open
Abstract
Videoconferencing is an emerging medium through which psychological therapy, including relationship interventions for couples, can be delivered. Understanding clients’ expectations and experiences of receiving therapy through this medium is important for optimizing future delivery. This study used a qualitative methodology to explore the expectations and experiences of couples throughout the process of the Couple CARE program, which was delivered through videoconferencing. Fifteen couples participated in semi-structured interviews during the first and last sessions of the intervention. The interviews were conducted using the iChat program, with the therapist conducting the first interview and an external interviewer conducting the second. Thematic analysis was used to identify themes from the interview transcripts. Five themes were identified from the pre-therapy interviews, reflecting couples’ initial impressions and expectations: new experience, comparison, practical aspects, connection and dynamics, and distance and space. Couples’ experiences were explored in the eight themes from the post-therapy interviews: technicalities, the idea of “distance,” satisfaction and comfort, confidentiality, comparisons, new experience, expectations change, and working alliance. Overall, the present study found that couples experienced a positive shift in expectations. Despite some initial concerns regarding the therapist’s ability to empathize over a screen and the potential for the technology to break down, many clients noted that videoconferencing allowed them to become fully immersed in the therapeutic process. In fact, many couples felt that videoconferencing created an element of ‘distance’ from the therapist that allowed them to feel a greater sense of control and comfort. Couples consistently described being able to effectively connect with the therapist, and that the video actually enhanced the therapeutic alliance, due to a greater perceived focus on therapy processes. Overall, despite some initial concerns, the majority of couples found the videoconferencing experience to be beneficial and positive.
Collapse
Affiliation(s)
- Andrea Kysely
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Brian Bishop
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Robert Kane
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Maryanne Cheng
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Mia De Palma
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Rosanna Rooney
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| |
Collapse
|
37
|
Cowan KE, McKean AJ, Gentry MT, Hilty DM. Barriers to Use of Telepsychiatry: Clinicians as Gatekeepers. Mayo Clin Proc 2019; 94:2510-2523. [PMID: 31806104 DOI: 10.1016/j.mayocp.2019.04.018] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/15/2019] [Accepted: 04/24/2019] [Indexed: 12/17/2022]
Abstract
Telepsychiatry is effective and has generated hope and promise for improved access and enhanced quality of care with reasonable cost containment. Clinicians and organizations are informed about clinical, technological, and administrative telepsychiatric barriers via guidelines, but there are many practical patient and clinician factors that have slowed implementation and undermined sustainability. Literature describing barriers to use of telepsychiatry was reviewed. PubMed search terms with date limits from January 1, 1959, to April 25, 2019, included telepsychiatry, telemedicine, telemental health, videoconferencing, video based, Internet, synchronous, real-time, two-way, limitations, restrictions, barriers, obstacles, challenges, issues, implementation, utilization, adoption, perspectives, perceptions, attitudes, beliefs, willingness, acceptability, feasibility, culture/cultural, outcomes, satisfaction, quality, effectiveness, and efficacy. Articles were selected for inclusion on the basis of relevance. Barriers are described from both patient and clinicians' perspectives. Patients and clinicians are largely satisfied with telepsychiatry, but concerns about establishing rapport, privacy, safety, and technology limitations have slowed acceptance of telepsychiatry. Clinicians are also concerned about reimbursement/financial, legal/regulatory, licensure/credentialing, and education/learning issues. These issues point to system and policy concerns, which, in combination with other administrative concerns, raise questions about system design/workflow, efficiency of clinical care, and changing organizational culture. Although telepsychiatry service is convenient for patients, the many barriers from clinicians' perspectives are concerning, because they serve as gatekeepers for implementation and sustainability of telepsychiatry services. This suggests that solutions to overcome barriers must start by addressing the concerns of clinicians and enhancing clinical workflow.
