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Kavanagh BE, Corney KB, Beks H, Williams LJ, Quirk SE, Versace VL. A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia. BMC Health Serv Res 2023; 23:1060. [PMID: 37794469 PMCID: PMC10552307 DOI: 10.1186/s12913-023-10034-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Inadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context. METHODS A systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted. RESULTS Fifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed. CONCLUSION Both healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria's Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.
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Affiliation(s)
- Bianca E Kavanagh
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia.
| | - Kayla B Corney
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
| | - Hannah Beks
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia
| | - Lana J Williams
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
| | - Shae E Quirk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia
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O'Keeffe D, Marshall D, Wheeler A, Allen E, Ronan H, Buckley A, Counihan E, Clarke M. Through COVID-19 and beyond: developing a multidisciplinary telehealth family intervention in first episode psychosis. Ir J Psychol Med 2023; 40:503-507. [PMID: 34847972 DOI: 10.1017/ipm.2021.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The COVID-19 pandemic presents unique challenges to high quality, safe Early Intervention in Psychosis (EIP) service provision. Due to the necessity to ensure EIP continues despite this, we developed a multidisciplinary, blended, telehealth intervention, incorporating psychoeducation and peer support, for family members of first episode psychosis service users: PERCEPTION. This perspective article aims to: describe PERCEPTION; offer reflections on our experience of delivering it; make recommendations for future research; and synthesise key learning to assist the integration of similar interventions in other EIP services. We provide a descriptive account of PERCEPTION's development and implementation, with reflections from the clinicians involved, on supporting families using this approach. We experienced telehealth as patient-focused, safe, and efficient and believe the intervention's blended nature augmented families' engagement. The approach adopted can assist service providers to attain balance between protecting public health and offering a meaningful, therapeutic intervention to support families in the current epoch.
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Affiliation(s)
- Donal O'Keeffe
- DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
| | - David Marshall
- DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
- Cluain Mhuire Community Mental Health Services, Blackrock, Dublin, Ireland
| | - Andrew Wheeler
- Cluain Mhuire Community Mental Health Services, Blackrock, Dublin, Ireland
| | - Eoghan Allen
- Cluain Mhuire Community Mental Health Services, Blackrock, Dublin, Ireland
| | - Helena Ronan
- Cluain Mhuire Community Mental Health Services, Blackrock, Dublin, Ireland
| | - Amy Buckley
- Cluain Mhuire Community Mental Health Services, Blackrock, Dublin, Ireland
| | - Eimear Counihan
- DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin, Ireland
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Braude G, Mohi S, Quinlan E, Shoullis A, Collison J. A change in frame and countertransference experiences: Transitioning from
face‐to‐face
to telepsychotherapy. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Georgia Braude
- Department of Psychological Science Australian College of Applied Psychology Sydney New South Wales Australia
| | - Simone Mohi
- Department of Psychological Science Australian College of Applied Psychology Sydney New South Wales Australia
| | - Elly Quinlan
- Department of Psychological Science Australian College of Applied Psychology Sydney New South Wales Australia
| | - Anthony Shoullis
- Department of Psychological Science Australian College of Applied Psychology Sydney New South Wales Australia
| | - James Collison
- Department of Psychological Science Australian College of Applied Psychology Sydney New South Wales Australia
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Colón Llamas T, Escobar Altare A, Ramírez Castro MF, Bermúdez Jaimes ME, López Sánchez MC, Castellanos Urrego SG. Telepsicología en un centro de atención psicológica universitario durante el COVID-19: Experiencias de consultantes y estudiantes. UNIVERSITAS PSYCHOLOGICA 2022. [DOI: 10.11144/javeriana.upsy21.tcap] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
El uso de la telepsicología como herramienta para la atención en salud mental ha presentado en las últimas décadas un importante incremento a nivel mundial. En Colombia, a pesar de existir servicios de teleconsulta, la publicación de estudios es limitada. A raíz de la crisis de salud generada por la pandemia por COVID-19 se implementó el servicio de atención por telepsicología en un centro de atención psicológica universitario. El presente trabajo se propuso caracterizar las experiencias de la atención en la modalidad de telepsicología de consultantes y estudiantes en práctica clínica, con el fin de ampliar el conocimiento en el área y aportar a la evaluación de la viabilidad de estos servicios. Se realizó un estudio descriptivo de caracterización con un diseño transversal. Se aplicó un cuestionario a 253 consultantes y 77 estudiantes, construido por el equipo investigador. La información obtenida mostró que la atención por telepsicología logró altos niveles de satisfacción con el tratamiento recibido, la posibilidad de establecer vínculo terapéutico y el desarrollo de habilidades clínicas en los estudiantes, siendo esta modalidad de atención una alternativa útil para deponer barreras de atención en salud. Se sugiere realizar estudios de seguimiento en diferentes momentos para mayor fiabilidad de los resultados.
