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Fletcher K, Wydera S, Thorpe N, Radford K, das Nair R, Booth V. A rapid realist review of clinical neuropsychology rehabilitation programmes to improve psychological wellbeing and quality of life for people with acquired brain injuries. Neuropsychol Rehabil 2024; 34:1035-1070. [PMID: 37975854 PMCID: PMC11332407 DOI: 10.1080/09602011.2023.2273580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Abstract
Approximately 20% of acquired brain injury (ABI) survivors experience reduced psychological wellbeing (PWB). Neuropsychological rehabilitation (NPR) is one approach supporting people with ABI to participate meaningfully in activities despite challenges. Although literature supports NPR effectiveness, little is known about change mechanisms. This systematic realist review identifies what NPR programmes have been designed, delivered, and evaluated for people with ABI to improve PWB and/or quality of life (QOL), as well as providing a context-relevant understanding of what NPR includes and how NPR might lead to positive outcomes. A rapid realist review was conducted in three phases: (1) structured retrieval and evidence extraction; (2) stakeholder consultation; (3) analysis and synthesis. Searches were completed, and findings from 35 publications and one stakeholder consultation were synthesized into a refined logic model. Six context-mechanism-outcome chains (CMOCs) were identified. Participants' relationships to internal experiences, and feelings of self-worth, mastery, and connection appeared to be mechanisms that led to improved PWB and QOL. Adaptation and individualized programmes were also key mechanisms to explain successful NPR. Embedding CMOCs into NPR could improve PWB and/or QOL for people with ABI. The logic model will inform ongoing development of a new online, group-based, NPR programme.
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Affiliation(s)
- K. Fletcher
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
- Midlands Partnership NHS Foundation Trust, Stafford, UK
| | - S. Wydera
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - N. Thorpe
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - K. Radford
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - R. das Nair
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- SINTEF, Trondheim, Norway
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - V. Booth
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
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Davis KA, Zhao F, Janis RA, Castonguay LG, Hayes JA, Scofield BE. Therapeutic alliance and clinical outcomes in teletherapy and in-person psychotherapy: A noninferiority study during the COVID-19 pandemic. Psychother Res 2024; 34:589-600. [PMID: 37399573 DOI: 10.1080/10503307.2023.2229505] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
Objective The current study aimed to inform the varied and limited research on clinical variables in the context of teletherapy. Questions remain about the comparative quality of therapeutic alliance and clinical outcome in the context of teletherapy compared to in-person treatment.Methods We utilized a cohort design and a noninferiority statistical approach to study a large, matched sample of clients who reported therapeutic alliance as well as psychological distress before every session as part of routine clinical practice at a university counseling center. A cohort of 479 clients undergoing teletherapy after the emergence of the COVID-19 pandemic was compared to a cohort of 479 clients receiving in-person treatment before the onset of the pandemic. Tests of noninferiority were conducted to investigate the absence of meaningful differences between the two modalities of service delivery. Client characteristics were also examined as moderators of the association between modality and alliance or outcome.Results Clients receiving teletherapy showed noninferior alliance and clinical outcome when compared to clients receiving in-person psychotherapy. A significant main effect on alliance was found with regard to race and ethnicity. A significant main effect on outcome was found with regard to international student status. Significant interactions on alliance were found between cohort and current financial stress.Conclusions Study findings support the continued use of teletherapy by demonstrating commensurate clinical process and outcome. Yet, it will be important for providers to be aware of existing mental health disparities that continue to accompany psychotherapy - in person and via teletherapy. Results and findings are discussed in terms of research and clinical implications. Future directions for researching teletherapy as a viable treatment delivery method are also discussed.
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Affiliation(s)
- Katherine A Davis
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Fanghui Zhao
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA
| | - Rebecca A Janis
- Counseling and Psychological Services, The Pennsylvania State University, University Park, PA, USA
| | - Louis G Castonguay
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Jeffrey A Hayes
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA
| | - Brett E Scofield
- Counseling and Psychological Services, The Pennsylvania State University, University Park, PA, USA
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Berardi C, Antonini M, Jordan Z, Wechtler H, Paolucci F, Hinwood M. Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework. BMC Health Serv Res 2024; 24:243. [PMID: 38408938 PMCID: PMC10898174 DOI: 10.1186/s12913-023-10536-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 12/28/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. METHODS We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. RESULTS Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients' intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. CONCLUSION It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. PROTOCOL REGISTRATION The protocol is registered on PROSPERO, CRD42021276838.
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Affiliation(s)
- Chiara Berardi
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia.
| | - Marcello Antonini
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK
| | - Zephanie Jordan
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Heidi Wechtler
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Francesco Paolucci
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Madeleine Hinwood
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Zhu D, Paige SR, Slone H, Gutierrez A, Lutzky C, Hedriana H, Barrera JF, Ong T, Bunnell BE. Exploring telemental health practice before, during, and after the COVID-19 pandemic. J Telemed Telecare 2024; 30:72-78. [PMID: 34241545 PMCID: PMC10375824 DOI: 10.1177/1357633x211025943] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study investigated how mental health providers' use of telemedicine has changed since the coronavirus disease (COVID) 2019 pandemic and their expectations for continuing to use it once the pandemic ends. METHODS A 15-min online survey was completed by 175 practicing and licensed telemental health providers who use telemedicine. In addition to personal and professional demographic items, the survey included items about the frequency of telemedicine use, proportion of caseload served by telemedicine, comfort using telemedicine before and during the COVID-19 pandemic, and expectations to use telemedicine after the pandemic ends. A series of χ2 analyses, an independent samples t-test, and analyses of variance were conducted. RESULTS The pandemic resulted in a greater proportion of telemental health providers using telemedicine on a daily basis (17% before and 40% during the pandemic; p < 0.01) and serving more than half of their caseload remotely (9.1% before and 57.7% during the pandemic; p < 0.05). Also, there was a statistically significant increase in their comfort using telemedicine before and during the pandemic (p < 0.001). Providers reported expecting to use telemedicine more often after the pandemic ends (M = 3.35; SD = 0.99). Expectations to provide telemental health services after the pandemic were greater for mental health counselors, providers who practiced in rural regions, and providers who served patients through out-of-pocket payments. DISCUSSION Telemental health providers use telemedicine daily as a result of the COVID-19 pandemic, with expectations of continuing to use telemedicine in practice after the pandemic. This expectation is more prominent in certain segments of providers and warrants further investigation.
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Affiliation(s)
- Demi Zhu
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
| | | | - Henry Slone
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
| | - Arianna Gutierrez
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
| | - Caroline Lutzky
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
| | - Hannah Hedriana
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
| | - Janelle F Barrera
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
- Doxy.me Research, Doxy.me, LLC, USA
| | | | - Brian E Bunnell
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
- Doxy.me Research, Doxy.me, LLC, USA
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Campbell LA, Clark SE, Chorney J, Emberly D, Carrey NJ, Bagnell A, Blenus J, Daneff M, Campbell JC. Understanding the uptake of virtual care for first and return outpatient appointments in child and adolescent mental health services: a mixed-methods study. BMJ Open 2023; 13:e074803. [PMID: 38110381 DOI: 10.1136/bmjopen-2023-074803] [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] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVE To describe patterns of virtual and in-person outpatient mental health service use and factors that may influence the choice of modality in a child and adolescent service. DESIGN A pragmatic mixed-methods approach using routinely collected administrative data between 1 April 2020 and 31 March 2022 and semi-structured interviews with clients, caregivers, clinicians and staff. Interview data were coded according to the Consolidated Framework for Implementation Research (CFIR) and examined for patterns of similarity or divergence across data sources, respondents or other relevant characteristics. SETTING Child and adolescent outpatient mental health service, Nova Scotia, Canada. PARTICIPANTS IWK Health clinicians and staff who had participated in virtual mental healthcare following its implementation in March 2020 and clients (aged 12-18 years) and caregivers of clients (aged 3-18 years) who had received treatment from an IWK outpatient clinic between 1 April 2020 and 31 March 2022 (n=1300). Participants (n=48) in semi-structured interviews included nine clients aged 13-18 years (mean 15.7 years), 10 caregivers of clients aged 5-17 years (mean 12.7 years), eight Community Mental Health and Addictions booking and registration or administrative staff and 21 clinicians. RESULTS During peak pandemic activity, upwards of 90% of visits (first or return) were conducted virtually. Between waves, return appointments were more likely to be virtual than first appointments. Interview participants (n=48) reported facilitators and barriers to virtual care within the CFIR domains of 'outer setting' (eg, external policies, client needs and resources), 'inner setting' (eg, communications within the service), 'individual characteristics' (eg, personal attributes, knowledge and beliefs about virtual care) and 'intervention characteristics' (eg, relative advantage of virtual or in-person care). CONCLUSIONS Shared decision-making regarding treatment modality (virtual vs in-person) requires consideration of client, caregiver, clinician, appointment, health system and public health factors across episodes of care to ensure accessible, safe and high-quality mental healthcare.
