To video, call, or text?: an experimental test of therapists' evaluations of telepsychology modalities

Telepsychology has experienced a rapid increase in utilization amongst COVID-19 allowing therapists to continue provision of high-quality psychological services to meet client needs. Previous research has established the effectiveness of telepsychology. However, little research has focused on understanding therapist preferential biases in the use of telepsychology modalities, particularly video, telephone, and text-based services. There is also limited research on how evidence-based therapeutic processes, strong predictors of treatment outcomes, such as working alliance, empathy, and session quality differ across modalities. This study uses an experimental design to test therapist preferential biases by examining how therapist ratings of therapeutic processes differ across three synchronous telepsychology modalities. Specifically, therapist participants were randomly presented with an excerpt of a mock therapy session conducted via video, telephone, or real-time SMS text-messaging and asked to rate the session on working alliance, empathy, and session quality. Contrary to our hypotheses, therapists rated these therapeutic processes similarly regardless of telepsychology modality. Analyses also found that these results did not change based on therapist telepsychology experience. Given the rapid adoption of telepsychology these results may have important counseling implications.