Consumer experiences of synchronous telepsychology within a community anxiety disorder clinic: A qualitative study

Background The provision of psychological services via telecommunication modalities, including videoconferencing, has increased in recent years, particularly subsequent to the COVID-19 pandemic. However, whilst previous research points to the efficacy and potential benefits of synchronous telepsychology in comparison to in-person therapy, the nuanced experiences and perspectives of consumers receiving psychological therapy via videoconferencing in real-world specialist public mental health services remain relatively unexplored.Aims This qualitative study aimed to explore how consumers with anxiety disorders treated at a public mental health clinic experienced psychological treatment via video-conferencing during and following the COVID-19 pandemic, with consideration of recommendations for future telepsychology implementation.Methods Semi-structured telephone interviews were conducted with 25 consumers with mixed anxiety diagnoses who received telepsychology treatment from clinical psychologists via videoconferencing at a community mental health service in Sydney, Australia. Transcribed interviews were analysed using thematic analysis.Results There was significant diversity in consumers’ opinions and experiences, with participants experiencing telepsychology as dually fostering warmth and disconnection, feeling both safer and less secure, and being at the same time accessible and anxiety-inducing. These experiences centred around four central themes: (1) Initial expectations of telepsychology, (2) Interplay with anxiety, (3) Psychological therapeutic interventions, and (4) Safety within the therapeutic context.Discussion Variation in consumer experiences potentially reflects the dialectical nature of the telepsychology experience. Participants with pre-established therapeutic relationships largely felt confident in technology and safe to exhibit emotional vulnerability during videoconferencing sessions, perceiving telepsychology to be a suitable alternative to in-person therapy. However, use of telepsychology should be individually determined, guided by the presenting psychological concerns, circumstances and consumer preferences. Consideration should also be given to potential therapy-process-related factors.