Collapse
Affiliation(s)
- Kirsten E Cowan
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN; Essentia Health, Duluth, MN
| | | | - Melanie T Gentry
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Donald M Hilty
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| |
Collapse
|
38
|
Orlando JF, Beard M, Kumar S. Systematic review of patient and caregivers' satisfaction with telehealth videoconferencing as a mode of service delivery in managing patients' health. PLoS One 2019; 14:e0221848. [PMID: 31469865 PMCID: PMC6716655 DOI: 10.1371/journal.pone.0221848] [Citation(s) in RCA: 239] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/18/2019] [Indexed: 12/16/2022] Open
Abstract
Telehealth is an alternative method of delivering health care to people required to travel long distances for routine health care. The aim of this systematic review was to examine whether patients and their caregivers living in rural and remote areas are satisfied with telehealth videoconferencing as a mode of service delivery in managing their health. A protocol was registered with PROSPERO international prospective register of systematic reviews (#CRD42017083597) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of Ovid Medline, Embase, CINAHL, ProQuest Health Research Premium Collection, Joanna Briggs Institute and the Cochrane Library was conducted. Studies of people living in rural and remote areas who attended outpatient appointments for a health condition via videoconference were included if the studies measured patient and/or caregivers' satisfaction with telehealth. Data on satisfaction was extracted and descriptively synthesised. Methodological quality of the included studies was assessed using a modified version of the McMaster Critical Review Forms for Quantitative or Qualitative Studies. Thirty-six studies of varying study design and quality met the inclusion criteria. The outcomes of satisfaction with telehealth were categorised into system experience, information sharing, consumer focus and overall satisfaction. There were high levels of satisfaction across all these dimensions. Despite these positive findings, the current evidence base lacks clarity in terms of how satisfaction is defined and measured. People living in rural and remote areas are generally satisfied with telehealth as a mode of service delivery as it may improve access to health care and avoid the inconvenience of travel.
Collapse
Affiliation(s)
- Joseph F. Orlando
- Physiotherapy Department, Royal Adelaide Hospital, Adelaide, Australia
| | - Matthew Beard
- Physiotherapy Department, Royal Adelaide Hospital, Adelaide, Australia
| | - Saravana Kumar
- School of Health Sciences, University of South Australia, Adelaide, Australia
| |
Collapse
|
39
|
Nagarajan M, S Y. Mental health counsellors’ perceptions on use of technology in counselling. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-018-0104-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
40
|
Norwood C, Moghaddam NG, Malins S, Sabin-Farrell R. Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clin Psychol Psychother 2018; 25:797-808. [PMID: 30014606 DOI: 10.1002/cpp.2315] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 01/18/2023]
Abstract
Videoconferencing psychotherapy (VCP)-the remote delivery of psychotherapy via secure video link-is an innovative way of delivering psychotherapy, which has the potential to overcome many of the regularly cited barriers to accessing psychological treatment. However, some debate exists as to whether an adequate working alliance can be formed between therapist and client, when therapy is delivered through such a medium. The presented article is a systematic literature review and two meta-analyses aimed at answering the questions: Is working alliance actually poorer in VCP? And is outcome equivalence possible between VCP and face-to-face delivery? Twelve studies were identified which met inclusion/exclusion criteria, all of which demonstrated good working alliance and outcome for VCP. Meta-analyses showed that working alliance in VCP was inferior to face-to-face delivery (standardized mean difference [SMD] = -0.30; 95% confidence interval [CI] [-0.67, 0.07], p = 0.11; with the lower bound of the CI extending beyond the noninferiority margin [-0.50]), but that target symptom reduction was noninferior (SMD = -0.03; 95% CI [-0.45, 0.40], p = 0.90; CI within the noninferiority margin [0.50]). These results are discussed and directions for future research recommended.
