Continuation of Teletherapy After the COVID-19 Pandemic: Survey Study of Licensed Mental Health Professionals

Background: The use of teletherapy has exponentially increased in the context of the ongoing COVID-19 pandemic. Studies on teletherapy documented substantial benefits of accessibility and convenience even before the start of the pandemic. Although recent studies show that this modality of therapy delivery is here to stay, few have studied who will most benefit from this trend. Objective: In this paper, we report predictors of continued teletherapy usage in a sample of licensed mental health professionals in the United States during a time period when pandemic-related restrictions began diminishing. As such, it is one of the first studies to examine factors related to continued benefits of teletherapy postpandemic. Methods: Participation from licensed mental health professionals was sought on listservs of national organizations of multiple mental health organizations. Data were collected via an anonymous link to a survey on Qualtrics between January 2021 and April 2021. Participants responded to questions on therapist demographics, practice setting, experiences of shifting to teletherapy, perspectives on continued use of teletherapy, and their client characteristics. Findings related to client characteristics that predicted continued teletherapy usage are presented here. Results: A total of 186 individuals consented to participate in the survey, with a final sample of 114 with complete data. A majority of participants identified as female (92/114, 80.7%), White (94/114, 82.5%), and having a master's degree (75/114, 65.5%) from a nationally accredited program (106/114, 93%). Data were analyzed using heteroskedastic regression modeling with client-related factors as predictors. Two models were run with and without distance travelled by clients as a control variable. Model estimates from both models showed that continued use of teletherapy postpandemic was predicted by the following factors: higher percentage of clients from rural areas, younger and older adult clients, clients with Medicare, and clients with marginalized gender and religious/spiritual identities. Significantly, having a higher percentage of clients from lower socioeconomic status, a higher percentage of those with Medicaid coverage, and a higher percentage of couples and families as clients predicted decreased use of teletherapy postpandemic. Conclusions: Findings from the study suggest that while some groups of clients are more likely to continue to receive benefits of teletherapy, vulnerable groups such as those in lower socioeconomic conditions, Medicaid beneficiaries, and those who seek couple and family therapy may be less likely to be served by it. These differences point to a need to address factors driving telehealth care disparities such as access to technology, housing, and childcare issues, as well as the need for continued training for licensed professionals.