Date of Award

2022

Document Type

Dissertation

Degree Name

Philosophy (Ph.D)

Department

Psychology

First Advisor

William Chaplin

Second Advisor

Tara Rooney

Third Advisor

Raymond DiGiuseppe

Abstract

The COVID-19 pandemic resulted in closures, increased stressors, and a high need for mental health services. To provide continuity of care and meet the rising need for therapy, mental health providers rapidly transitioned to telehealth. This transition occurred with the support of policy changes and leniency in telehealth guidelines. A survey including participant and client demographic variables, readiness for telehealth, transition time, methods for telehealth practice, and therapist efficacy in-person and via telehealth was created in Qualtrics. It was completed by 79 mental health providers to provide insight into this transition and inform future practice. This study hypothesized that (1) there would be differences between mental health professionals and how they adapted to telehealth based on demographic factors; (2) those with prior training and experience would be better prepared for telehealth and adapt more quickly, (3) therapists would feel more efficacious in their in-person practice than over telehealth, and (4) those with prior training and experience with telehealth would report higher levels of therapist-efficacy. The first hypothesis was supported, and differences were found in training, telehealth platform use, data collection and storage, transition time, and readiness for telehealth across professions, type of facility, and years of experience. The second hypothesis was not supported as no significant predictors of transition time were found. The third hypothesis was supported and a large effect size was found indicating that therapists felt efficacious in both settings, but more efficacious in-person (t(78) = 7.29, P<.001, D = .854). Regarding the fourth hypothesis, client technology access was the only significant predictor of therapist-efficacy over telehealth. These findings have implications for clinical administration, graduate training, policy, and ethical considerations. First, clinicians can prepare themselves for future telehealth use by reviewing their consent process, technology, and data collection/storage strategies. Second, graduate programs can support future mental health providers by incorporating telehealth into their curricula. Third, policies regarding insurance reimbursement and initiatives targeting the digital gap may improve telehealth services and ensure more equitable access to healthcare. Finally, increased awareness of the risks of technology use and clarification of regulations regarding telehealth can protect both clients and clinicians.

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