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Affiliation(s)
- Leslie Anne Campbell
- Community Health & Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Psychiatry, IWK Health, Halifax, Nova Scotia, Canada
- Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sharon E Clark
- Mental Health and Addictions, IWK Health, Halifax, Nova Scotia, Canada
| | - Jill Chorney
- Psychiatry, IWK Health, Halifax, Nova Scotia, Canada
- Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Mental Health and Addictions, IWK Health, Halifax, Nova Scotia, Canada
| | - Debbie Emberly
- Mental Health and Addictions, IWK Health, Halifax, Nova Scotia, Canada
| | - N J Carrey
- Psychiatry, IWK Health, Halifax, Nova Scotia, Canada
- Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alexa Bagnell
- Psychiatry, IWK Health, Halifax, Nova Scotia, Canada
- Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jaime Blenus
- Mental Health and Addictions, IWK Health, Halifax, Nova Scotia, Canada
| | - Miriam Daneff
- Mental Health and Addictions, IWK Health, Halifax, Nova Scotia, Canada
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Békés V, Belleville G, Lebel J, Ouellet MC, Chen Z, Morin CM, Bergeron N, Campbell TS, Ghosh S, Bouchard S, Guay S, MacMaster FP. Trainee Therapists' Perceptions of a Blended Intervention to Promote Resilience after a Natural Disaster: A Qualitative Case Study. J Clin Med 2022; 11:4361. [PMID: 35955982 PMCID: PMC9369013 DOI: 10.3390/jcm11154361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Natural disasters happen in an increased frequency, and telemental health interventions could offer easily accessible help to reduce mental health symptoms experienced by survivors. However, there are very few programs offered to natural disaster survivors, and no research exists on therapists' experiences with providing blended interventions for natural disaster survivors. AIMS Our qualitative case study aims to describe psychologists' experiences with an online, therapist-assisted blended intervention for survivors of the Fort McMurray wildfires in Alberta, Canada. METHOD The RESILIENT intervention was developed in the frames of a randomized controlled trial to promote resilience after the Fort McMurray wildfires by providing survivors free access to a 12-module, therapist-assisted intervention, aiming to improve post-traumatic stress, insomnia, and depression symptoms. A focus group design was used to collect data from the therapists, and emerging common themes were identified by thematic analysis. RESULTS Therapists felt they could build strong alliances and communicate emotions and empathy effectively, although the lack of nonverbal cues posed some challenges. The intervention, according to participating therapists, was less suitable for participants in high-stress situations and in case of discrepancy between client expectations and the intervention content. Moreover, the therapists perceived specific interventions as easy-to-use or as more challenging based on their complexity and on the therapist support needed for executing them. Client engagement in the program emerged as an underlying theme that had fundamental impact on alliance, communication, and ultimately, treatment efficiency. Therapist training and supervision was perceived as crucial for the success of the program delivery. CONCLUSIONS Our findings provided several implications for the optimalization of blended interventions for natural disaster survivors from our therapists' perspective.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School, Yeshiva University, 1165 Morris Park Ave, The Bronx, NY 10461, USA;
| | - Geneviève Belleville
- School of Psychology, Laval University, 2325 Rue de l’Université, Québec, QC G1V 0A6, Canada; (G.B.); (J.L.); (M.-C.O.); (C.M.M.)
| | - Jessica Lebel
- School of Psychology, Laval University, 2325 Rue de l’Université, Québec, QC G1V 0A6, Canada; (G.B.); (J.L.); (M.-C.O.); (C.M.M.)
| | - Marie-Christine Ouellet
- School of Psychology, Laval University, 2325 Rue de l’Université, Québec, QC G1V 0A6, Canada; (G.B.); (J.L.); (M.-C.O.); (C.M.M.)
| | - Zhaoyi Chen
- Ferkauf Graduate School, Yeshiva University, 1165 Morris Park Ave, The Bronx, NY 10461, USA;
| | - Charles M. Morin
- School of Psychology, Laval University, 2325 Rue de l’Université, Québec, QC G1V 0A6, Canada; (G.B.); (J.L.); (M.-C.O.); (C.M.M.)
| | - Nicolas Bergeron
- Département de Psychiatrie, Centre Hospitalier de l’Université de Montréal, 1000 Rue St-Denis, Montréal, QC H2X 0C1, Canada;
- Department of Psychiatry and Addiction, University of Montreal, 2900 Edouard Montpetit Blvd., Montreal, QC H3T 1J4, Canada;
| | - Tavis S. Campbell
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada;
| | - Sunita Ghosh
- Faculty of Medicine and Dentistry, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada;
| | - Stephane Bouchard
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, CISSS de l’Outaouais, 283 Alexandre-Taché Blvd., Gatineau, QC J8X 3X7, Canada;
| | - Stéphane Guay
- Department of Psychiatry and Addiction, University of Montreal, 2900 Edouard Montpetit Blvd., Montreal, QC H3T 1J4, Canada;
- School of Criminology, University of Montreal, 2900 Edouard Montpetit Blvd., Montreal, QC H3T 1J4, Canada
| | - Frank P. MacMaster
- Addictions and Mental Health Strategic Clinical Network, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada;
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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: 15] [Impact Index Per Article: 5.0] [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.
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Affiliation(s)
| | - Kok-Mun Ng
- Counseling, Oregon State University, Corvallis, OR, USA
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Mendes-Santos C, Nunes F, Weiderpass E, Santana R, Andersson G. Understanding Mental Health Professionals' Perspectives and Practices Regarding the Implementation of Digital Mental Health: Qualitative Study. JMIR Form Res 2022; 6:e32558. [PMID: 35412459 PMCID: PMC9044148 DOI: 10.2196/32558] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/26/2022] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices. OBJECTIVE This study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices. METHODS A qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)-psychologists and psychiatrists-was conducted. The transcribed interviews were thematically analyzed. RESULTS Mental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals. CONCLUSIONS The publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Society, Linköping University, Linköping, Sweden
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
- Fraunhofer Portugal AICOS, Porto, Portugal
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
| | | | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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Al-Mahrouqi T, Al-Alawi K, Al-Alawi M, Al Balushi N, Al Ghailani A, Al Sabti H, Al Sinawi H. A promising future for tele-mental health in Oman: A qualitative exploration of clients and therapists' experiences. SAGE Open Med 2022; 10:20503121221086372. [PMID: 35371483 PMCID: PMC8969011 DOI: 10.1177/20503121221086372] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives Tele-mental health services can play an important role in overcoming barriers in mental health services in the Eastern Mediterranean Region. However, despite its potential, tele-mental health has not been widely adopted in Oman. This study is an exploratory investigation into the experiences of therapists and their clients in utilizing video-based tele-mental health care during the COVID-19 pandemic. Methods A total of 19 semistructured qualitative interviews were individually conducted, it included 13 adult clients with mental health conditions who received video-based tele-mental health care and six clinical psychologists who provided video-based tele-mental health care during the COVID-19 pandemic. Results The clients reported favorable experiences using tele-mental health, with the primary benefits being convenience, easy accessibility to subspecialized care, reduced absenteeism from work with commuting costs, and alleviated mental health stigma. The therapists also expressed experiencing benefits from tele-mental health, such as reduced risk of intrahospital infection, reduced healthcare costs, and the achievement of work-life balance. Primary concerns were related to the lack of public tele-mental health services, lack of specified tele-mental health guidelines, shortage of trained therapists, limited access to high-speed Internet, electronic devices, privacy, and concerns toward the security of telehealth systems in general. Conclusion Clients and therapists report that tele-mental health offers new opportunities to improve the quality of mental healthcare services in Oman, and that the challenges could be resolved by establishing governmental tele-mental health services along with developing tele-mental health guidelines and implementing local postgraduate clinical psychology programs in universities in Oman.
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Affiliation(s)
- Tamadhir Al-Mahrouqi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | - Mohammed Al-Alawi
- Behavioral Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Naser Al Balushi
- Behavioral Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdullah Al Ghailani
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | - Hamed Al Sinawi
- Behavioral Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman
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Romanchych E, Desai R, Bartha C, Carson N, Korenblum M, Monga S. Healthcare providers' perceptions of virtual-care with children's mental health in a pandemic: A hospital and community perspective. Early Interv Psychiatry 2022; 16:433-443. [PMID: 34309196 PMCID: PMC8444835 DOI: 10.1111/eip.13196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/21/2021] [Accepted: 07/04/2021] [Indexed: 12/29/2022]
Abstract
AIM The purpose of the present study was to explore the experiences of a diverse group of mental health clinicians both in hospital and in the community, who were required to rapidly adopt virtual-care practices in the delivery of mental health services to children, adolescents, and their families. METHODS Mental health clinicians (N = 117) completed the Clinician Virtual-Care Experience Survey assessing the following domains: ease of technology use, client/patient-provider interaction quality, and clinician wellbeing. RESULTS Although over 70% of clinicians had not used virtual-care to deliver mental health services prior to the Coronavirus Disease 2019 pandemic, more than 80% felt it was easy to operate the virtual platforms. Clinicians were divided in their perceptions of the effectiveness of virtual-care, with only 42% reporting that they felt they were as effective in delivering healthcare services virtually as compared to in-person. Virtual-care was described as being more effective for specific populations, while challenges were described in building rapport and when delivering difficult or unexpected feedback. CONCLUSIONS Clinicians felt there were some benefits of adopting virtual-care practices, while challenges were also identified. Understanding of the impact of virtual-care on service providers is essential in order to strengthen mental healthcare for children, adolescents, and their families even beyond the pandemic.
