Clinical Social Workers, Telemental Health and the COVID-19 Pandemic

As a result of the COVID-19 Pandemic, and due to the shelter in place order that most states required, licensed clinical social workers (CSW’s) were forced to switch from in person services to telemental health services almost overnight. Many did so without previous training, adequate technology, a confidential office, or professional support. While there is a growing body of research regarding the increased use of telemental health in the mental health field during COVID-19, there is minimal research which narrows in what it was like for the CSW’s who made this transition. The purpose of this study was to better understand the lived experience of CSW’s who transitioned to provide telemental health services during the national shelter in place order as a response to the global COVID-19 pandemic, and how this impacted them professionally and personally. A qualitative, phenomenological mode of inquiry was used, and data analysis was guided by an adaptation of Moustakas’ transcendental phenomenological method. Ten CSW’s were interviewed for this study between April 2023 and August of 2023 through Zoom. The interviews were transcribed verbatim, and the data were coded, analyzed, and organized into themes and subthemes. A textural and a structural description, and a composite textural-structural for each CSW interviewed were completed. Six themes emerged from the interviews with eleven subthemes. The themes are 1) the transition to telemental health, 2) professional insecurity, 3) working from home works, 4) the shared reality is harder, 5) self-care is a priority, 6) it is going to be ok. The subthemes are a) challenges, b) guidance on best practices for telemental health, c) insurance reimbursement, d) protection from COVID-19, e) more free time in the day, f) flexible work schedule, g) telemental health is preferred for some clients, h) fear of the unknown, i) amplified mental health problem, j) empathetic connections and disconnections, and k) connections. Finding suggest that CSW’s transitioned quickly to telemental health care and found they were able to provide effective therapy services for their clients, even though they initially struggled with feelings of professional insecurity due to lack of experience or training. The CSW's interviewed for this study discovered that there were many benefits to working from home. Additionally, they experienced emotional and mental hardship due to the shared reality of living through the pandemic while simultaneously providing therapeutic care for their clients. Through the efforts of regular self-care, the CSW's were able to mitigate the effects of compassion fatigue and burnout. Implications for future research in social work practice and education will be discussed, as well as suggestions for future research topics.