Collapse
Affiliation(s)
- Carl Norwood
- Trent Doctorate in Clinical Psychology, College of Social Sciences, University of Lincoln, Lincoln, UK
- Trent Doctorate in Clinical Psychology, Division of Psychiatry and Applied Psychology, The University of Nottingham, Nottingham, UK
| | - Nima G Moghaddam
- Trent Doctorate in Clinical Psychology, College of Social Sciences, University of Lincoln, Lincoln, UK
| | - Sam Malins
- CLAHRC EM, IMH Building, University of Nottingham, Nottingham, UK
| | - Rachel Sabin-Farrell
- Trent Doctorate in Clinical Psychology, College of Social Sciences, University of Lincoln, Lincoln, UK
- Trent Doctorate in Clinical Psychology, Division of Psychiatry and Applied Psychology, The University of Nottingham, Nottingham, UK
| |
Collapse
|
41
|
Kim JI, Yun JY, Park H, Park SY, Ahn Y, Lee H, Kim TK, Yoon S, Lee YJ, Oh S, Denninger JW, Kim BN, Kim JH. A Mobile Videoconference-Based Intervention on Stress Reduction and Resilience Enhancement in Employees: Randomized Controlled Trial. J Med Internet Res 2018; 20:e10760. [PMID: 30348630 PMCID: PMC6234345 DOI: 10.2196/10760] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Videoconferencing-based treatments have shown great potential in increasing engagement and compliance by decreasing the barriers of time and distance. In general, employees tend to experience a lot of stress, but find it difficult to visit a clinic during office hours. OBJECTIVE The purpose of this study was to investigate the effectiveness of a mobile videoconference-based intervention for stress reduction and resilience enhancement in employees. METHODS In total, 81 participants were randomly allocated to one of the three conditions: mobile videoconferencing, in-person, and self-care; of these, 72 completed the study. All participants underwent assessment via self-reported questionnaires before, immediately after, and 1 month after the intervention. Intervention lasted for 4 weeks and consisted of elements of cognitive behavioral therapy, positive psychology, and meditation. Changes in clinical variables regarding stress and resilience across time were compared between treatment conditions. RESULTS There were significant condition × time effects on variables measuring perceived stress, resilience, emotional labor, and sleep, demonstrating significantly differential effects across time according to treatment condition. Moreover, there were significant effects of condition on perceived stress and occupational stress. There were no significant differences in any variable between the mobile videoconferencing and in-person conditions at 1 month after the intervention. CONCLUSIONS Results indicate that both mobile videoconferencing and in-person interventions were comparably effective in decreasing stress and enhancing resilience. Further studies with a larger sample size and a longer follow-up period are warranted to investigate the long-term effect of mobile videoconferencing interventions. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT03256682; https://clinicaltrials.gov/ct2/show/NCT03256682 (Archived by WebCite at http://www.webcitation.org/71W77bwnR).
Collapse
Affiliation(s)
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic Of Korea.,Seoul National University College of Medicine, Seoul, Republic Of Korea
| | - Heyeon Park
- Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Suk-Young Park
- Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | | | - Hansol Lee
- Korean Academy of Gifted Education, Seoul, Republic Of Korea
| | | | - Sooran Yoon
- Aimmed Company Ltd, Seoul, Republic Of Korea
| | | | - Sohee Oh
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic Of Korea
| | - John W Denninger
- Benson-Henry Institue for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Bung-Nyun Kim
- Seoul National University Hospital, Seoul, Republic Of Korea.,Seoul National University College of Medicine, Seoul, Republic Of Korea.,Human Behavioral Medical Institute, Seoul National University Medical Research Center, Seoul, Republic Of Korea
| | - Jeong-Hyun Kim
- Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| |
Collapse
|
42
|
Vaitheswaran S, Crockett P, Wilson S, Millar H. Telemental health: videoconferencing in mental health services. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.111.008904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
SummaryVideo technology was first used in psychiatric services in the 1950s but came into general use in the 1990s, particularly in North America and Australia. Video has utility across all ages and in a wide range of clinical situations. These include case conferencing for patients with complex problems (e.g. when planning discharge from specialist inpatient units), psychological assessment and treatment, Mental Health Act assessments, suicide risk assessment and work in forensic settings. Potential for benefit may be most obvious in remote locations, but video use is also relevant in urban settings. Lack of training and experience, inadequate access to equipment and insufficient technical support have all limited the take-up of this technology in the UK. This article briefly reviews the literature and outlines technical and cost considerations when using video technology. Three services in Scotland are described to illustrate ways in which videoconferencing can enhance services.
Collapse
|
43
|
Anderson KE, Byrne CE, Crosby RD, Le Grange D. Utilizing Telehealth to deliver family-based treatment for adolescent anorexia nervosa. Int J Eat Disord 2017; 50:1235-1238. [PMID: 28801943 DOI: 10.1002/eat.22759] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to test the feasibility and preliminary effect size on the main outcome measure (weight gain) of family-based treatment (FBT) for adolescents with anorexia nervosa (AN) and their families delivered via a Telehealth platform (i.e., an HIPAA compliant videoconferencing format). METHOD Ten adolescents, mean age of 16.08 years (SD = 1.99), meeting DSM-5 criteria for AN or atypical AN, were enrolled in the study and offered FBT via a Telehealth platform. Feasibility and acceptability were evaluated by rates of recruitment and retention. Treatment outcome was determined utilizing percent median body mass index (%mBMI), the eating disorder examination (EDE), and measures for depression and self-esteem. RESULTS Recruitment target was achieved within allotted time, and all participants were retained for the course of treatment. Percent mBMI improved significantly from baseline to the end-of-treatment (p = .013) and from baseline to the 6-month follow-up (p = .032). Similar results were achieved for the EDE Global Score (p = .002 and .001, respectively). DISCUSSION These findings provide preliminary evidence that it is feasible to deliver FBT via Telehealth and that satisfactory clinical outcomes are achievable.
