Acceptability and Utility of Telehealth Group Services for Youth Problematic Sexual Behaviors in Rural Communities: Caregiver, Youth, and Clinician Insights

Use of telehealth for behavioral health services has rapidly expanded with potential to reduce rural health disparities. Applying evidence-based treatments for problematic sexual behavior (PSB) among youth via telehealth can prevent further sexual harm of children. Successful implementation of telehealth in rural communities requires examining the acceptability, understanding, barriers, and facilitators of the approach. Using a qualitative approach, this study explores family and clinician perception of the utility of telehealth to enhance access to PSB cognitive behavioral group treatment (PSB-CBT) services. Results revealed telehealth provided opportunities to address internal (e.g., shame, stigma) and external barriers (e.g., time, transportation, childcare), as well as impact of unique rural communities' characteristics. Privacy, safety, reduced isolation and shame, and enhanced sense of community among members were noted as benefits of group telehealth, while technology literacy, device accessibility, and group appropriateness were reported obstacles. Strategies to enhance success included telehealth orientation, loaning secure devices, integrated therapeutic activities, focused efforts on building relationships among members, and augmenting with family sessions. Future research on implementation and treatment outcomes of group telehealth for PSB is recommended.