2024 Theses Doctoral

Shifting from In-Person to Teletherapy: Client Experiences in Teletherapy during COVID-19

Ort, Daisy Cheryl

The COVID-19 pandemic prompted a widespread shift to teletherapy, a historically underutilized yet potent modality that can help increase access to mental health treatment. While numerous studies have investigated the adaptation to teletherapy from the perspective of therapists, there remains a paucity of research on client perspectives. To address this gap, the present study examined the teletherapy process and outcome from the perspective of 2,118 clients who shifted to teletherapy during the pandemic with the same therapist they had been seeing in-person pre-pandemic.

Specifically, this study investigated client-perceived changes, concerns, disclosure patterns, benefits, drawbacks, and treatment preferences in teletherapy. Findings revealed that the majority of clients reported teletherapy to be as engaging, effective, and valuable as in-person therapy, with therapeutic boundaries remaining intact. However, several factors, including positive regard, privacy concerns, and technological distractions, significantly influenced clients’ treatment engagement, effectiveness, and future treatment preferences. In addition, clients experiencing elevated distress reported teletherapy as less engaging and effective than in-person treatment. Implications for therapists and clients to optimize teletherapy, as well as directions for future research, are discussed.