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Gori A, Topino E, Brugnera A, Compare A. Assessment of professional self-efficacy in psychological interventions and psychotherapy sessions: Development of the Therapist Self-Efficacy Scale (T-SES) and its application for eTherapy. J Clin Psychol 2022; 78:2122-2144. [PMID: 35615900 PMCID: PMC9796675 DOI: 10.1002/jclp.23391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/20/2022] [Accepted: 05/13/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to develop the Therapist Self-Efficacy Scale (T-SES), and test its validity in a sample of Italian mental health therapists, to assess their professional self-efficacy concerning their practice of eTherapy in a synchronous video-based setting. METHODS A sample of 322 Italian mental health professionals (37.6% psychologists, 62.4% psychotherapists; Mage = 38.48, SD = 8.509) completed an online survey. RESULTS The T-SES showed a clear, one-factor structure with good psychometric properties. Significant associations were found with insight orientation, general self-efficacy, self-esteem, and personality traits of openness, conscientiousness, and agreeableness. The results showed no differences between psychologists and psychotherapists, or differences based on years of experience. CONCLUSION The T-SES is an agile and versatile self-report measure for mental health professionals to assess their self-efficacy concerning their therapeutic activity, which can provide information for tailoring training for eTherapy.
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Affiliation(s)
- Alessio Gori
- Department of Health SciencesUniversity of FlorenceFlorenceItaly,Integrated Psychodynamic Psychotherapy Institute (IPPI)FlorenceItaly
| | - Eleonora Topino
- Department of Human SciencesLUMSA University of RomeRomeItaly
| | - Agostino Brugnera
- Department of Human and Social SciencesUniversity of BergamoBergamoItaly
| | - Angelo Compare
- Department of Human and Social SciencesUniversity of BergamoBergamoItaly
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Leuchtenberg S, Gromer D, Käthner I. Videoconferencing versus
face‐to‐face
psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance, empathy and treatment characteristics. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Leuchtenberg
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Daniel Gromer
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Ivo Käthner
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
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7
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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.
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8
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Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: A single centre evaluation. J Adv Nurs 2021; 78:498-509. [PMID: 34590738 PMCID: PMC8657364 DOI: 10.1111/jan.15050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/12/2021] [Accepted: 09/16/2021] [Indexed: 01/23/2023]
Abstract
Aims The overall aim of this evaluation was to look at the impact of the changes in working practices during the pandemic on nurses. This secondary analysis provided an evaluation of virtual care and being able/required to work from home. Design This was secondary analysis of an evaluation using semi‐structured interviews. Methods Conducted at a single National Health Service (NHS) university hospital in the United Kingdom between May and July 2020. Forty‐eight operational leads and nurses participated in semi‐structured interviews which were digitally recorded, transcribed verbatim and analysed using a framework analysis. Results Two overarching themes emerged relating to the patient experience and nursing experience. There were both positive and negative elements associated with virtual care and remote working related to these themes. However, the majority of nurses found that virtual clinics were useful when proper resources were provided, and managerial strategies were put in place to support them. Participants felt that virtual care could benefit many but not all patient groups moving forward, and that flexibility around working from home would be desirable in the future. Conclusion Virtual care and remote working were implemented to accommodate the restrictions imposed because of the pandemic. The benefits of these changes to nurses and patients support these being business as usual. However, clear policies are needed to ensure that nurses feel supported when working remotely and there are robust assessments in place to ensure virtual care is provided to patients who have access to the necessary technology. Impact This was a study of the move to virtual care and remote working during the COVID‐19 pandemic. Telemedicine and flexible working were not common in the NHS prior to the pandemic but the current evaluation supports the role out of these as standard care with policies in place to ensure that nurses and patients are appropriately supported.
