Fears and challenges of dialectical behavior therapists using telehealth

Abstract

Despite the effectiveness and safety of telehealth, many clinicians are hesitant to deliver Dialectical Behavior Therapy (DBT) remotely to high-risk clients. However, the COVID-19 pandemic resulted in a rapid shift to telehealth services, pushing patients and providers to adapt to therapy in an online format. Only a few studies have assessed providers’ attitudes about the transition of DBT to telemedicine during COVID-19, identifying both challenges and advantages. Using an online self-report survey, the current study assessed DBT therapists’ experiences with telehealth use for DBT implementation, with an emphasis on clinicians’ fear of treating suicidal patients (N = 99). Despite endorsing some challenges with telehealth, almost all therapists reported they will continue implementing some DBT via telehealth post-COVID, highlighting both clinicians’ perceived benefits and challenges of telehealth. Fear of treating suicidal patients was associated with higher perceived telehealth challenges and higher reported future telehealth use. Several other descriptive patterns are discussed. This study provides important preliminary findings about DBT therapists’ telehealth practices and experiences, suggesting future directions for research and practice. The transition to telehealth offers a long-term opportunity for clinicians to leverage technology in the delivery of DBT to increase access and improve mental health.