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Affiliation(s)
- Erin Romanchych
- Department of PsychiatryHospital for Sick ChildrenTorontoCanada
| | - Riddhi Desai
- Department of PsychiatryHospital for Sick ChildrenTorontoCanada
| | - Christina Bartha
- Department of PsychiatryHospital for Sick ChildrenTorontoCanada
- SickKids Centre for Community Mental HealthTorontoCanada
| | - Neill Carson
- SickKids Centre for Community Mental HealthTorontoCanada
| | - Marshall Korenblum
- SickKids Centre for Community Mental HealthTorontoCanada
- Department of PsychiatryUniversity of TorontoTorontoCanada
| | - Suneeta Monga
- Department of PsychiatryHospital for Sick ChildrenTorontoCanada
- Department of PsychiatryUniversity of TorontoTorontoCanada
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Digitizing Social Counseling-Insights for Workplace Health Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020917. [PMID: 35055750 PMCID: PMC8775588 DOI: 10.3390/ijerph19020917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023]
Abstract
Working digitally can lead to changes in work organization and social interactions, as well as work pace and workload. Online counseling is more and more integrated in social counseling. Research exists on employees' and users' attitudes towards online counseling as well as on the advantages and disadvantages of online counseling. There is a lack of studies on the stressors and strains caused by the increasing digitalization and the associated health consequences in this context. With an interview study, we investigated the general work situation of counselors, with a focus on stressors, strain, and resources caused by online counseling. Consecutively, we discuss the results in relation to their impact on workplace health management. Twenty-two explorative interviews with counselors from a German welfare organization were conducted in 2019 and 2020. Qualitative content analysis according to Mayring was used for analysis. Counselors' use of online devices depends on their own digital affinity and is likely to be used when advantages for clients are seen. Difficulties were mentioned in establishing a relationship of trust with the clients. Good teamwork and regular informal exchanges among colleagues contribute to job satisfaction. Overall, we found only few health-related effects. Results of the study suggest that digitization can have positive effects on the job satisfaction of counselors, if the associated changes are supported by organizational measures.
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12
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Magal T, Negev M, Kaphzan H. Attitudinal Barriers Hindering Adoption of Telepsychiatry among Mental Healthcare Professionals: Israel as a Case-Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12540. [PMID: 34886266 PMCID: PMC8656860 DOI: 10.3390/ijerph182312540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/07/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022]
Abstract
Despite proven advantages for the use of telemedicine in psychiatry, mental healthcare professionals have shown deep-seated mistrust and suspicion of telepsychiatry, which hinders its widespread application. The current study examines the attitudes of Israeli mental health professionals towards telepsychiatry and seeks to uncover the effects of experience and organizational affiliation on its adoption. The methodology included qualitative and thematic analysis of 27 in-depth interviews with Israeli mental health professionals, focusing on three major themes-clinical quality, economic efficiency, and the effects on the work-life balance of healthcare professionals. The attitudes of mental health professionals were found to be widely divergent and sharply dichotomized regarding different aspects of telepsychiatry and its suitability for mental healthcare services. However, there was a general consensus that telemedicine may not fulfil its promise of being a panacea to the problems of modern public medicine. In addition, attitudes were related to hierarchical position, organizational affiliation, and personal experience with telepsychiatry. Specifically, organizational affiliation influenced experience with and support for the assimilation of telepsychiatry. The study also revealed the role of organizational leadership and culture in promoting or inhibiting the proliferation and adoption of innovative technologies and services in modern medicine.
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Affiliation(s)
- Tamir Magal
- School of Public Health, University of Haifa, Haifa 3498838, Israel;
| | - Maya Negev
- School of Public Health, University of Haifa, Haifa 3498838, Israel;
| | - Hanoch Kaphzan
- Department of Neurobiology, Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel;
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13
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Békés V, Aafjes‐van Doorn K, Zilcha‐Mano S, Prout T, Hoffman L. Psychotherapists' acceptance of telepsychotherapy during the COVID-19 pandemic: A machine learning approach. Clin Psychol Psychother 2021; 28:1403-1415. [PMID: 34723404 PMCID: PMC8652775 DOI: 10.1002/cpp.2682] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/17/2021] [Accepted: 10/26/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to develop predictive models of three aspects of psychotherapists' acceptance of telepsychotherapy (TPT) during the COVID-19 pandemic, attitudes towards TPT technology, concerns about using TPT technology and intention to use TPT technology in the future. METHOD Therapists (n = 795) responded to a survey about their TPT experiences during the pandemic, including quality of the therapeutic relationship, professional self-doubt, vicarious trauma and TPT acceptance. Regression decision tree machine learning analyses were used to build prediction models for each of three aspects of TPT acceptance in a training subset of the data and subsequently tested in the remaining subset of the total sample. RESULTS Attitudes towards TPT were most positive for therapists who reported a neutral or strong online working alliance with their patients, especially if they experienced little professional self-doubt and were younger than 40 years old. Therapists who were most concerned about TPT were those who reported higher levels of professional self-doubt, particularly if they also reported vicarious trauma experiences. Therapists who reported low working alliance with their patients were least likely to use TPT in the future. Performance metrics for the decision trees indicated that these three models held up well in an out-of-sample dataset. CONCLUSIONS Therapists' professional self-doubt and the quality of their working alliance with their online patients appear to be the most pertinent factors associated with therapists' acceptance of TPT technology during COVID-19 and should be addressed in future training and research.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of PsychologyYeshiva UniversityNew YorkNew YorkUSA
| | | | | | - Tracy Prout
- Ferkauf Graduate School of PsychologyYeshiva UniversityNew YorkNew YorkUSA
| | - Leon Hoffman
- New York Psychoanalytic InstituteNew YorkNew YorkUSA
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14
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Parisi KE, Dopp AR, Quetsch LB. Practitioner use of and attitudes towards videoconferencing for the delivery of evidence-based telemental health interventions: A mixed methods study. Internet Interv 2021; 26:100470. [PMID: 34712597 PMCID: PMC8529504 DOI: 10.1016/j.invent.2021.100470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/29/2021] [Accepted: 10/13/2021] [Indexed: 12/25/2022] Open
Abstract
The implementation of evidence-based psychosocial interventions using video-conference delivery (VCD) has the potential to increase accessibility to effective treatments, although its use remains limited and understudied. This study employed a mixed methods approach in surveying mental health practitioners about their attitudes regarding VCD of interventions that are considered evidence-based (i.e., have been shown to improve targeted outcomes in rigorous research). One hundred and eleven practitioners were sampled from several national and regional U.S. practice organizations and were administered quantitative surveys about their use of and attitudes towards VCD of evidence-based interventions (EBI). We examined the relationship between practitioner-level technology access, experience, and training with technology fluency and acceptability of using VCD. Quantitative results indicated the most frequently used adaptation for VCD was Tailoring and that practitioner education predicted attitudes towards EBIs. A subset (n = 20) of respondents were then purposively selected for qualitative interviews to further investigate accessibility, appropriateness, and feasibility of delivering EBIs via video conference. A conventional content analysis revealed that VCD was appropriate and acceptable for EBIs; however, many practitioners also described barriers related to feasibility of implementation. The results of this study have important implications for telemental health dissemination efforts which seek to extend services to populations not served well by traditional, in-person mental health services.
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Affiliation(s)
- Kathryn E. Parisi
- University of Arkansas, Department of Psychological Science, 216 Memorial Hall, Fayetteville, AR 72701, United States of America,Corresponding author.
| | - Alex R. Dopp
- RAND Corporation, Department of Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90401, United States of America
| | - Lauren B. Quetsch
- University of Arkansas, Department of Psychological Science, 216 Memorial Hall, Fayetteville, AR 72701, United States of America
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15
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Feijt MA, de Kort YAW, Westerink JHDM, Bierbooms JJPA, Bongers IMB, IJsselsteijn WA. Assessing Professionals' Adoption Readiness for eMental Health: Development and Validation of the eMental Health Adoption Readiness Scale. J Med Internet Res 2021; 23:e28518. [PMID: 34533469 PMCID: PMC8486999 DOI: 10.2196/28518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/02/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The last few decades have witnessed significant advances in the development of digital tools and applications for mental health care. Despite growing evidence for their effectiveness, acceptance and use of these tools in clinical practice remain low. Hence, a validated and easy-to-use instrument for assessing professionals' readiness to adopt eMental health (EMH) is necessary to gain further insights into the process of EMH adoption and facilitate future research on this topic. OBJECTIVE The aim of this study is to develop and validate an instrument for assessing mental health care professionals' readiness to adopt EMH. METHODS Item generation was guided by literature and inputs from mental health care professionals and experts in survey development. Exploratory factor analyses were conducted on an initial set of 29 items completed by a sample of mental health care professionals (N=432); thereafter, the scale was reduced to 15 items in an iterative process. The factor structure thus obtained was subsequently tested using a confirmatory factor analysis with a second sample of mental health care professionals (N=363). The internal consistency, convergent validity, and predictive validity of the eMental Health Adoption Readiness (eMHAR) Scale were assessed. RESULTS Exploratory factor analysis resulted in a 3-factor solution with 15 items. The factors were analyzed and labeled as perceived benefits and applicability of EMH, EMH proactive innovation, and EMH self-efficacy. These factors were confirmed through a confirmatory factor analysis. The total scale and subscales showed a good internal consistency (Cronbach α=.73-.88) along with acceptable convergent and predictive relationships with related constructs. CONCLUSIONS The constructed eMHAR Scale showed a conceptually interpretable 3-factor structure having satisfactory characteristics and relationships with relevant concepts. Its ease of use allows for quick acquisition of data that can contribute to understanding and facilitating the process of adoption of EMH by clinical professionals.