Collapse
Affiliation(s)
| | | | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota.,The University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Daniel Le Grange
- University of California, San Francisco, San Francisco, California.,The University of Chicago, Chicago, Illinois
| |
Collapse
|
44
|
Pitchforth E, Nolte E, Corbett J, Miani C, Winpenny E, van Teijlingen E, Elmore N, King S, Ball S, Miler J, Ling T. Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies. HEALTH SERVICES AND DELIVERY RESEARCH 2017. [DOI: 10.3310/hsdr05190] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BackgroundThe notion of a community hospital in England is evolving from the traditional model of a local hospital staffed by general practitioners and nurses and serving mainly rural populations. Along with the diversification of models, there is a renewed policy interest in community hospitals and their potential to deliver integrated care. However, there is a need to better understand the role of different models of community hospitals within the wider health economy and an opportunity to learn from experiences of other countries to inform this potential.ObjectivesThis study sought to (1) define the nature and scope of service provision models that fit under the umbrella term ‘community hospital’ in the UK and other high-income countries, (2) analyse evidence of their effectiveness and efficiency, (3) explore the wider role and impact of community engagement in community hospitals, (4) understand how models in other countries operate and asses their role within the wider health-care system, and (5) identify the potential for community hospitals to perform an integrative role in the delivery of health and social care.MethodsA multimethod study including a scoping review of community hospital models, a linked systematic review of their effectiveness and efficiency, an analysis of experiences in Australia, Finland, Italy, Norway and Scotland, and case studies of four community hospitals in Finland, Italy and Scotland.ResultsThe evidence reviews found that community hospitals provide a diverse range of services, spanning primary, secondary and long-term care in geographical and health system contexts. They can offer an effective and efficient alternative to acute hospitals. Patient experience was frequently reported to be better at community hospitals, and the cost-effectiveness of some models was found to be similar to that of general hospitals, although evidence was limited. Evidence from other countries showed that community hospitals provide a wide spectrum of health services that lie on a continuum between serving a ‘geographic purpose’ and having a specific population focus, mainly older people. Structures continue to evolve as countries embark on major reforms to integrate health and social care. Case studies highlighted that it is important to consider local and national contexts when looking at how to transfer models across settings, how to overcome barriers to integration beyond location and how the community should be best represented.LimitationsThe use of a restricted definition may have excluded some relevant community hospital models, and the small number of countries and case studies included for comparison may limit the transferability of findings for England. Although this research provides detailed insights into community hospitals in five countries, it was not in its scope to include the perspective of patients in any depth.ConclusionsAt a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes. There is a need for more research into the effectiveness and cost-effectiveness of community hospitals, the role of the community and optimal staff profile(s).FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
- Emma Pitchforth
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
| | - Ellen Nolte
- European Observatory on Health Systems and Policies, London School of Economics and Political Science and London School of Hygiene & Tropical Medicine, London, UK
| | - Jennie Corbett
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
| | - Céline Miani
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
| | - Eleanor Winpenny
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
| | - Edwin van Teijlingen
- Department of Human Sciences and Public Health, University of Bournemouth, Bournemouth, UK
| | - Natasha Elmore
- Cambridge Centre for Health Services Research (CCHSR), Institute of Public Health, University of Cambridge, Cambridge, UK
| | | | - Sarah Ball
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
| | - Joanna Miler
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Tom Ling
- Cambridge Centre for Health Services Research (CCHSR), RAND Europe, Cambridge, UK
| |
Collapse
|
45
|
Graves TA, Tabri N, Thompson-Brenner H, Franko DL, Eddy KT, Bourion-Bedes S, Brown A, Constantino MJ, Flückiger C, Forsberg S, Isserlin L, Couturier J, Paulson Karlsson G, Mander J, Teufel M, Mitchell JE, Crosby RD, Prestano C, Satir DA, Simpson S, Sly R, Lacey JH, Stiles-Shields C, Tasca GA, Waller G, Zaitsoff SL, Rienecke R, Le Grange D, Thomas JJ. A meta-analysis of the relation between therapeutic alliance and treatment outcome in eating disorders. Int J Eat Disord 2017; 50:323-340. [PMID: 28152196 DOI: 10.1002/eat.22672] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/12/2016] [Accepted: 12/12/2016] [Indexed: 12/11/2022]
Abstract
