Addressing concerns and adapting psychological techniques for videoconsultations: a practical guide

ABSTRACT

Objective: The 2020 coronavirus pandemic required many psychologists to rapidly transition to telehealth services to reduce virus exposure. Telepsychology services expanded quickly in Australia. This article seeks to provide simple and practical recommendations for clinicians who are changing their practice.

Method: A narrative literature review focusing on psychologists’ concerns regarding telehealth-facilitated psychology or telepsychology was undertaken.

Results: Research literature and guidelines from peak professional bodies such as The Australian Psychological Society and the American Psychological Association, inform two sections of the article: Common Concerns about Videoconsultations and; Practical Considerations for Effective Videoconsultations. Telepsychology, has numerous benefits, especially during emergency situations. However, concerns regarding efficacy, therapeutic alliance, and the digital divide have contributed to psychologists’ unwillingness to use telepsychology. Evidence suggests that efficacy and therapeutic alliance is comparable between telepsychology and in-person services. Simple evidence-based adjustments to therapeutic practice can optimise videoconsultations and increase the effectiveness of telepsychology. Despite the rapid change to videoconsultations, evidence suggests that Australian psychologists need not be concerned about clinical efficacy or therapeutic alliance related to telepsychology. However, it is acknowledged that transitioning to telehealth models of care is disruptive.

Conclusion: This paper can assist clinicians in selecting appropriate clients for telepsychology, increase effectiveness and mitigate risks.

KEY POINTS

What is already known about this topic:

1. Research supports the clinical efficacy and establishment of therapeutic alliance related to telepsychology services and highlights that concerns regarding the digital divide need to be evidence-based, not based on assumptions.

2. As outlined in this paper, it is important to consider client suitability and ethical considerations prior to delivering telepsychology services.

3. The adaptations to psychological techniques, as highlighted in this paper, can increase the effectiveness of videoconsultations.

What this topic adds:

1. An examination of common concerns related to videoconsultations including: efficacy, therapeutic alliance and the digital divide.

2. A practical evidence-based checklist for pre-therapy videoconsultation considerations.

3. An evidence-based checklist of practice adaptations that can increase effectiveness in videoconsultation.

KEYWORDS:

• Telehealth
• telepsychology
• clinical guidelines
• ethical
• therapeutic alliance

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data sharing

Data sharing is not applicable to this article as no new data were created or analysed in this study.

Notes

1. Some definitions of telehealth and telepsychology include telephone consultations. Telehealth and telepsychology in this paper pertains to real-time videoconferencing.

2. This article was written during the COVID-19 pandemic. The need to protect therapists and clients from viral exposure during a pandemic is a prime example of how context needs to be part of the assessment.