Thread by @neilthomas3182

Using videoconferencing to deliver psychological therapy: pleased that our invited review of the empirical literature for journal Psychology & Psychotherapy is now online #openaccess. Explainer in thread...1/20 bpspsychub.onlinelibrary.wiley.com/doi/full/10.11…

We’ve been using videoconferencing in therapy since before the pandemic, eg to support self-guided courses in CBT on mentalhealthonline.org.au, and to increase access to specialist therapies in our @voicesclinic 2/

For this paper we wanted to conduct a broad state-of-the-field review of videoconferencing therapy to be able to inform practitioners, researchers and service users. We reviewed both clinical trials and qualitative data on clients' and practitioners' experiences. 3/

Our review looked at how/with whom videoconferencing had been used, how people had found it, reports of opportunities and challenges, and direct comparisons with in-person therapy. 4/x

NB we focused only on adults seeking mental health treatment, and on the delivery of psychological therapy rather than other types of help. We focused on videoconferencing rather than phone etc 5/x

Review findings: We found over 50 separate studies that examined videoconferencing therapy for depression, PTSD, panic, social anxiety, health anxiety, OCD, hoarding, hair-pulling, all of which found it to be feasible and acceptable to clients. Thread 6/ bpspsychub.onlinelibrary.wiley.com/doi/full/10.11…

There have not yet been studies on videoconferencing psychotherapy for psychosis, bipolar or complex trauma (although videoconferencing use seems acceptable in broader MH care for psychosis, and we have been using successfully at @voicesclinic). 7/

In (pre-pandemic) studies of videoconferencing therapy, facilitating or enabling access was the most often reported advantage, incl physical distance, but also associated financial cost, and barriers from anxiety and stigma of in-person attendance. 8/ bpspsychub.onlinelibrary.wiley.com/doi/full/10.11…

Videoconferencing therapy client experiences: whilst some expressed a preference for in-person, and early discomfort with the new mode of interaction was often reported, discomfort reduced as ppl adapted, and many clients embraced using new technology. 9/ bpspsychub.onlinelibrary.wiley.com/doi/full/10.11…

Challenges of videoconferencing therapy reported in studies to date include lack of privacy in the person’s home for use of telehealth and navigation of technical issues. Therapists often reported finding it harder to read rapport with clients. 10/ bpspsychub.onlinelibrary.wiley.com/doi/full/10.11…

Outcomes of videoconferencing therapy: in large randomised controlled trials that had direct comparisons with in-person therapy, videoconferencing therapy showed, on average, equivalent rates of satisfaction, therapy completion, and outcome. 11/
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#PTSD has been the most studied population (supported by US VA funding) for videoconferencing-based therapy, so there is especially strong evidence for the efficacy of exposure-focused therapies used for trauma (eg prolonged exposure, CPT). See table for other populations. 12/

In spite of therapists finding the process of monitoring the therapeutic relationship harder, randomised trials that directly compare client ratings of rapport between video and in-person therapy find them to be similar on average. 13/ bpspsychub.onlinelibrary.wiley.com/doi/full/10.11…

Although some clients find videoconferencing therapy more difficult, clients find videoconferencing easier, less confronting. In other research we’ve heard people feel like they have more control. Hence on average no difference, but fit is important 14/
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Videoconferencing therapy is often framed as a “substitute” for in-person therapy, but it was not 2nd best in our review findings. Now covid has led to wide use, we hope to see more thought re the opportunities it brings eg helping ppl within their own environment. 15/

To see a discussion of our findings on videoconferencing psychotherapy and suggestions for how to use in practice you can see my presentation at the 2021 State of Telehealth Summit (free registration to see all presentations on-demand until 28 Feb) mentalhealthacademy.com.au/telehealth 16/

You can access our guide to using videoconferencing in #MentalHealth practice at videomentalhealth.org 17/

On 31 March I’ll be running a Q&A session with Psychology & Psychotherapy editor @sbucci76 to talk about the findings of our review of videoconferencing to deliver psychological therapy. Register free at eventbrite.co.uk/e/meet-the-aut… 18/

Ppl in Australia can access, via videoconferencing, psychological therapy at @Swinburne Psychology Clinic swinburne.edu.au/research/centr…, specialist therapy for psychosis at voicesclinic.com.au, and counselling for ppl in residential aged care at swinburne.edu.au/research/centr…

Thanks for listening! Thanks to coauthors @deBoer_ko @rachelmbrand @MacCaity, Liz Seabrook, Maja Nedeljkovic and all collaborators working in this area of mental health service delivery (end of thread)