The therapeutic alliance has demonstrated an association with favorable psychotherapeutic outcomes in the treatment of eating disorders (EDs). However, questions remain about the inter-relationships between early alliance, early symptom improvement, and treatment outcome. We conducted a meta-analysis on the relations among these constructs, and possible moderators of these relations, in psychosocial treatments for EDs. Twenty studies met inclusion criteria and supplied sufficient supplementary data. Results revealed small-to-moderate effect sizes, βs = 0.13 to 0.22 (p < .05), indicating that early symptom improvement was related to subsequent alliance quality and that alliance ratings also were related to subsequent symptom reduction. The relationship between early alliance and treatment outcome was partially accounted for by early symptom improvement. With regard to moderators, early alliance showed weaker associations with outcome in therapies with a strong behavioral component relative to nonbehavioral therapies. However, alliance showed stronger relations to outcome for younger (vs. older) patients, over and above the variance shared with early symptom improvement. In sum, early symptom reduction enhances therapeutic alliance and treatment outcome in EDs, but early alliance may require specific attention for younger patients and for those receiving nonbehaviorally oriented treatments.
Collapse
Affiliation(s)
- Tiffany A Graves
- Eating Disorders Clinical and Research Program (EDCRP), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Nassim Tabri
- Eating Disorders Clinical and Research Program (EDCRP), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Heather Thompson-Brenner
- Eating Disorders Clinical and Research Program (EDCRP), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Debra L Franko
- Eating Disorders Clinical and Research Program (EDCRP), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program (EDCRP), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | | | - Amy Brown
- Eating Disorder Service, South London and Maudsley NHS Foundation Trust, London, England, United Kingdom
| | - Michael J Constantino
- Department of Psychological and Brain Sciences, University of Massachusetts-Amherst, Amherst, Massachusetts, United States
| | - Christoph Flückiger
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, United States and Institute fur Psychologie, University of Bern, Bern, Switzerland
| | - Sarah Forsberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, United States
| | - Leanna Isserlin
- Division of Child & Adolescent Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer Couturier
- Pediatric Eating Disorders Program, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | | | - Johannes Mander
- ZZP Center for Psychological Psychotherapy, University of Heidelberg, Heidelberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany and Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - James E Mitchell
- Neuropsychiatric Research Institute, Fargo, North Dakota, United States and University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota, United States and University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States
| | | | - Dana A Satir
- Department of Psychiatry, University of Colorado Denver, Denver, Colorado, United States
| | - Susan Simpson
- School of Psychology, Social Work, and Social Policy, University of South Australia, South Australia, Australia
| | - Richard Sly
- School of Nursing Science, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - J Hubert Lacey
- Department of Health and Social Care Sciences, St. George's, University of London, London, England, United Kingdom
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine and The School of Social Service Administration, University of Chicago, Chicago, Illinois, United States
| | - Giorgio A Tasca
- Brain and Mind Research Institute, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Shannon L Zaitsoff
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Renee Rienecke
- The University of Michigan Comprehensive Eating Disorders Program, Ann Arbor, Michigan, United States
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, California, United States
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program (EDCRP), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| |
Collapse
|
46
|
Winpenny EM, Corbett J, Miani C, King S, Pitchforth E, Ling T, van Teijlingen E, Nolte E. Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models. Int J Integr Care 2016; 16:13. [PMID: 28316553 PMCID: PMC5354221 DOI: 10.5334/ijic.2463] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 10/24/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries. METHODS We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis. RESULTS 75 studies were included from ten countries. Community hospitals provide a wide range of services, with wide diversity of provision appearing to reflect local needs. Community hospitals are staffed by a mixture of general practitioners (GPs), nurses, allied health professionals and healthcare assistants. We found many examples of collaborative working arrangements between community hospitals and other health care organisations, including colocation of services, shared workforce with primary care and close collaboration with acute specialists. CONCLUSIONS Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care.