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Affiliation(s)
- Milou A Feijt
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Yvonne A W de Kort
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Joyce H D M Westerink
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
- Digital Engagement, Cognition & Behavior Group, Philips Research, Eindhoven, Netherlands
| | - Joyce J P A Bierbooms
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Mental Healthcare Eindhoven, Eindhoven, Netherlands
| | - Inge M B Bongers
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Mental Healthcare Eindhoven, Eindhoven, Netherlands
| | - Wijnand A IJsselsteijn
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
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16
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Whiting DL, Chuah SL, Simpson GK, Deane FP, Reynolds J. Video-consulting to address mental health needs after traumatic brain injury: evaluation of a training workshop to build capacity among psychologists. Brain Inj 2021; 35:1065-1074. [PMID: 34334058 DOI: 10.1080/02699052.2021.1953594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) can lead to significant psychological distress, but few psychologists in Australia are trained in working with this complex clinical group. Despite government funding to provide video-consulting (VC) services in Australia, uptake before COVID-19 was limited. OBJECTIVE This mixed methods study evaluated whether training in eHealth and evidence based TBI psychological therapies increased provider uptake of VC in clinical practice, and delivery of mental health services to individuals with TBI. METHODS Mental health professionals completed a range of self-report measures before (n = 50), after (n = 48), and four months following (n = 30) a one-day workshop. Participants' TBI knowledge, client-base and levels of access, confidence, motivation and attitudes toward VC were assessed. Knowledge did not increase after training but participants had significant increases in their confidence and motivation to using VC at follow up. Significant reductions in pragmatic barriers to using VC were reported post training and at follow up, all barrier categories indicated significant reductions. There was no significant change in clinical practice of the participants. CONCLUSIONS Training to increase TBI knowledge requires specific assessment tools and although training appears to reduce barriers to using VC, uptake in clinical practice may require additional supervision and warrants further research.
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Affiliation(s)
- Diane L Whiting
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Sarah L Chuah
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Australia.,John Walsh Centre for Rehabilitation Research, Sydney School of Medicine, the University of Sydney, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Julia Reynolds
- Research School of Psychology, The Australian National University, Australia
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17
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Bunnell BE, Kazantzis N, Paige SR, Barrera J, Thakkar RN, Turner D, Welch BM. Provision of Care by "Real World" Telemental Health Providers. Front Psychol 2021; 12:653652. [PMID: 34025519 PMCID: PMC8138039 DOI: 10.3389/fpsyg.2021.653652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022] Open
Abstract
Despite its effectiveness, limited research has examined the provision of telemental health (TMH) and how practices may vary according to treatment paradigm. We surveyed 276 community mental health providers registered with a commercial telemedicine platform. Most providers reported primarily offering TMH services to adults with anxiety, depression, and trauma-and stressor-related disorders in individual therapy formats. Approximately 82% of TMH providers reported endorsing the use of Cognitive Behavioral Therapy (CBT) in their remote practice. The most commonly used in-session and between-session (i.e., homework) exercises included coping and emotion regulation, problem solving, mindfulness, interpersonal skills, relaxation, and modifying and addressing core beliefs. CBT TMH providers had a higher odds of using in-session and homework exercises and assigning them through postal mail, email or fax methods, as compared to non-CBT TMH providers. TMH providers, regardless of treatment paradigm, felt that assigning homework was neither easy nor difficult and they believed their patients were somewhat-to-moderately compliant to their assigned exercises. CBT TMH providers also collected clinical information from their patients more often than non-CBT TMH providers. They reported being less satisfied with their method, which was identified most often as paper-based surveys and forms. Overall, TMH providers employ evidence-based treatments to their patients remotely, with CBT TMH providers most likely to do so. Findings highlight the need for innovative solutions to improve how TMH providers that endorse following the CBT treatment paradigm remotely assign homework and collect clinical data to increase their satisfaction via telemedicine.
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Affiliation(s)
- Brian E. Bunnell
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Doxy.me Research, Doxy.me, Inc., Rochester, NYUnited States
| | - Nikolaos Kazantzis
- Cognitive Behavior Therapy Research Unit, Institute for Social Neuroscience Psychology, Melbourne, VIC, Australia
| | | | - Janelle Barrera
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Doxy.me Research, Doxy.me, Inc., Rochester, NYUnited States
| | - Rajvi N. Thakkar
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Dylan Turner
- Doxy.me Research, Doxy.me, Inc., Rochester, NYUnited States
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me, Inc., Rochester, NYUnited States
- Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
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18
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Kroll K, Brosig C, Malkoff A, Bice-Urbach B. Evaluation of a Systems-Wide Telebehavioral Health Training Implementation in Response to COVID-19. J Patient Exp 2021; 8:2374373521997739. [PMID: 34179392 PMCID: PMC8205362 DOI: 10.1177/2374373521997739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In response to the Coronavirus disease 2019 pandemic, it became important to rapidly train mental health providers to provide telebehavioral health services (TBH) within a pediatric care setting. This study examined the perceived usefulness of various TBH training materials; provider motivation, comfort, and confidence in implementation of TBH services; and perceived benefits and barriers of TBH. After completing various training options and implementing TBH services for 1 month, providers indicated all training materials were helpful, with the recorded webinar being identified as the most helpful resource. This study describes the rapid training of mental health providers in preparation of system-wide TBH services.
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Affiliation(s)
- Kristin Kroll
- Department of Pediatrics, Medical College of Wisconsin, and Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
| | - Cheryl Brosig
- Department of Pediatrics, Medical College of Wisconsin, and Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
| | - Anne Malkoff
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Brittany Bice-Urbach
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
- Brittany Bice-Urbach, Children’s Wisconsin, Child Development Center, 13800 W. North Ave Ste 120, Brookfield, WI 53205, USA.
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19
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Shang Z, Arnaert A, Hindle Y, Debe Z, Côté-Leblanc G, Saadi A. Experiences of psychiatrists and support staff providing telemental health services to Indigenous peoples of Northern Quebec. BMC Health Serv Res 2021; 21:85. [PMID: 33485327 PMCID: PMC7825224 DOI: 10.1186/s12913-021-06072-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/11/2021] [Indexed: 01/01/2023] Open
Abstract
Background Due to regional, professional, and resource limitations, access to mental health care for Canada’s Indigenous peoples can be difficult. Telemental health (TMH) offers the opportunity to provide care across vast distances and has been proven to be as effective as face-to-face services. To our knowledge, there has been no qualitative study exploring the experiences of TMH staff serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study. Methods Using a qualitative descriptive design, the entire staff of a TMH clinic was recruited, comprising of four psychiatrists and four support staff. Individual semi-structured interviews were conducted through videoconferencing, and results were thematically analyzed. Results To address the mental health gap in Northern communities, all psychiatrists believe in the necessity of in-person care and note the synergistic effect of combining in-person care and TMH services. This approach to care allows psychiatrists to maintain both an insider and outsider identity. However, if a patient’s condition requires hospitalization, then the TMH staff face a new set of information sharing and communication challenges with the inpatient staff. TMH staff believe that the provision of culturally sensitive care to Northern patients at the inpatient unit is progressing; however, more work needs to be done. Despite the strong collegial atmosphere within the clinic and collective efforts to provide quality TMH services, all participants express a sense of frustration with the paper-based and scattered documentation system. Conclusion The TMH team works in cohesion to offer TMH services to Indigenous peoples; yet, automatization is needed to improve the workflow efficiency within the clinic and collaboration with the Northern clinics. More research is needed on the functioning of TMH teams and the separate but important roles of each team member. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06072-5.
