Telepractice research

The future of telepractice

To better understand how practitioners can support families via telepractice services, we looked at the main findings from two research studies we conducted.

In one study we built expert consensus on best practice in telepractice. In the another, we examined parent experiences with telepractice.

Here, we summarise what we found.

Strong endorsement overall was found for practices that facilitate and support practitioners and clients in their access to, training in, and use of technology

We asked 17 experts from Australia and the USA to be part of a panel. The experts were academics, researchers, practitioners, service managers and policy specialists and all specialised in telepractice in the family services sector, health and allied health sectors, or in supporting vulnerable families in a telepractice context.

The expert panel reached consensus on 119 practices and conditions seen to be essential and/or feasible in the application of telepractice to deliver support services to families experiencing vulnerability.

There was a focus on equitable access, privacy, security and safety concerns as well as appropriate organisational support for practitioners.

Expert feedback

When planning and conducting telepractice services, the expert panel agreed it is important for agencies to consider the following:

A blend of in-person and telepractice modes are widely endorsed, dependent on type of service and the needs and preferences of practitioner and client
Interaction between practitioner and client should adopt synchronous and asynchronous methods of telepractice, including monitoring of engagement in web-based home activities, the use of email to share information, and the use of text-messaging to send agreed goals and actions to the client.

We asked the expert panel what areas are essential to telepractice service delivery:

100%

Agree it is essential that service delivery providers develop an organisational strategy to address common barriers to telepractice

100%

Agree it is essential to have a plan for contacting each other if the session ‘drops out’ or either party encounters technical issues

100%

Consider it essential that service providers check any specific language requirements/interpreter needs and how these will be addressed

92%

Believe that practitioners should ask parents/carers who else is at home when on video and/or audio, and if the conversation could be overheard or intruded upon

90%

Agree it is essential that the practitioner can be flexible with times for contact

85%

Agree it is essential that parents/carers are coached via videoconferencing when relevant (e.g. parent/carer roleplays skills via video)

Parental point of view

We consulted with 20 parents to explore their experiences of telepractice when receiving family support services.

We wanted to gain a broad understanding of the aspects of telepractice that are acceptable and useful in meeting families’ needs, and to explore some of the barriers and facilitators to engagement with telepractice with a view to expanding on these early findings in the Parenting Today in Victoria survey in 2022.

Overall, telepractice is well received by parents in terms of satisfaction, usefulness, likeability and helpfulness.

Telepractice acceptance may be impacted by type of service, being less acceptable where physical assessments about their child’s functioning and development are required, or in services where social interaction may be a primary purpose, such as playgroups.

Parents have expressed that telepractice may be more acceptable if privacy is strengthened and there is adequate support using and accessing technology, with resources and guidance on suitable home set-up for telepractice participation.

Family characteristics may also impact telepractice acceptance, for example some children may be easily distracted or find it difficult to maintain attention and engagement in online consultations.

For many families however, telepractice is acceptable and meets their needs. Factors that facilitate telepractice acceptance include its convenience and the reduced travel and costs, as well as having technology and resources readily available.

Feedback from parents about telepractice experiences tell us that parental acceptance of telepractice can be influenced by certain elements

Positive elements

Convenience was the most helpful and valued aspect of telepractice
Technology (access to internet and technology, and previous experience and confidence in using technology) supported parental participation in telepractice
Forming positive relationships and connections with service providers enhanced acceptance
The capacity for telepractice to maintain continuity of care.

Negative elements

Relationships were the most reported barriers to telepractice
Difficulty establishing a rapport with the service provider and difficulty engaging children in online sessions
Lack of any physical assessment component (e.g. of the child’s development)
Having children present at home and the lack of a private space to discuss confidential issues with the service provider
Access to technology.

Reasons for how and why telepractice services did or did not meet parent needs

Positive reasons

No travel time
Saving money
Less stressful not having to take their child out for a short appointment.

Negative reasons

Some assessments are not possible via telepractice
Quality of service impacted by decreased ability for people to relate over the videocall
[When participating in group programs it is] very impersonal having so many people on one videoconference
[Child] engagement in therapy is more difficult to manage
Had to attend child’s counselling session with them so may not be as effective
Unable to find a private space to take part in the session.

Conclusions and implications

The research studies summarised here present information about acceptable ways of interacting with families using telepractice. These insights help fill gaps in knowledge about the best ways to provide parenting support via telepractice, especially as we adjust to a post-COVID reality of increased reliance on telepractice in family support.

The family services sector could seek to improve parent acceptance of telepractice by addressing barriers associated with privacy concerns and use of technology, including by providing technological resources and guidance to parents on suitable home set-up for telepractice participation.

Our findings suggest that telepractice is well-received by parents in terms of satisfaction, usefulness, likeability and helpfulness, however, the type of service being delivered may be a key determinant of parent telepractice acceptance.

In some services, parents prefer the service provider to make physical assessments about their child’s functioning and development in an in-person setting. Parents also view some services (e.g. playgroups) as less conducive to telepractice, where social interaction is perceived as more effective in person.

Factors identified as key to the acceptance of telepractice include its convenience and the reduced travel and costs for families associated with this delivery mode, as well as having technology and resources readily available.

Many parents also indicated a preference for a blended model of care, including options to choose their mode of service delivery, or a combination of telepractice and in-person services.

Practices that facilitate and support practitioners and clients in their access to, training in, and use of technology, were widely endorsed.

There was also a focus on equitable access, privacy, security and safety concerns as well as appropriate organisational support for practitioners.

Another area of strong consensus was the use and implementation of synchronous and asynchronous services as a hybrid model of delivery, and that websites, videos and online activities be embedded within the session or made available as additional home-based strategies.

Methods to support engagement and access to telepractice services for culturally and linguistically diverse communities also found wide consensus.

These findings show that parents would like options for accessing family services via both telepractice and in-person delivery, and that these preferences are dependent on service type, but also on convenience and increasing familiarity with computer-assisted communication.

This has implications for designing and implementing family support services via a blended model of telepractice and in-person care.

Funded by the Victorian Government.

We would like to thank the experts who participated in the Delphi study for their time and for sharing their expertise. A special thanks to the parents who shared their experiences of telepractice, and to the service providers who helped share information about this study with families.

The future of telepractice

Strong endorsement overall was found for practices that facilitate and support practitioners and clients in their access to, training in, and use of technology

Expert feedback

Adapt program/session design to suit practitioner and client

Adapt the service to telepractice

Ensure client is prepared for telepractice

Technology is used to supplement the session when relevant

Protect privacy

Resources are available to practitioners

We asked the expert panel what areas are essential to telepractice service delivery:

100%

100%

100%

92%

90%

85%

Parental point of view

Summary of results

Parent feedback

Suggestions for improving telepractice

Feedback from parents about telepractice experiences tell us that parental acceptance of telepractice can be influenced by certain elements

Positive elements

Negative elements

Reasons for how and why telepractice services did or did not meet parent needs

Positive reasons

Negative reasons

Conclusions and implications

Parent study

Expert study

Implications

More information

Funded by the Victorian Government.

We would like to thank the experts who participated in the Delphi study for their time and for sharing their expertise. A special thanks to the parents who shared their experiences of telepractice, and to the service providers who helped share information about this study with families.

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