(PS8-D84) A Mixed-methods Exploration of Therapists’ Experiences with Teletherapy for High-risk Patients

Despite a recent surge in the prevalence of video-, phone-, and text-messaging-therapy, questions remain about how virtual treatment compares to the face-to-face model, from the perspectives of both the patient and therapist (Aref-Adib & Hassiotis, 2021). Past studies have examined clinicians’ perceptions of teletherapy for suicidal patients (Gilmore & Ward-Ciesielski, 2019), but further work must examine how suitable teletherapy is for treating high-risk behaviors and related disorders more broadly (e.g., self-injurious thoughts and behaviors, bipolar disorder, borderline personality disorder, substance use, eating disorders). 

This study uses a mixed-methods approach to explore therapists’ views toward using teletherapy to treat particularly severe mental health problems. A total of 73 therapists were recruited: 21% (n = 15) identified as male, 75% (n = 55) as female, and 4% (n = 3) as non-binary. They reported an average of 9.44 years of clinical experience (SD = 8.28). Participants completed a survey assessing demographics; usage and perceptions of teletherapy; perceived self-efficacy with regard to risk assessment/management; and level of burnout. A subset of the larger group (n = 9, of whom 5 were male and 4 were female) completed in-depth, semi-structured qualitative interviews in order to gain further insight into their experiences and attitudes toward using teletherapy, particularly for the treatment of high-risk behaviors and related disorders. 

All respondents to the survey were seeing at least some of their patients via video-chat, and preliminary analyses suggest that, on average, they used video-chat to see around 68% of their clients (SD = 31.37). A large majority of participants (n = 56; 77%) said their experience with video-chat had been “Good” or “Excellent.” 

Additional quantitative analyses are currently underway, and will include: between-group comparisons based on participants’ specializations (e.g., CBT vs. DBT), clinical settings, types of teletherapy they offer, and their level of experience using teletherapy to treat high-risk patients. Correlations and regression models will also be used to examine the potentially predictive relationships between clinicians’ perceptions of teletherapy, risk assessment self-efficacy, usage of teletherapy, and burnout. 

Qualitative data collection is ongoing, with an expected completion date in April 2022. Interview transcripts will be coded using a grounded theory approach, deriving themes and analytic categories directly from the data, and this process will be completed independently by multiple reviewers to ensure reliability before codes are finalized. Qualitative data will be used to inform conclusions about quantitative results, and further mixed-methods analyses will explore how interviews can add insight into therapists’ experiences using teletherapy to treat high-risk patients, with a particular focus on their attitudes toward the modality and their plans for future provision of mental health services.