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Table 5 Provider responses and themes regarding major impacts of COVID-19 on work

From: An observational study of the impact of COVID-19 and the rapid implementation of telehealth on community mental health center providers

Theme Provider responses
Patient/client and provider interactions Technology My caseload lives in a rural area so not all kids have access to internet or stable internet.
Blocked cell number.
No response.
Lack technology.
Developing and/or maintaining rapport Not being able to build rapport with new clients—it’s difficult to introduce yourself via telephone or even video.
It is difficult to have longer appointments.
It has been difficult to fully engage families as I have been able to before.
I used to have very high guardian engagement, and for me, this has decreased.
It has been very difficult to see my clients consistently. A lot of the people I work with are students, and unfortunately, some of the parents don’t hold their children accountable for doing video sessions.
My clients’ participation has gone down tremendously.
Communication It is difficult for students to pay attention and they are easily distracted when I am trying to have sessions with them.
It is sometimes difficult to connect with the client or to judge their state of mind without the visual clues.
Sessions are shorter.
It has also been more enjoyable regarding relationships with clients. I think it may be due to the less formal atmosphere as clients are comfortable in their homes.
Productivity expectations Reduced productivity My productivity has dropped because I have been having issues coordinating with some families.
Less productivity hours.
Loss of productivity, increased phone calls and chasing clients, helping clients download Zoom, Skype, etc.
Increased demands Increase in documentation required.
Increase pressure regarding productivity and revenue.
More paperwork without receiving productivity for increased time spent.
Work-life balance General work-life balance Lack of home life/work life balance, stressful, time management is difficult.
My work-life balance has been disrupted.
Working much later in the evening.
Working at home with children Working from home while taking care of my child makes it difficult to do my best work with clients.
It can be difficult to work from home with children.