Telehealth and Systemic Family Therapy: Pilot Study Assessing Consumer Experience

Background

In 2017 AAMFT assigned a CEO Workgroup to develop online therapy best practices (see the Request for Proposal, Appendix A). These Best Practices have been downloaded over 6,000 times since posting. Further, AAMFT has been informed that various state regulatory boards have consulted with these guidelines in making temporary telehealth provisions during the COVID-19 pandemic. 

 

As many state legislatures had difficulty convening, staff saw most state COVID-19 responses come from state governors or governmental agencies. Stay-at-home orders and social distancing recommendations forced many MFTs and MFTs in training to move to telehealth in order to continue seeing clients or accumulating required experience hours under supervision. The switch to telehealth revealed many emergent barriers to practice for MFTs, including extensive pre-required courses on telehealth, mandatory face-to-face hours, restrictions on supervision performed through telehealth, and others. MFTs also saw barriers to insurance reimbursement for telehealth, in which many large insurance providers did not reimburse telehealth at the same rate as an in-person visit or reimburse telehealth visits at all.

 

Numerous challenges were encountered with MFTs providing telehealth services. Some examples include:

 
    • In Alabama where MFTs were required to take 15-hoursof telehealth training, with an additional nine hours required for supervisors that wanted to practice tele-supervision. The tele-supervision requirement was especially restrictive, as only two MFTs in thestate had taken that additional training. AAMFT staff coordinated advocacy efforts with the Alabama Association for Marriage and Family Therapy (ALAMFT), and submitted letters (see the ALAMFT letter ) advocating for the waiving of these requirements. AAMFT staff and the Alabama Network leaders attended an emergency licensing board meeting, where these requirements were waived.
    • In Connecticut, AAMFT worked with the Connecticut Association for Marriage and Family Therapy (CTAMFT) leadership, and hired a lobbyist, to address a variety of issues facing MFTs, including continuing education requirements for license renewal, insurance reimbursement for telehealth, and MFT associates’ ability to practice telehealth. Staff worked with the CTAMFT Chair to submit a letter to Governor Lamont outlining these challenges. An executive order was signed that relaxed continuing education requirements for renewal for certain renewal dates. Staff worked with the CTAMFT Chair to submit a letter  to Connecticut’s Insurance Commissioner regarding slow reimbursement processing.
    • In Kansas, the Family TEAM Leader advocated for telehealth and tele-supervision hours to count towards the required experience hours for the Licensed Clinical Marriage and Family Therapist requirements. This effort was successful.

 

Despite these challenges and barriers to implementation, numerous advantages exist with telehealth:

 
    • Access to services;
    • Alleviates pressure on mental health shortage areas;
    • Rural areas may have increased access; and
    • Those who may have a stigma about going to an office can receive services in the privacy of their home.

 

Scope of Study

The focus of this pilot study is on the consumer, and potential consumer experience and perceptions about telehealth family therapy services. The AAMFT Research and Education Foundation will provide seed money for a pilot study focused on perceptions and experiences of consumers regarding telehealth services. Such a study should satisfy the following:

 
    1. Contribute to society in a healthy and productive manner.
    2. Include a comprehensive focus on perceptions and experiences toward telehealth so that further research can be generated to enhance positive outcome areas as well as solving identified barriers.
    3. The study should be mindful that the outcomes/results should help advance research in this area AND assist the practice and profession of systemic family therapy in key advocacy areas such as increasing access to mental health care.
    4. The study should generate key information that will allow for future funding partnerships including with other foundations or Federal funding agencies so that continued work can occur.

Read the Request for Proposal here
View the Proposal Template here


 *If this is a project that interests you, please consider making a donation to the AAMFT Research and Education Foundation, so that we can continue to support these projects and programs to assist with the advancement of systemic marriage and family therapy!   


 




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