Theme | Provider responses | |
---|---|---|
Modality specific challenges | Play therapy | Barriers to implementing services like play therapy that are somewhat dependent on the setting. |
Eye movement desensitization and reprocessing (EMDR) | Haven’t tried EMDR bilateral stimulation. | |
Clients discomfort rating Outcome and Session Rating Scale (ORS/SRS) verbally. | ||
I cannot do EMDR treatment—clients not preferring to try the phone way of doing it. | ||
Contingency management / Combined MET/CBT | Prize draws and drug screens are difficult to do. | |
Can’t supply “rewards.” | ||
Can’t administer urine drug screens to assess for substance use. | ||
Group therapy | My Intensive Outpatient treatment and Relapse Prevention groups don’t feel as productive using Zoom. | |
Interaction with each other is more difficult. | ||
People that were in an Intensive Outpatient Program group are now contacted 1-2 times weekly by an LCSW that may not have addictions experience of the level of experience needed. So clients are missing out a lot on the value of group therapy. | ||
No longer facilitating a group and having to contact clients individually, which has been time consuming. | ||
Therapy materials / Worksheets | Lack of client ability to access the worksheets | |
Not being able to hand the client a cognitive distortion list. | ||
Can’t share worksheets with patients | ||
Client is not able to fill out [assessment] themselves. | ||
Getting materials to patients is basically not happening due to the level of tech availability and ability. | ||
I don’t have access to the VPN from home so I have to save everything myself into a folder and remember to send to clients before/during/after appointments. | ||
Confidentiality | Privacy | Many clients have less privacy at home—may have partners/kids around |
Trauma | Some client’s [diminished] willingness to process trauma. | |
I have not been able to carry out TF-CBT properly due to not being able to meet with some of my patients via face-to-face even if it is virtual. | ||
I am uncomfortable with them on healing their trauma due to not being able to see if they are upset, being triggered, etc. | ||
Children | Engaging children in telehealth | It is difficult to teach my students over the video sessions at times depending on the subject we are discussing and distractions. |
Conducting sessions via video or telephone has created some difficulties for young clients that struggle with inattention. | ||
Younger kids often engage better face to face. | ||
Children with complex behavioral health needs | It is difficult to explain it to an adolescent, especially ones with learning disabilities/lower IQ over the phone. | |
Most of my clients are elementary school age children who need behavioral management services and substantial support. Doing this over the computer instead of face to face is not optimal. |