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Affiliation(s)
- Zhida Shang
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Yvonne Hindle
- Centre Intégré Universitaire de Santé et Services Sociaux de l'Ouest-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Zoumanan Debe
- Centre Intégré Universitaire de Santé et Services Sociaux de l'Ouest-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Geneviève Côté-Leblanc
- Centre Intégré Universitaire de Santé et Services Sociaux de l'Ouest-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Amine Saadi
- Centre Intégré Universitaire de Santé et Services Sociaux de l'Ouest-de-L'Île-de-Montréal, Montréal, Québec, Canada
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20
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Felker BL, McGinn MM, Shearer EM, Raza GT, Gold SD, Kim JM, Rojas SM, Roussev MS, Varkovitzky RL, Liu H, Morrison KL, McCann RA. Implementation of a Telemental Health Training Program Across a Mental Health Department. TELEMEDICINE REPORTS 2021; 2:26-31. [PMID: 33575684 PMCID: PMC7869919 DOI: 10.1089/tmr.2020.0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 05/07/2023]
Abstract
Introduction: Telemental health (TMH) has increased substantially. However, health care systems have found it challenging to implement TMH ubiquitously. A quality improvement project guided by implementation science methodology was used to design and implement a TMH training program. Materials and Methods: Implementation science methodology (Promoting Access to Research Implementation in Health Services, Reach-Effectiveness-Adoption-Implementation-Maintenance, Implementation/Facilitation) provided the framework to design and implement the training program. A total of 100 interdisciplinary mental health providers from outpatient mental health clinics participated. Results: Providers reported satisfaction with the training program. Results indicated that the training increased providers' TMH knowledge and competence. The number of providers using TMH and patients who received TMH nearly doubled. Conclusions: Implementation science methodology was important in creating an organizational framework at this facility to design, evaluate, and implement an innovative TMH training program.
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Affiliation(s)
- Bradford L. Felker
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle Washington, USA
| | - Meghan M. McGinn
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle Washington, USA
| | - Erika M. Shearer
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle Washington, USA
- Department of Veterans Affairs VA Puget Sound Health Care System, Tacoma, Washington, USA
| | - Gina T. Raza
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Sari D. Gold
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle Washington, USA
| | - Jean M. Kim
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Sasha M. Rojas
- Department of Veterans Affairs VA Puget Sound Health Care System, Tacoma, Washington, USA
| | - Milena S. Roussev
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Ruth L. Varkovitzky
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle Washington, USA
- Department of Veterans Affairs VA Puget Sound Health Care System, Tacoma, Washington, USA
| | - Huiting Liu
- Department of Veterans Affairs VA Puget Sound Health Care System, Tacoma, Washington, USA
| | - Kate L. Morrison
- Department of Veterans Affairs VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Russell A. McCann
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle Washington, USA
- Department of Veterans Affairs VA Puget Sound Health Care System, Tacoma, Washington, USA
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21
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Racine N, Hartwick C, Collin-Vézina D, Madigan S. Telemental health for child trauma treatment during and post-COVID-19: Limitations and considerations. CHILD ABUSE & NEGLECT 2020; 110:104698. [PMID: 32839022 PMCID: PMC7437482 DOI: 10.1016/j.chiabu.2020.104698] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/12/2020] [Accepted: 08/15/2020] [Indexed: 05/07/2023]
Abstract
The ongoing COVID-19 pandemic has led to unprecedented disruptions and stress in the lives of children and families internationally. Heightened family stress and turmoil can increase risk for, and exacerbate, child maltreatment. As a result, child maltreatment experts are concerned that there will be an influx of children requiring trauma assessment and treatment during and after COVID-19. As physical distancing measures have been implemented and will likely persist into 2021, organizations providing trauma treatment to children and their families have had to rapidly pivot to telemental health to maintain service delivery with clients. While the benefits of telemental health have been identified, including reduced barriers to access, increased cost effectiveness, and broad availability of services, there are unique limitations to its implementation within a child maltreatment population, such as challenges with attention and emotion regulation skills, difficulties identifying dissociative symptoms, and increased time with perpetrators of abuse due to shelter in place orders. These limitations are exacerbated for children and families who are most marginalized and facing the highest levels of social and economic barriers. Lack of access to reliable technology, lack of a private or confidential space for sessions, and reluctance to process trauma in the absence of a safe environment, are all barriers to conducting effective trauma treatment over telemental health. This article discusses both the benefits and barriers to telemental health in a child maltreatment population and offers considerations for child trauma service provision, program development, and policy during and post the COVID-19 pandemic.
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Affiliation(s)
- Nicole Racine
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada
| | - Cailey Hartwick
- Child Abuse Service, Alberta Children's Hospital, 3820 24 Avenue NW, T2P 2M5, Calgary, AB, Canada
| | - Delphine Collin-Vézina
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada; Child Abuse Service, Alberta Children's Hospital, 3820 24 Avenue NW, T2P 2M5, Calgary, AB, Canada; School of Social Work, McGill, University, 3506 University Street, Room 321A, Montreal, Quebec, H3A2A7, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada.
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22
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Humer E, Stippl P, Pieh C, Pryss R, Probst T. Experiences of Psychotherapists With Remote Psychotherapy During the COVID-19 Pandemic: Cross-sectional Web-Based Survey Study. J Med Internet Res 2020; 22:e20246. [PMID: 33151896 PMCID: PMC7704121 DOI: 10.2196/20246] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/14/2020] [Accepted: 10/02/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The current situation around the COVID-19 pandemic and the measures necessary to fight it are creating challenges for psychotherapists, who usually treat patients face-to-face with personal contact. The pandemic is accelerating the use of remote psychotherapy (ie, psychotherapy provided via telephone or the internet). However, some psychotherapists have expressed reservations regarding remote psychotherapy. As psychotherapists are the individuals who determine the frequency of use of remote psychotherapy, the potential of enabling mental health care during the COVID-19 pandemic in line with the protective measures to fight COVID-19 can be realized only if psychotherapists are willing to use remote psychotherapy. OBJECTIVE This study aimed to investigate the experiences of psychotherapists with remote psychotherapy in the first weeks of the COVID-19 lockdown in Austria (between March 24 and April 1, 2020). METHODS Austrian psychotherapists were invited to take part in a web-based survey. The therapeutic orientations of the psychotherapists (behavioral, humanistic, psychodynamic, or systemic), their rating of the comparability of remote psychotherapy (web- or telephone-based) with face-to-face psychotherapy involving personal contact, and potential discrepancies between their actual experiences and previous expectations with remote psychotherapy were assessed. Data from 1162 psychotherapists practicing before and during the COVID-19 lockdown were analyzed. RESULTS Psychotherapy conducted via telephone or the internet was reported to not be totally comparable to psychotherapy with personal contact (P<.001). Psychodynamic (P=.001) and humanistic (P=.005) therapists reported a higher comparability of telephone-based psychotherapy to in-person psychotherapy than behavioral therapists. Experiences with remote therapy (both web- and telephone-based) were more positive than previously expected (P<.001). Psychodynamic therapists reported more positive experiences with telephone-based psychotherapy than expected compared to behavioral (P=.03) and systemic (P=.002) therapists. In general, web-based psychotherapy was rated more positively (regarding comparability to psychotherapy with personal contact and experiences vs expectations) than telephone-based psychotherapy (P<.001); however, psychodynamic therapists reported their previous expectations to be equal to their actual experiences for both telephone- and web-based psychotherapy. CONCLUSIONS Psychotherapists found their experiences with remote psychotherapy (ie, web- or telephone-based psychotherapy) to be better than expected but found that this mode was not totally comparable to face-to-face psychotherapy with personal contact. Especially, behavioral therapists were found to rate telephone-based psychotherapy less favorably than therapists with other theoretical backgrounds.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
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Acceptability of Telemedicine Features to Promote Its Uptake in Practice: A Survey of Community Telemental Health Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228525. [PMID: 33212979 PMCID: PMC7698537 DOI: 10.3390/ijerph17228525] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 12/27/2022]
Abstract
Understanding what motivates mental health providers to use telemedicine (i.e., telemental health) is critical for optimizing its uptake, especially during unprecedented times (e.g., the COVID-19 pandemic). Drawing from the Technology Acceptance Model (TAM), this report examined the characteristics of telemental health providers and how the acceptability of telemedicine features contributes to their intention to use the technology more often in practice. Telemental health providers (N = 177) completed an online survey between March and May 2019. Most providers (75%) spent less than 25% of their work-week using telemedicine, but 70% reported an intention to use telemedicine more in the future. The belief that telemedicine affords greater access to patients, work-life balance, flexibility in providing care, and the opportunity to be at the forefront of innovative care were significant predictors of intentions to use the technology more in the future. Other significant predictors included needing assistance to coordinate insurance reimbursements, manage a successful telemedicine practice, and integrate the telemedicine program with other health IT software. Findings have important implications for increasing the frequency of telemedicine use among telemental health providers. Future research and practice should leverage providers' positive beliefs about telemedicine acceptability and consider their needs to enhance its uptake.
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Dores AR, Geraldo A, Carvalho IP, Barbosa F. The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207663. [PMID: 33096650 PMCID: PMC7589044 DOI: 10.3390/ijerph17207663] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 12/20/2022]
Abstract
The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. This study aimed to explore psychologists’ practices related with the use of ICTs before and during the COVID-19 lockdown, to identify the main changes that the pandemic has brought and the impact that such changes have had on their practice with clients, and also identify the factors that potentially have affected such changes. The Portuguese Psychologists Association announced the study, and 108 psychologists responded to an online survey during the mandatory lockdown. The results showed that these professionals continued to provide their services due to having adopted ICTs. Comparing with face-to-face interventions, psychologists recognized that additional precautions/knowledge were needed to use such technologies. Despite the challenges identified, they described the experience with the use of ICTs as positive, meeting clients’ adherence, and yielding positive results. Psychologists with the most years of professional experience maintained their services the most, but those with average experience showed the most favorable attitudes toward the use of technologies and web-based interventions.