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Affiliation(s)
- Luke Hughes
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Anika Petrella
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK
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9
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Khan S, Shapka JD, Domene JF. Counsellors’ experiences of online therapy. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1885009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Shereen Khan
- Health and Counselling Services, Simon Fraser University, Burnaby, Canada
| | - Jennifer D. Shapka
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, Canada
| | - Jose F. Domene
- Werlund School of Education, University of Calgary, Calgary, Canada
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10
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Knott V, Habota T, Mallan K. Attitudes of Australian psychologists towards the delivery of therapy via video conferencing technology. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12464] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Vikki Knott
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia,
- Discipline of Psychological Sciences, Australian College of Applied Psychology, Brisbane, Queensland, Australia,
| | - Tina Habota
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia,
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK,
| | - Kimberley Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia,
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11
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McLean SA, Booth AT, Schnabel A, Wright BJ, Painter FL, McIntosh JE. Exploring the Efficacy of Telehealth for Family Therapy Through Systematic, Meta-analytic, and Qualitative Evidence. Clin Child Fam Psychol Rev 2021; 24:244-266. [PMID: 33492545 PMCID: PMC7829321 DOI: 10.1007/s10567-020-00340-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/14/2023]
Abstract
There is a current escalating need for telehealth (TH) options in family mental health services. In the absence of replicated evidence, TH guidelines from peak bodies are largely based on assumptions of the effectiveness of TH methods. New investments in TH would optimally be based in evidence of clinical efficacy. To this end, we conducted three studies in which we (1) systematically reviewed eight professional guidelines for TH family therapy, (2) examined replicated evidence for the efficacy of TH family therapy through systematic review of 20 studies and meta-analyses of 13 effects, and (3) synthesised clinical accommodations to TH methodology from a study of 12 experienced TH family therapists. The studies found (1) a predominant focus in existing TH guidelines on operational matters pertaining to TH and relative neglect of therapeutic process; (2) meta-analyses of efficacy for child behavioural problems (k = 8) and parental depression (k = 5) showed equivalent outcomes in TH and face-to-face therapy and enhanced outcomes in TH relative to treatment as usual, resource provision (i.e. written materials), or wait-list control. Narrative review of 20 studies for a range of relational and mental health outcomes aligned with these findings; and (3) therapists defined clear conditions for enhanced engagement and therapeutic process via TH and reflected on cautions and accommodations for purposes of rapport building and mitigating risk. Given moderate-strong evidence for the efficacy of TH methods of family therapy for a range of conditions, we offer recommendations for future implementation of TH for family therapy.
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Affiliation(s)
- Siân A McLean
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, 3056, Australia.
| | - Anna T Booth
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, 3056, Australia
| | - Alexandra Schnabel
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, 3056, Australia
| | - Bradley J Wright
- Department of Psychology and Counselling, School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Felicity L Painter
- Department of Psychology and Counselling, School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Jennifer E McIntosh
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, 3056, Australia
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12
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Simpson S, Richardson LK, Pelling N. Introduction to the Special Issue “Telepsychology: Research and Practice”. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Susan Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia,
| | | | - Nadine Pelling
- School of Psychology, Social Work and Social Policy, University of South Australia,
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13
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Frueh BC. Solving Mental Healthcare Access Problems in the Twenty‐first Century. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12140] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Hoffmann M, Wensing M, Peters-Klimm F, Szecsenyi J, Hartmann M, Friederich HC, Haun MW. Perspectives of Psychotherapists and Psychiatrists on Mental Health Care Integration Within Primary Care Via Video Consultations: Qualitative Preimplementation Study. J Med Internet Res 2020; 22:e17569. [PMID: 32554369 PMCID: PMC7333073 DOI: 10.2196/17569] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/18/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background Many patients with mental disorders remain untreated. Video-based mental health care demonstrates comparable effectiveness to face-to-face treatments and is a promising mode for delivering specialized care within primary care. Nevertheless, professionals struggle with implementing video consultations in their daily practice. Specifically, little is known about mental health specialists’ acceptance of mental health video consultations in routine practice. The PROVIDE (ImPROving cross-sectoral collaboration between primary and psychosocial care: An implementation study on VIDEo consultations) project aims to improve cross-sectoral collaboration between primary and psychosocial care through implementing video consultations in primary care. To increase the uptake of video consultations, it is crucial to account for necessary prerequisites and to tailor interventions to the needs of the target group prior to implementation. Objective The aim of this study was to