Spanish-Speaking Therapists Increasingly Switch to Telepsychology During COVID-19: Networked Virtual Reality May Be Next

Abstract

Background: Social distancing restrictions imposed due to the Novel Coronavirus 2019 (COVID-19) pandemic resulted in a rapid shift in the delivery of psychological interventions from in-person to telehealth. Much of the research on this transition has been conducted with English-speaking mental health providers, leaving a gap in understanding related to how this shift has impacted Spanish-speaking treatment providers. Methods: Fifty non-U.S. Spanish-speaking therapists completed a survey related to their use of telecommunication modalities; client population characteristics; professional, ethical, and legal/regulatory issues; and telehealth training and practice. Participants completed the survey at one time point and retrospectively described their use of telehealth both pre-pandemic and during the pandemic. Results: Most of the 50 Spanish-speaking therapists surveyed reported using telepsychology 58% before COVID-19 versus 84% during the COVID-19 pandemic (χ² = 5.76, p < 0.05). Compared with pre-pandemic, the number of hours therapists spent using telepsychology per week increased significantly for early adopter therapists (those who began using telehealth before the pandemic began) (Z = -3.18, p = 0.001) and also for late adopter therapists who only began using telehealth during the pandemic (Z = -3.74, p < 0.001). Many therapists reported equity issues. Most participants also reported ethical and regulatory concerns regarding security/confidentiality or Health Insurance Porability and Accountability Act. Conclusions: The rapid adoption of technology to deliver therapy during COVID-19 has spurred growing pains for Spanish-speaking therapists and their underserved clients, and more research is needed to better understand and improve the therapists' adoption of these technologies with diverse patient populations.

Keywords: COVID-19; Spanish-speaking therapists; telehealth; telepsychology; underserved; virtual reality.

Fig. 1.

Percent increase in telepsychology during pandemic (for early adopter therapists).

Fig. 2.

Percent increase in telepsychology during pandemic (for late adopter therapists).

Fig. 3.

The most frequent modes of telecommunication used during teletherapy (for early adopters).

Fig. 4.

The most frequent modes of telecommunication used during teletherapy (for late adopters).

Fig. 5.

Number of hours per week the therapist used telepsychology.

Fig. 6.

Wilcoxon signed-rank paired comparisons of therapists' comfort, confidence, burnout, and use of mindfulness, and percentage of therapists using telepsychology before versus during the pandemic.

Fig. 7.

Mindfulness RiverWorld, image by bigenvironments.com, copyright Hunter Hoffman, www.vrpain.com