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Affiliation(s)
- Artemisa R. Dores
- Center for Rehabilitation Research, School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences of University of Porto, 4200-135 Porto, Portugal; (A.G.); (F.B.)
- Correspondence:
| | - Andreia Geraldo
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences of University of Porto, 4200-135 Porto, Portugal; (A.G.); (F.B.)
| | - Irene P. Carvalho
- CINTESIS and Department of Clinical Neurosciences and Mental Health, School of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal;
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences of University of Porto, 4200-135 Porto, Portugal; (A.G.); (F.B.)
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25
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Reilly SE, Zane KL, McCuddy WT, Soulliard ZA, Scarisbrick DM, Miller LE, Mahoney Iii JJ. Mental Health Practitioners' Immediate Practical Response During the COVID-19 Pandemic: Observational Questionnaire Study. JMIR Ment Health 2020; 7:e21237. [PMID: 32931440 PMCID: PMC7546864 DOI: 10.2196/21237] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been associated with increased psychological distress, signaling the need for increased mental health services in the context of stay-at-home policies. OBJECTIVE This study aims to characterize how mental health practitioners have changed their practices during the pandemic. The authors hypothesize that mental health practitioners would increase tele-mental health services and that certain provider types would be better able to adapt to tele-mental health than others. METHODS The study surveyed 903 practitioners, primarily psychologists/doctoral-level (Psych/DL) providers, social workers/master's-level (SW/ML) providers, and neuropsychologists employed in academic medical centers or private practices. Differences among providers were examined using Bonferroni-adjusted chi-square tests and one-way Bonferroni-adjusted analyses of covariance. RESULTS The majority of the 903 mental health practitioners surveyed rapidly adjusted their practices, predominantly by shifting to tele-mental health appointments (n=729, 80.82%). Whereas 80.44% (n=625) were not using tele-mental health in December 2019, only 22.07% (n=188) were not by late March or early April 2020. Only 2.11% (n=19) reported no COVID-19-related practice adjustments. Two-thirds (596/888, 67.10%) reported providing additional therapeutic services specifically to treat COVID-19-related concerns. Neuropsychologists were less likely and Psych/DL providers and SW/ML providers were more likely than expected to transition to tele-mental health (P<.001). Trainees saw fewer patients (P=.01) and worked remotely more than licensed practitioners (P=.03). Despite lower rates of information technology service access (P<.001), private practice providers reported less difficulty implementing tele-mental health than providers in other settings (P<.001). Overall, the majority (530/889, 59.62%) were interested in continuing to provide tele-mental health services in the future. CONCLUSIONS The vast majority of mental health providers in this study made practice adjustments in response to COVID-19, predominantly by rapidly transitioning to tele-mental health services. Although the majority reported providing additional therapeutic services specifically to treat COVID-19-related concerns, only a small subset endorsed offering such services to medical providers. This has implications for future practical directions, as frontline workers may begin to seek mental health treatment related to the pandemic. Despite differences in tele-mental health uptake based on provider characteristics, the majority were interested in continuing to provide such services in the future. This may help to expand clinical services to those in need via tele-mental health beyond the COVID-19 pandemic.
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Affiliation(s)
- Shannon E Reilly
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
| | - Katherine L Zane
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
| | - William T McCuddy
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
| | - Zachary A Soulliard
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
| | - David M Scarisbrick
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
- Department of Neuroscience, West Virginia University, Morgantown, WV, United States
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Liv E Miller
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
- Department of Neuroscience, West Virginia University, Morgantown, WV, United States
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - James J Mahoney Iii
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
- Department of Neuroscience, West Virginia University, Morgantown, WV, United States
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
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26
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Lawson DW, Stolwyk RJ, Ponsford JL, Baker KS, Tran J, Wong D. Acceptability of telehealth in post-stroke memory rehabilitation: A qualitative analysis. Neuropsychol Rehabil 2020; 32:1-21. [PMID: 32677539 DOI: 10.1080/09602011.2020.1792318] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite evidence of the efficacy of telerehabilitation post-stroke, uptake has lagged behind the development of available technology, slowed by low confidence in user experience. We aimed to explore the issue of acceptability by characterizing the experience of telerehabilitation for service providers and consumers of a memory rehabilitation program. Semi-structured interviews were conducted with nine clinicians (Mage = 33.29; SD = 7.37; range 25-44) and 25 stroke survivors with memory difficulties (Mage = 54.12; SD = 10.99; range 36-82) following a 6-week compensatory memory skills program delivered via in-home videoconferencing. Thematic analysis identified a range of perspectives under three overarching themes: (1) Content and Delivery; (2) Relationship and Connection; and (3) The Role and Benefits of Telerehabilitation. Reports from both respondent groups were overwhelmingly positive about the telerehabilitation experience and identified the benefits of increasing service availability. Videoconferencing technology was usable and occasional reliability issues were not a barrier. Users identified a range of benefits and challenges regarding communication, rapport building, and integration of rehabilitation in the home environment. Furthermore, most stroke survivors reported benefit from the intervention, via the acquisition of memory strategies and improved self-confidence through better understanding of their deficits. Overall, telerehabilitation of memory was acceptable to users.
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Affiliation(s)
- David W Lawson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Katharine S Baker
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Joanna Tran
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Dana Wong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
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27
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Miu AS, Vo HT, Palka JM, Glowacki CR, Robinson RJ. Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement. COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1791800] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Adriana S. Miu
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hoa T. Vo
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jayme M. Palka
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Reed J. Robinson
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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28
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Békés V, Grondin F, Bouchard S. Barriers and facilitators to the integration of web‐based interventions into routine care. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020. [DOI: 10.1111/cpsp.12335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Mendes-Santos C, Weiderpass E, Santana R, Andersson G. Portuguese Psychologists' Attitudes Toward Internet Interventions: Exploratory Cross-Sectional Study. JMIR Ment Health 2020; 7:e16817. [PMID: 32250273 PMCID: PMC7171568 DOI: 10.2196/16817] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/10/2019] [Accepted: 01/26/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Despite the significant body of evidence on the efficacy and cost-effectiveness of internet interventions, the implementation of such programs in Portugal is virtually non-existent. In addition, Portuguese psychologists' use and their attitudes towards such interventions is largely unknown. OBJECTIVE The aim of this study was to explore Portuguese psychologists' knowledge, training, use and attitudes towards internet interventions; to investigate perceived advantages and limitations of such interventions; identify potential drivers and barriers impacting implementation; and study potential factors associated to previous use and attitudes towards internet interventions. METHODS An online cross-sectional survey was developed by the authors and disseminated by the Portuguese Psychologists Association to its members. RESULTS A total of 1077 members of the Portuguese Psychologists Association responded to the questionnaire between November 2018 and February 2019. Of these, 37.2% (N=363) were familiar with internet interventions and 19.2% (N=188) considered having the necessary training to work within the field. 29.6% (N=319) of participants reported to have used some form of digital technology to deliver care in the past. Telephone (23.8%; N=256), e-mail (16.2%; N=175) and SMS (16.1%; N=173) services were among the most adopted forms of digital technology, while guided (1.3%; N=14) and unguided (1.5%; N=16) internet interventions were rarely used. Accessibility (79.9%; N=860), convenience (45.7%; N=492) and cost-effectiveness (45.5%; N=490) were considered the most important advantages of internet interventions. Conversely, ethical concerns (40.7%; N=438), client's ICT illiteracy (43.2%; N=465) and negative attitudes towards internet interventions (37%; N=398) were identified as the main limitations. An assessment of participants attitudes towards internet interventions revealed a slightly negative/neutral stance (Median=46.21; SD=15.06) and revealed greater acceptability towards blended treatment interventions (62.9%; N=615) when compared to standalone internet interventions (18.6%; N=181). Significant associations were found between knowledge (χ24=90.4; P<.001), training (χ24=94.6; P<.001), attitudes (χ23=38.4; P<.001) and previous use of internet interventions and between knowledge (χ212=109.7; P<.001), training (χ212=64.7; P<.001) and attitudes towards such interventions, with psychologists reporting to be ignorant and not having adequate training in the field, being more likely to present more negative attitudes towards these interventions and not having prior experience in its implementation. CONCLUSIONS This study revealed that most Portuguese psychologists are not familiar with and have no training or prior experience using internet interventions and had a slightly negative/neutral attitude towards such interventions. There was greater acceptability towards blended treatment interventions compared to standalone internet interventions. Lack of knowledge and training were identified as the main barriers to overcome, underlining the need of promoting awareness and training initiatives to ensure internet interventions successful implementation.
