Addiction and Mental Health Clinicians’ Attitudes Toward Telepsychology: Predicting Post-Pandemic Telepsychology Uptake (Preprint)

BACKGROUND The COVID-19 pandemic has resulted an unprecedented uptake of telepsychology services; however, clinicians are mixed in their attitudes toward virtual technologies. OBJECTIVE This study explored clinician attitudes towards video, telephone, and in-person services and tested the utility of the unified theory of acceptance and use of technology (UTAUT) to predict clinician intention to offer telepsychology post-pandemic. METHODS Clinician satisfaction and therapeutic alliance were compared across in-person, video, and telephone while ease of communication, technology attitudes, and intention to use post-pandemic were compared across video and telephone services in 118 addiction and mental health clinicians during the COVID-19 pandemic. RESULTS Clinicians reported more positive attitudes toward in-person services than both virtual technologies, and more positive attitudes towards video- than telephone-based services across measures (P < .001). Based on the UTAUT, performance expectancy positively predicted concurrent intention to use video (β = 0.46, P < .001) and telephone (β = 0.35, P < .001) services in future practice. Social influence (β = 0.24, P = .004) and facilitating conditions (β = 0.19, P = .028) additionally predicted intention to use telephone. CONCLUSIONS Clinicians have more positive attitudes towards in-person than virtual technologies, with video perceived more positively than telephone; performance expectancy is a primary facilitator to uptake of both virtual modalities. Recommendations and limitations are discussed.

Digital Technology In Psychiatry: Expectations, Barriers And Understanding Of Clinicians (Preprint)

BACKGROUND Digital technology has the potential to transform psychiatry, but adoption has been limited. The proliferation of telepsychiatry during COVID increases urgency of optimizing technology for clinical practice. Understanding clinician attitudes and preferences is crucial to effective implementation and patient benefit. OBJECTIVE Our objective was to elicit clinician perspectives on emerging digital technology. METHODS Clinicians in a large psychiatry department (inpatient and outpatient) were invited to complete an online survey about their attitudes towards digital technology in practice, focusing on implementation, clinical benefits, and expectations about patients’ attitudes. The survey consisted of 23 questions that could be answered on either a 3-point or 5-point Likert scale. We report frequencies and percentages of responses. RESULTS 139 clinicians completed the survey. They represented a variety of years-experience, credentials and diagnostic sub-specialties (response rate of 69.5%). Eighty-three percent (n=116) stated that digital data could improve their practice. Twenty-three percent of responders reported that they had viewed patients’ profiles on social media (n=32). Among anticipated benefits, clinicians rated symptom self-tracking (n=101, 72.7%) as well as clinical intervention support (n=90, 64.7%) as most promising. Among anticipated challenges, clinicians mostly expressed concerns over greater time demand (n=123, 88.5%) and whether digital data would be actionable (n=107, 77%). Ninety-five percent (n=132) of clinicians expected their patients to share digital data. CONCLUSIONS Overall, clinicians reported a positive attitude toward the use of digital data to improve patient outcomes but also highlight significant barriers that implementation need to overcome. Although clinicians’ self-reported attitudes about digital technology may not necessarily translate into behavior, results suggest that technologies that reduce clinician burden and are easily interpretable have the greatest likelihood of uptake.

1408 Virtual Phone Call or Video Consultations: Patient and Clinician Preference During Covid-19

Aim In response to COVID-19 and social distancing guidelines, healthcare services have evolved. Telehealth is part of this change and many services introduced virtual telephone clinics. The HSE recently approved a video conferencing tool, ‘Attend Anywhere’, however this is not widely used at present. We have received positive feedback from patients, but only a few studies provide information on overall satisfaction of virtual consultations. We aim to validate this by assessing preferences towards virtual telephone and video consultations. Method 50 patients from the breast care clinic were included. Patients excluded were any new symptomatic patients or those with any incapacity. Questionnaires with Likert scales were used to assess patient and clinician attitudes towards ‘phone’ (PC) or ‘video’ consultations (VC). Results The majority of patients (64%) requested a PC rather than a VC (36%). More patients used technology regularly in the VC group (88%) than the PC group (69%), and 94% of VC patients had experience with video calls (47% PC). VC patients felt safe using ‘Attend Anywhere’(94%), said it was ‘more personal’ than a phone call (72%) but preferred face-to-face for future consultations as they ‘liked the reassurance of a physical exam’(78% VC; 59% PC). All clinicians felt the lack of examination in virtual clinics impacts the doctor-patient relationship and would prefer face-to-face consultations where possible. Conclusions Our findings demonstrate a positive patient and clinician attitude to virtual clinics, however face-to-face appointments are preferred by both groups. We will repeat this survey following COVID-19 restrictions to determine if attitudes have changed.

Changes in community clinicians’ attitudes and competence following a transdiagnostic Cognitive Behavioral Therapy training

Background: Although the literature suggests that attitudes toward evidence-based practices (EBPs) are associated with provider use of EBPs, less is known about the association between attitudes and how competently EBPs are delivered. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Methods: Community clinicians ( N = 891) received intensive training in cognitive behavioral therapy skills followed by 6 months of consultation. Clinician attitudes were assessed using the Evidence-Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data were analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase). Results: Latent change models identified significant improvement in attitudes ( Mslatent change ⩾ 1.07, SEs ⩽ 0.19, zs ⩾ 6.85, ps < .001) and competence ( Mslatent change ⩾ 13.13, SEs ⩽ 3.53, zs ⩾ 2.30, ps < .001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training ( bs ⩾ 1.58, SEs ⩽ 1.13, z ⩾ 1.89, p < .048, β ⩾ .09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase ( b = 1.40, SE = 1.07, z = 1.31, p = .19, β = .08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Conclusions: Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training. Following participation in initial training workshops, other factors such as subjective norms, implementation culture, or system-level policy shifts may be more predictive of change in competence throughout consultation. Plain Language Summary Although previous research has suggested that a learner’s knowledge of evidence-based practices (EBPs) and their attitudes toward EBPs may be related, little is known about the association between a learner’s attitudes and their competence in delivering EBPs. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following training in an EBP. This study suggests that community clinicians’ initial attitudes about evidence-based mental health practices are related to how well they ultimately learn to deliver those practices. This finding suggests that future implementation efforts may benefit from directly targeting clinician attitudes prior to training, rather than relying on more broad-based training strategies.