Mental health clinicians’ motivation and awareness of key considerations as predictors of online therapy uses and applications

Abstract

Despite their well-documented effectiveness, online psychological interventions seem to be underperforming with the latest evidence revealing high client dropout rates. The literature indicates that online client engagement tends to improve through a sound online therapeutic alliance and interventions that are credible, reliable and of high-quality. There is little research, however, as to the specific clinician-related factors that might predict the adoption of online therapy practices and interventions that map onto the above online therapy qualities. To address this gap in the literature, the current thesis assesses statistically, whether online practicing clinicians’ awareness of key considerations in online therapy (AKCOT) and motivations are linked to the adoption of associated (outcome) online therapy uses and applications (OOTUA). It was hypothesised that clinicians’ AKCOT and motivations would predict OOTUA. Two studies were employed to this effect. Study one (n= 19, UK-based participants) developed a series of purpose-built scales measuring AKCOT and OOTUA. It also evaluated pre-existing motivational scales such as intrinsic, extrinsic motivation, perceived competence (in forming an online therapeutic alliance) and attributional style towards mental health stigma, ascertaining their usefulness in the context of the current project. Study two adopted a multiple regression analysis design where a total of 174 (138 UK-based and 36 America-based) online practicing clinicians completed an online survey. The factors of AKCOT were measured by the purpose-built scales developed in study one, assessing awareness of key consideration in online disinhibition theory, online therapy ethical considerations and training requirements. The corresponding OOTUA factors were measured on self-report scales capturing associated (to the AKCOT) online therapy applications. The motivational constructs were measured using an intrinsic motivation inventory, general causality-controlled orientation and perceived competence scales. The main findings showed that the AKCOT predictors consistently accounted for approximately 30% and the motivation predictors for approximately 10-20% of the variance in OOTUA. Discussion of the findings considers theoretical and practical implications at the professional regulatory and training level. It is proposed that professional psychological bodies update their regulations around online therapy, and counselling and psychotherapy training courses ensure that trainees are familiarised with online therapy theoretical and practical key considerations as part of their core qualifying training.