explore the acceptance of video consultations embedded in primary care from the perspectives of mental health specialists in Germany. Methods We conducted a qualitative, exploratory, preimplementation study in urban and rural counties. We conducted three semistructured focus groups with 11 mental health specialists. We used qualitative content analysis combining an inductive-deductive approach, applying the Tailored Implementation in Chronic Diseases (TICD) framework to the text material, which comprises individual health professional factors; patient factors; professional interactions; incentives and resources; capacity for organizational change; social, political, and legal factors; and guideline factors. Results Against the background of long waiting times and a shortage of mental health specialists, especially in rural areas, participants valued video consultations as a potential means to improve access to mental health care. With respect to the TICD framework domains, the participants most often discussed individual health professional factors, followed by patient factors. All participants highlighted the importance of a trusting relationship between the patient and the therapist and doubted whether such a relationship could be established through video consultations (11/11, 100%). However, participants considered mental health specialist video consultations to be particularly suited for patients in rural areas, those with impaired mobility, and those who may otherwise remain untreated (6/11, 55%). Most participants expected video consultations to help the aforementioned patient groups avoid tedious searching for an available therapist and save on travel time and, therefore, improve access to specialized care for patients (7/11, 64%). Moreover, the participants expected video consultations to improve collaboration with the family physician (6/11, 55%). Finally, participants identified organizational aspects, such as reliable scheduling, the duration of the individual consultation (9/11, 82%), and reimbursement conditions (7/11, 67%), as key drivers for the acceptance and adoption of the model. Conclusions While mental health specialists expect video consultations to improve access to specialized care for some patients, they consistently wonder whether such consultations can establish a trusting patient-therapist relationship. When implementing video consultations, these concerns should be addressed by training providers in managing technology-based treatment settings, with extra consideration for fostering the patients’ and therapists’ engagement. Trial Registration German Clinical Trials Register DRKS00012487; https://tinyurl.com/uhg2one
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Affiliation(s)
- Mariell Hoffmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Frank Peters-Klimm
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
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15
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Christensen LF, Moller AM, Hansen JP, Nielsen CT, Gildberg FA. Patients' and providers' experiences with video consultations used in the treatment of older patients with unipolar depression: A systematic review. J Psychiatr Ment Health Nurs 2020; 27:258-271. [PMID: 31677331 DOI: 10.1111/jpm.12574] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/23/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Depression is the most common cause of mental illness amongst older people. As a result of the growth of the older population, it is expected that an increasing number of older people will need treatment. Depression can be effectively treated-but fewer than half of those who are affected receive treatment. Barriers to receiving treatment are lack of resources and trained healthcare providers, social stigma, incorrect diagnoses and long distances to treatment facilities. There is an increased need for alternative ways of treating patients with depression. The use of video consultations has shown to be a viable option for delivering mental health care to older patients. Use of video consultations allows patients to receive treatment in their own homes. None of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression. This paper provides knowledge regarding the use of video consultations, especially for older people with depression. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: No previous review has sought to understand the use of video consultations in mental health care to older patients with depression. The results show that video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. An initial scepticism from participants quickly disappeared when video consultations were experienced in action. The challenges associated with the use of video consultations seem to consist of technical problems and lack of support from staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health practitioners should consider the use of video consultations because it can support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. ABSTRACT: Introduction Depression is the leading cause of mental illness amongst an ageing population and fewer than half of those who are affected receive treatment. There is an increased need for alternative ways of treating patients; the use of video consultations has been shown to be a viable option for delivering mental health care. However, none of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression and providers. Aim To conduct a systematic review of the existing literature focusing on patients' and providers' experiences of video consultations for depression. Method Eight scientific databases were searched. In all, 3,537 articles were identified and, of these, 21 peer-reviewed articles were included in this review. Results The results show that video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. Any initial scepticism quickly disappeared when video consultations were experienced in action. The challenges seem to consist of technical problems and lack of support from staff. Discussion The experiences and satisfaction of older people with depression seem to be positive, although methodological limitations and deficiencies of the reviewed articles should be considered. More qualitative research is needed, and future studies should focus on specific diagnoses and providers' experiences. Implications for practice Video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible.