Collapse
Affiliation(s)
- Eleanor M. Winpenny
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Jennie Corbett
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Celine Miani
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Sarah King
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Emma Pitchforth
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Tom Ling
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Edwin van Teijlingen
- Bournemouth House B112c, 19 Christchurch Road, Bournemouth, BH1 3LH, United Kingdom
| | - Ellen Nolte
- London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| |
Collapse
|
47
|
Simpson SG, Reid CL. Therapeutic alliance in videoconferencing psychotherapy: a review. Aust J Rural Health 2016; 22:280-99. [PMID: 25495622 DOI: 10.1111/ajr.12149] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 01/06/2023] Open
Abstract
Psychotherapy services are limited in remote and rural areas in Australia and across the globe. Videoconferencing has become well established as a feasible and acceptable mode of psychological treatment delivery. Therapeutic alliance (TA) is an essential factor underlying successful therapy across therapeutic models. In order to determine the state of knowledge regarding TA in psychotherapy via videoconferencing, a literature review was conducted on research studies that formally measured TA as primary, secondary or tertiary outcome measures over the past 23 years. The databases searched were Medline, PsycArticles, PsycINFO, PsycEXTRA and EMBASE. Searching identified 9915 articles that measured satisfaction, acceptability or therapeutic rapport, of which 23 met criteria for the review. Three studies were carried out in Australia, 11 in USA, 4 in Canada, 3 in Scotland and 2 in England. Studies overwhelmingly supported the notion that TA can be developed in psychotherapy by videoconference, with clients rating bond and presence at least equally as strongly as in-person settings across a range of diagnostic groups. Therapists also rated high levels of TA, but often not quite as high as that of their clients early in treatment. The evidence was examined in the context of important aspects of TA, including bond, presence, therapist attitudes and abilities, and client attitudes and beliefs. Barriers and facilitators of alliance were identified. Future studies should include observational measures of bond and presence to supplement self-report.
Collapse
Affiliation(s)
- Susan G Simpson
- Psychology Clinic, University of South Australia, Adelaide, South Australia, Australia
| | | |
Collapse
|
48
|
Théberge-Lapointe N, Marchand A, Langlois F, Gosselin P, Watts S. Efficacy of a cognitive-behavioural therapy administered by videoconference for generalized anxiety disorder. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY 2015. [DOI: 10.1016/j.erap.2014.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
49
|
Therapeutic Alliance in Clinical Videoconferencing: Optimizing the Communication Context. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/978-3-319-08765-8_10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
50
|
Pilot Open Case Series of Voice over Internet Protocol-delivered Assessment and Behavior Therapy for Chronic Tic Disorders. COGNITIVE AND BEHAVIORAL PRACTICE 2014; 23:40-50. [PMID: 30595642 DOI: 10.1016/j.cbpra.2014.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment for children with Chronic Tic Disorders (CTDs). Nevertheless, many families of children with CTDs are unable to access CBIT due to a lack of adequately trained treatment providers, time commitment, and travel distance. This study established the interrater reliability between in-person and VoIP administrations of the Yale Global Tic Severity Scale (YGTSS), and examined the preliminary efficacy, feasibility, and acceptability of Voice over Internet Protocol (VoIP)-delivered CBIT for reducing tics in children with CTDs in an open case series. Across in-person and VoIP administrations of the YGTSS, results showed mean agreement of 91%, 96%, and 95% for motor, phonic, and total tic severity subscales. In the pilot feasibility study, four children received 8-weekly sessions of CBIT via VoIP and were assessed at pre- and post-treatment by an independent evaluator. Results showed a 29.44% decrease in clinician-rated tic severity from pre to post-assessment on the YGTSS. Two of the four patients were considered treatment responders at post treatment, using Clinical Global Impressions-Improvement ratings. Therapeutic alliance, parent and child treatment satisfaction and videoconferencing satisfaction ratings were high. CBIT was considered feasible to implement via VoIP, although further testing is recommended.
Collapse
|