Are Therapists Less Skilful in Teletherapy Than In-Person Therapy Scenarios? A Latent Profile Analysis of Facilitative Interpersonal Skills

Abstract

Emerging research suggests that therapists feel less efficacious administering therapy remotely than in-person. These findings, however, are based almost exclusively on therapist self-reports. The current study compared therapists' self-reported and observer-rated therapeutic skills across simulated in-person and teletherapy scenarios to determine if common factors and therapeutic skills differed between the two treatment settings. A diverse sample of 223 licensed therapists and trainees simulated the provision of psychotherapy using standardised clips of challenging therapeutic scenarios in both tele- and in-person therapy. Common factors and therapeutic skills in tele- and in-person therapy simulations were rated by trained coders and compared. Latent profile analysis identified latent subgroups of therapists based on differences between skills when providing in-person and teletherapy. Both self-report and observer-rated measures indicated that therapists demonstrated reduced common factors and therapeutic skills in teletherapy scenarios than in-person therapy scenarios. Three latent profiles based on differences in skills between teletherapy versus in-person therapy among therapists were identified: developing teletherapists (54.26%), teletherapy experts (34.98%) and teletherapy-challenged therapists (10.76%). No variable assessed in the study differentiated the three groups. Therapists generally demonstrated lower levels of therapeutic skills in teletherapy compared with in-person therapy settings. Considerable variability in the skill difference between the two psychotherapy formats was found among therapists. Trainings targeting skills that are complicated by teletherapy (e.g., emotional expression) are needed.