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Society, Linköping University, Linköping, Sweden
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisboa, Portugal
| | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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30
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Muir SD, de Boer K, Thomas N, Seabrook E, Nedeljkovic M, Meyer D. Videoconferencing Psychotherapy in the Public Sector: Synthesis and Model for Implementation. JMIR Ment Health 2020; 7:e14996. [PMID: 31961334 PMCID: PMC7001045 DOI: 10.2196/14996] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/24/2019] [Accepted: 09/30/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Videoconferencing psychotherapy (VCP) is a growing practice among mental health professionals. Early adopters have predominantly been in private practice settings, and more recent adoption has occurred in larger organizations, such as the military. The implementation of VCP into larger health service providers in the public sector is an important step in reaching and helping vulnerable and at-risk individuals; however, several additional implementation challenges exist for public sector organizations. OBJECTIVE The aim of this study was to offer an implementation model for effectively introducing VCP into public sector organizations. This model will also provide practical guidelines for planning and executing an embedded service trial to assess the effectiveness of the VCP modality once implemented. METHODS An iterative search strategy was employed, drawing on multiple fields of research across mental health, information technology, and organizational psychology. Previous VCP implementation papers were considered in detail to provide a synthesis of the barriers, facilitators, and lessons learned from the implementation attempts in the military and other public sector settings. RESULTS A model was formulated, which draws on change management for technology integration and considers the specific needs for VCP integration in larger organizations. A total of 6 phases were formulated and were further broken down into practical and measurable steps. The model explicitly considers the barriers often encountered in large organizational settings and suggests steps to increase facilitating factors. CONCLUSIONS Although the model proposed is time and resource intensive, it draws on a comprehensive understanding of larger organizational needs and the unique challenge that the introduction of VCP presents to such organizations.
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Affiliation(s)
- Samuel David Muir
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Kathleen de Boer
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Elizabeth Seabrook
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
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31
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Connolly SL, Miller CJ, Lindsay JA, Bauer MS. A systematic review of providers' attitudes toward telemental health via videoconferencing. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020; 27:10.1111/cpsp.12311. [PMID: 35966216 PMCID: PMC9367168 DOI: 10.1111/cpsp.12311] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 11/12/2019] [Indexed: 11/29/2022]
Abstract
Telemental health conducted via videoconferencing (TMH-V) has the potential to improve access to care, and providers' attitudes toward this innovation play a crucial role in its uptake. This systematic review examined providers' attitudes toward TMH-V through the lens of the unified theory of acceptance and use of technology (UTAUT). Findings suggest that providers have positive overall attitudes toward TMH-V despite describing multiple drawbacks. Therefore, the relative advantages of TMH-V, such as its ability to increase access to care, may outweigh its disadvantages, including technological problems, increased hassle, and perceptions of impersonality. Providers' attitudes may also be related to their degree of prior TMH-V experience, and acceptance may increase with use. Limitations and implications of findings for implementation efforts are discussed.
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Affiliation(s)
- Samantha L. Connolly
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Christopher J. Miller
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jan A. Lindsay
- HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
- Baylor College of Medicine, Houston, Texas
- South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
| | - Mark S. Bauer
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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32
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Whaibeh E, Mahmoud H, Vogt EL. Reducing the Treatment Gap for LGBT Mental Health Needs: the Potential of Telepsychiatry. J Behav Health Serv Res 2019; 47:424-431. [DOI: 10.1007/s11414-019-09677-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Kim EH, Gellis ZD, Bradway CK, Kenaley B. Depression care services and telehealth technology use for homebound elderly in the United States. Aging Ment Health 2019; 23:1164-1173. [PMID: 30472881 DOI: 10.1080/13607863.2018.1481925] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating depression in older adults, they have been slowly adopted by Home Health Care (HHC) agencies. Therefore, this study was conducted to determine how HHC agencies perceive and use telehealth technology for depression care among homebound older adult patients. Methods: Five-hundred-and-sixteen staff from the National Association for Homecare & Hospice (NAHC) member home health care agencies completed the online survey. Questions were asked of HHC staff regarding performance expectancy, effort expectancy, social influences, facilitating conditions, telehealth use and intention to use/continue to use telehealth. Results: The majority had a neutral or positive perception towards telehealth. However, participants from agencies that have yet to use telehealth (mean: 3.25, SD: 1.56) reported a less intention to use the technology for depression care versus those from agencies that did (mean: 4.64, SD: 1.37). This may be partially explained by the finding that only 32% perceived themselves as having the knowledge and 25% as having resources to use telehealth. Additionally, facilitating conditions and social influences were significant predictors of intention to use/continue to use telehealth for depression care (p-values < .01). Conclusion: Overall, staff had a neutral or positive perception towards telehealth. Factors such as fewer years of experience in using telehealth and a small annual budget may explain a negative perception towards telehealth. Therefore, further education and resources are needed to support telehealth use. Future studies may consider comparing telehealth programs and identifying supporting policies.
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Affiliation(s)
- Eun Hae Kim
- a School of Social Work , Texas State University , San Marcos , TX , USA
| | - Zvi D Gellis
- b School of Social Policy & Practice , University of Pennsylvania , Philadelphia , PA , USA
| | | | - Bonnie Kenaley
- d School of Social Work , Boise State University , Boise , ID , USA
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34
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Caver KA, Shearer EM, Burks DJ, Perry K, De Paul NF, McGinn MM, Felker BL. Telemental health training in the Veterans Administration Puget Sound Health Care System. J Clin Psychol 2019; 76:1108-1124. [PMID: 31115049 DOI: 10.1002/jclp.22797] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 01/13/2018] [Accepted: 02/15/2019] [Indexed: 12/14/2022]
Abstract
As a pioneer of training in the field of psychology, the Veterans Affairs (VA) HealthCare System serves as a leader in the training in and provision of Telemental Health (TMH) services in the United States. To meet goals toward continued expansion of these services, the VA TMH training program includes both web-based didactic courses and a skills competency test at a basic level with supervision and consultation in TMH for more advanced training and is available to staff psychologists and psychologist trainees. Despite these efforts, barriers for training in and implementation of TMH occur at the provider, system, and patient level. At the national level, the VA is actively working to resolve these barriers and we share site-specific examples implemented by the VA Puget Sound Health Care System promoting access through TMH team to further address barriers to training and implementation.
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Affiliation(s)
- Kelly A Caver
- VA Puget Sound Health Care System, Seattle, Washington
| | | | - Derek J Burks
- VA Portland Health Care System, Portland, Oregon.,Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
| | - Kristen Perry
- VA Puget Sound Health Care System, Seattle, Washington.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | | | - Meghan M McGinn
- VA Puget Sound Health Care System, Seattle, Washington.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Bradford L Felker
- VA Puget Sound Health Care System, Seattle, Washington.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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Perry K, Gold S, Shearer EM. Identifying and addressing mental health providers' perceived barriers to clinical video telehealth utilization. J Clin Psychol 2019; 76:1125-1134. [PMID: 30859573 DOI: 10.1002/jclp.22770] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 02/06/2018] [Accepted: 02/15/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Clinical video telehealth (CVT) is an innovative modality to provide care directly to Veterans' homes. Despite prior training initiatives, CVT remains underutilized. This project sought to better understand barriers to implementation and to compare responses of CVT utilizers versus nonutilizers. METHOD Mental health staff were invited to complete an online anonymous survey on their use of CVT in clinical practice. RESULTS A total of 159 mental health staff completed the survey. Although the majority of the sample endorsed personal use of a video chat program, less than half reported using CVT for patient care. Among nonutilizers, lack of training was the most frequently endorsed barrier to CVT use whereas administrative burden was the most frequently endorsed barrier by utilizers. CONCLUSIONS This study extends existing literature by determining barriers to CVT adoption. It identifies several barriers among utilizers versus nonutilizers. Discussion includes potential guidelines for overcoming barriers to CVT utilization.
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Affiliation(s)
- Kristen Perry
- VA Puget Sound Health Care System, Tacoma, Washington.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Sari Gold
- VA Puget Sound Health Care System, Tacoma, Washington.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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Mahmoud H, Vogt E. Telepsychiatry: an Innovative Approach to Addressing the Opioid Crisis. J Behav Health Serv Res 2018; 46:680-685. [DOI: 10.1007/s11414-018-9611-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Uso de las nuevas tecnologías por parte de los psicólogos españoles y sus necesidades. CLINICA Y SALUD 2017. [DOI: 10.1016/j.clysa.2017.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McGill BC, Sansom-Daly UM, Wakefield CE, Ellis SJ, Robertson EG, Cohn RJ. Therapeutic Alliance and Group Cohesion in an Online Support Program for Adolescent and Young Adult Cancer Survivors: Lessons from "Recapture Life". J Adolesc Young Adult Oncol 2017; 6:568-572. [PMID: 28581346 DOI: 10.1089/jayao.2017.0001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Psychological support services for adolescent and young adults (AYAs) with cancer are moving online and are increasingly peer based. It is unclear whether online service delivery impacts critical therapeutic elements such as collaborative patient-therapist rapport and group cohesion. AYA cancer survivors (N = 39) participating in a six-week online cognitive-behavioral therapy group program-"Recapture Life"-rated their perception of therapeutic alliance and group cohesion. Participant-rated alliance and group cohesion were high throughout the program, and therapist-rated participant openness, trust, and motivation strengthened over time. The findings provide further support for the expansion of AYA cancer support services to the online domain.