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Affiliation(s)
- Lone Fisker Christensen
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Research Unit for Telepsychiatry and E-mental Health, University of Southern Denmark, Odense, Denmark.,Research Unit, Department of Mental Health, Esbjerg, Region of Southern Denmark, Esbjerg, Denmark
| | - Anne Marie Moller
- Research Unit for Telepsychiatry and E-mental Health, University of Southern Denmark, Odense, Denmark.,Health Promotion Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens Peter Hansen
- Research Unit, Department of Mental Health, Esbjerg, Region of Southern Denmark, Esbjerg, Denmark.,Center for Psychiatric Nursing and Health Research, Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Connie Thuroe Nielsen
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Mental Health, Vejle, Region of Southern Denmark, Vejle, Denmark
| | - Frederik Alkier Gildberg
- Center for Psychiatric Nursing and Health Research, Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Bleyel C, Hoffmann M, Wensing M, Hartmann M, Friederich HC, Haun MW. Patients' Perspective on Mental Health Specialist Video Consultations in Primary Care: Qualitative Preimplementation Study of Anticipated Benefits and Barriers. J Med Internet Res 2020; 22:e17330. [PMID: 32310139 PMCID: PMC7199141 DOI: 10.2196/17330] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background Due to limited access to specialist services, most patients with common mental disorders (depression or anxiety, or both) usually receive treatment in primary care. More recently, innovative technology-based care models (eg, video consultations) have been proposed to facilitate access to specialist services. Against this background, the PROVIDE (Improving Cross-Sectoral Collaboration Between Primary and Psychosocial Care: An Implementation Study on Video Consultations) project aims to improve the provision of psychosocial care through implementing video consultations integrated into routine primary care. Objective From the patients’ perspective, this qualitative preimplementation study explored (1) anticipated benefits from and (2) barriers to implementing mental health specialist video consultations embedded in primary care services and (3) prerequisites for interacting with therapists via video consultations. Methods Using a purposive (ie, stratified) sampling strategy, we recruited 13 patients from primary care practices and a tertiary care hospital (psychosomatic outpatient clinic) for one-off semistructured interviews. In a computer-assisted thematic analysis, we inductively (bottom-up) derived key themes concerning the practicability of mental health specialist video consultations. To validate our results, we discussed our findings with the interviewees as part of a systematic member checking. Results Overall, we derived 3 key themes and 10 subthemes. Participants identified specific benefits in 2 areas: the accessibility of mental health specialist care (shorter waiting times: 11/13, 85%; lower threshold for seeking specialist mental health care: 6/13, 46%; shorter travel distances: 3/13, 23%); and the environment in primary care (familiar travel modalities, premises, and employees: 5/13, 38%). The main barriers to the implementation of mental health video consultations from the patients’ perspective were the lack of face-to-face contact (13/13, 100%) and technical challenges (12/13, 92%). Notably, participants’ prerequisites for interacting with therapists (12/13, 92%) did not seem to differ much from those concerning face-to-face contacts. Conclusions Mental health service users mostly welcomed mental health specialist video consultations in primary care. Taking a pragmatic stance, service users, who are often frustrated about uncoordinated care, particularly valued the embedment of the consultations in the familiar environment of the primary care practice. With respect to interventional studies and implementation, our findings underscore the need to minimize technical disruptions during video consultations and to ensure optimal resemblance to face-to-face settings (eg, by training therapists in consistently reacting to nonverbal cues). Trial Registration German Clinical Trials Register DRKS00012487; https://tinyurl.com/uhg2one
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Affiliation(s)
- Caroline Bleyel
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Mariell Hoffmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
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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.
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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
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Grondin F, Lomanowska AM, Jackson PL. Empathy in computer-mediated interactions: A conceptual framework for research and clinical practice. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2019. [DOI: 10.1111/cpsp.12298] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Mathersul DC, Mahoney LA, Bayley PJ. Tele-yoga for Chronic Pain: Current Status and Future Directions. Glob Adv Health Med 2018; 7:2164956118766011. [PMID: 29637012 PMCID: PMC5888810 DOI: 10.1177/2164956118766011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 02/13/2018] [Accepted: 02/19/2018] [Indexed: 01/18/2023] Open
Abstract
Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed.
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Affiliation(s)
- Danielle C Mathersul
- 1War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Louise A Mahoney
- 1War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Peter J Bayley
- 1War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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