The impact of the pandemic has been tremendous and undoubtably interrupted what many of us conceived as being “normality”. There is a clear distinction between our pre-pandemic lives and post pandemic lives – with particular emphasis on work, lifestyle, relationships as well as access to physical and mental health care. Specifically, the pandemic made mainstream the ongoing use of telehealth (appointments by video or phone call) as a way of accessing necessary treatment and support. These changes also appear to have persisted beyond the initial lock-down phase of the pandemic.
The clinical effectiveness across disciplines offering telehealth was demonstrated in a review conducted by Snowswell et al., (2021), highlighting that there was no significant difference between provision of services offered in person or online. Knowing what we know, what are the considerations that need to be made in delivering healthcare (i.e. psychological therapy) through telehealth or in person. There is some evidence that telehealth-based interventions for certain presentations (i.e. Post Traumatic Stress Disorder) show effective outcomes compared to waitlist comparisons – however in comparison to in person treatment telehealth outcomes were inferior. Essentially, there are some presentations that show better outcomes when delivered in person (i.e. Post Traumatic Stress Disorder). Clearly to some form of treatment is shown to be better than none, however when the option is available certain presentations can be better treated in person. This is particularly relevant to rural/regional populations and the ongoing impacts of the Covid-19 pandemic.
So, what does this mean about our ongoing use of telehealth in Therapy? From client perspectives, a review of 14 treatment studies looking into factors such as therapeutic relationship and outcomes show experiences of telehealth and in person sessions were comparable (Jenkins et al., 2015). It seems that there is some middle ground in recognising that accessibility is important and the provision of telehealth services largely mitigates this potential barrier.
In a post-pandemic world – ongoing reflection regarding the use of telehealth and face to face services will be necessary for improving clinical outcomes. Moving forward with this in mind, recognising that telehealth has served an important role in mental health care in recent years – let’s continue to improve and find new ways to engage with mental health care.
Citations
Cartwright, M., Hirani, S. P., Rixon, L., Beynon, M., Doll, H., Bower, P., … & Newman, S. P. (2013). Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial. Bmj, 346.
Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J., & Smith, A. C. (2021). The clinical effectiveness of telehealth: a systematic review of meta-analyses from 2010 to 2019. Journal of Telemedicine and Telecare, 1357633X211022907.
Jenkins-Guarnieri, M. A., Pruitt, L. D., Luxton, D. D., & Johnson, K. (2015). Patient perceptions of telemental health: Systematic review of direct comparisons to in-person psychotherapeutic treatments. Telemedicine and e-Health, 21(8), 652-660.