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Affiliation(s)
- Brittany C McGill
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Australia .,2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital , Randwick, Australia
| | - Ursula M Sansom-Daly
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Australia .,2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital , Randwick, Australia .,3 Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital , Randwick, Australia
| | - Claire E Wakefield
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Australia .,2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital , Randwick, Australia
| | - Sarah J Ellis
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Australia .,2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital , Randwick, Australia
| | - Eden G Robertson
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Australia .,2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital , Randwick, Australia
| | - Richard J Cohn
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Australia .,2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital , Randwick, Australia
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Mermelstein H, Guzman E, Rabinowitz T, Krupinski E, Hilty D. The Application of Technology to Health: The Evolution of Telephone to Telemedicine and Telepsychiatry: A Historical Review and Look at Human Factors. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s41347-017-0010-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Cipolletta S, Mocellin D. Online counseling: An exploratory survey of Italian psychologists’ attitudes towards new ways of interaction. Psychother Res 2017; 28:909-924. [DOI: 10.1080/10503307.2016.1259533] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Sabrina Cipolletta
- Dipartimento di Psicologia Generale, Università degli Studi di Padova, Padova, Italy
| | - Damiano Mocellin
- Dipartimento di Psicologia Generale, Università degli Studi di Padova, Padova, Italy
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The promise and the reality: a mental health workforce perspective on technology-enhanced youth mental health service delivery. BMC Health Serv Res 2016; 16:562. [PMID: 27724951 PMCID: PMC5057226 DOI: 10.1186/s12913-016-1790-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 09/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Digital technologies show promise for reversing poor engagement of youth (16-24 years) with mental health services. In particular, mobile and internet based applications with communication capabilities can augment face-to-face mental health service provision. The literature in this field, however, fails to adequately capture the perspectives of the youth mental health workforce regarding utility and acceptability of technology for this purpose. METHODS This paper describes results of in-depth qualitative data drawn from various stakeholders involved in provision of youth mental health services in one Australian rural region. Data were obtained using focus groups and semi-structured interviews with regional youth mental health clinicians, youth workers and support/management staff (n = 4 focus groups; n = 8 interviews) and analysed via inductive thematic analysis. RESULTS Results question the acceptability of technology to engage clients within youth mental health services. Six main themes were identified: young people in a digital age, personal connection, power and vulnerability, professional identity, individual factors and organisational legitimacy. CONCLUSIONS These findings deepen the understanding of risks and challenges faced when adopting new technologies in mental healthcare. Recommendations for technology design and implementation in mental health services are made.
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Kim E, Gellis ZD, Hoak V. Telehealth Utilization for Chronic Illness and Depression Among Home Health Agencies: A Pilot Survey. Home Health Care Serv Q 2015; 34:220-31. [DOI: 10.1080/01621424.2015.1108891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chakrabarti S. Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World J Psychiatry 2015; 5:286-304. [PMID: 26425443 PMCID: PMC4582305 DOI: 10.5498/wjp.v5.i3.286] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 05/07/2015] [Accepted: 06/09/2015] [Indexed: 02/05/2023] Open
Abstract
Telepsychiatry, i.e., the use of information and communication technologies to provide psychiatric services from a distance, has been around for more than half a century now. Research over this period has shown that videoconferencing-based telepsychiatry is an enabling and empowering form of service delivery, which promotes equality of access, and high levels of satisfaction among patients. The range of services offered by videoconferencing-based telepsychiatry, potential users and points of delivery of such services are theoretically limitless. Telepsychiatry has both clinical utility and non-clinical uses such as administrative, learning and research applications. A large body of accumulated evidence indicates that videoconferencing-based telepsychiatric assessments are reliable, and clinical outcomes of telepsychiatric interventions are comparable to conventional treatment among diverse patient populations, ages and diagnostic groups, and on a wide range of measures. However, on many aspects of effectiveness, the evidence base is still relatively limited and often compromised by methodological problems. The lack of cost-effectiveness data in particular, is a major hindrance, raising doubts about the continued viability of telepsychiatric services. Added to this are the vagaries of technology, negative views among clinicians, poor uptake by providers, and several legal, ethical and administrative barriers. These hamper the widespread implementation of telepsychiatry and its integration with routine care. Though further advances in technology and research are expected to solve many of these problems, the way forward would be to promote telepsychiatry as an adjunct to conventional care, and to develop hybrid models, which incorporate both traditional and telepsychiatric forms of mental health-care.
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Jenkins-Guarnieri MA, Pruitt LD, Luxton DD, Johnson K. Patient Perceptions of Telemental Health: Systematic Review of Direct Comparisons to In-Person Psychotherapeutic Treatments. Telemed J E Health 2015; 21:652-60. [PMID: 25885491 DOI: 10.1089/tmj.2014.0165] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Although there is growing empirical support for the clinical efficacy of telemental health (TMH) treatments, questions remain about how patient perceptions of the TMH treatment process may compare with those of traditional in-person psychotherapy treatments. MATERIALS AND METHODS Through a systematic review, we specifically examine measures of patient treatment satisfaction and therapeutic alliance in studies that included direct comparisons of video teleconferencing or telephone-based psychotherapeutic TMH treatments with in-person treatment delivery. We performed a comprehensive search of the PsychINFO and MEDLINE databases for articles published in the last 10 years (2004-2014) on TMH treatments that included in-person comparison groups, yielding 552 initial results with 14 studies meeting our full inclusion criteria. RESULTS The findings generally show comparable treatment satisfaction as well as similar ratings of therapeutic alliance. Some results suggested the potential for decreased patient comfort with aspects of group treatment delivered via TMH. CONCLUSIONS We discuss implications for providing psychotherapeutic treatments via TMH and review practice recommendations for assuring and enhancing satisfaction with TMH services.
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Affiliation(s)
| | - Larry D Pruitt
- 1 National Center for Telehealth & Technology , Tacoma, Washington
| | - David D Luxton
- 1 National Center for Telehealth & Technology , Tacoma, Washington
- 2 Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine , Seattle, Washington
| | - Kristine Johnson
- 1 National Center for Telehealth & Technology , Tacoma, Washington
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Bruno R, Abbott JAM. Australian Health Professionals’ Attitudes Toward and Frequency of Use of Internet Supported Psychological Interventions. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2015. [DOI: 10.1080/00207411.2015.1009784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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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]
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Luxton DD, Pruitt LD, O'Brien K, Stanfill K, Jenkins-Guarnieri MA, Johnson K, Wagner A, Thomas E, Gahm GA. Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression. Contemp Clin Trials 2014; 38:134-44. [DOI: 10.1016/j.cct.2014.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/04/2014] [Accepted: 04/05/2014] [Indexed: 10/25/2022]
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Hertlein KM, Blumer MLC, Smith JM. Marriage and Family Therapists’ Use and Comfort with Online Communication with Clients. CONTEMPORARY FAMILY THERAPY 2013. [DOI: 10.1007/s10591-013-9284-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Luxton DD, O'Brien K, McCann RA, Mishkind MC. Home-based telemental healthcare safety planning: what you need to know. Telemed J E Health 2013; 18:629-33. [PMID: 23061644 DOI: 10.1089/tmj.2012.0004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Telemental health (TMH) care provided directly to the home is an emerging area of care delivery. TMH care involves awareness of safety issues and adequate safety planning, although detailed practical recommendations for home-based TMH safety planning are absent in the literature. With this article we aim to increase awareness of safety issues associated with home-based synchronous TMH treatment and to discuss recommendations for consistent safety planning that can inform the development of standard operating procedures, emergency protocols, and overall good TMH practice. Specific areas discussed include consideration of state and local requirements, appropriateness of TMH care, technology and infrastructure, and emergency management and monitoring procedures. The topic of safety, as it relates to TMH policy, as well as the need for additional TMH research are also discussed.
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Affiliation(s)
- David D Luxton
- National Center for Telehealth & Technology, Tacoma, Washington 98431, USA.
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50
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Hage E, Roo JP, van Offenbeek MAG, Boonstra A. Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review. BMC Health Serv Res 2013; 13:19. [PMID: 23311452 PMCID: PMC3575225 DOI: 10.1186/1472-6963-13-19] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 12/28/2012] [Indexed: 11/22/2022] Open
Abstract
Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the changes in ownership required for sustainable e-Health adoption. Conclusions Rural e-Health implementation is an emerging, rapidly developing, field. Too often, e-Health adoption fails due to underestimating implementation factors and their interactions. We argue that rural e-Health implementation only leads to sustainable adoption (i.e. it “sticks”) when the implementation carefully considers and aligns the e-Health content (the “clicks”), the pre-existing structures in the context (the “bricks”), and the interventions in the implementation process (the “tricks”).
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Affiliation(s)
- Eveline Hage
- Department of Innovation Management & Strategy, University of Groningen, PO box 800, 9700 AV, Groningen, Netherlands.
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