Impact of Telehealth Services on Individuals with Anxiety Disorder- A Literature Review

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Impact of Telehealth Services on Individuals with Anxiety Disorder: A Literature Review Aylin Estrada College of Humanities and Social Sciences, Grand Canyon University CNL-540: Research Methods and Program Evaluation Dr. Lucas July 19, 2023 1

Impact of Telehealth Services on Individuals with Anxiety Disorder: A Literature Review Anxiety disorders are among the most common mental health conditions, affecting a significant portion of the global population. Telehealth, defined as the remote delivery of healthcare services via technology (Mechanic et al., 2019), has gained prominence as an alternative mode of delivering mental healthcare. With the increasing prevalence of anxiety disorders and advancements in technology, telehealth has emerged as a viable mode of delivering mental healthcare. The review synthesizes existing research studies, including qualitative and quantitative approaches, to evaluate the effectiveness, accessibility, and patient satisfaction associated with telehealth interventions for anxiety. The findings highlight the potential benefits and limitations of telehealth in treating anxiety disorders and discuss the significance of qualitative and quantitative research in informing professional counseling practice. Additionally, the review explores key characteristics of effective writing and publication in counseling and psychological research. Literature Analysis Within the recent decade, mental and behavioral disorders have become the fifth most costly group of diseases in the U.S. (Langarizadeh et al., 2017). With the increase of diagnoses of mental health disorders such as anxiety, alternative methods of mental health services, such as telehealth, have become a popular information and communication system to provide convenient and flexible support to clients. A study conducted by Kotera et al., (2021) investigated the experiences of therapists who have been providing online therapy and explored the potential implications for working with clients in this digital medium. This study employed a qualitative research method to gain insight into the perspectives of therapists who have shifted from traditional face-to-face therapy to online platforms. Their findings indicated that therapists 2

reported that online therapy can be as effective as in-person therapy for anxiety clients, provided certain adaptations and strategies are employed. The study emphasizes the potential benefits of online therapy for anxiety treatment and provides insights into enhancing the therapeutic process in a virtual setting (Kotera et al., 2021). The study also outlines potential implications and challenges that therapist and clients may face while utilizing online therapy. Once potential challenge included building rapport and connection with clients. Establishing a strong therapeutic alliance and building rapport with clients was found to be slightly more challenging in the online setting compared to face-to-face therapy. Therapists discussed the need to adapt their approach to foster a sense of connection and trust with clients. A similar study examining the effects of telephone-delivered cognitive-behavioral therapy to older adults with anxiety disorders by researchers Brenes et al., (2012) also reported similar findings in regards to the effectiveness and convenience of providing telehealth mental health services to vulnerable populations. The article presents the findings of a randomized controlled trial that evaluates the effectiveness of telephone-delivered cognitive-behavioral therapy (CBT) in treating late-life anxiety disorders. Late-life anxiety disorders refer to anxiety disorders that occur in older adults, and they can significantly impact the well-being and quality of life in this population. Participants were older adults diagnosed with anxiety disorders, and they were randomly assigned to receive either telephone-delivered CBT or a waitlist control condition. The results indicated that telephone-delivered CBT led to significant reductions in anxiety symptoms compared to the control group. Moreover, improvements were maintained at the follow-up assessment. The results indicated that the effectiveness of telephone-delivered CBT is comparable to traditional in-person CBT for treating late-life anxiety disorders. This finding highlights the potential of teletherapy as an equally valid treatment modality for this population. 3

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(Brenes et al., 2012). One of the key concerns regarding telehealth services within the healthcare and mental health field is in regards to whether quality behavioral health care can be effectively delivered via telehealth and its viability as an effective medium for treatment still remains in question (Mulvaney-Day, 2022). Contributing to the relevant findings as previously outlined in the previous articles, a study conducted by Stubbings et al., (2013) presents the results of a randomized controlled trial that compares the effectiveness of in-person cognitive behavioral therapy (CBT) with videoconference-based CBT for mood and anxiety disorders. The study aimed to determine whether videoconference-based therapy could yield similar outcomes to traditional in-person therapy for individuals experiencing mood and anxiety disorders. Participants were randomly assigned to either in-person or videoconference-based CBT. The study found that both modalities were equally effective in reducing symptoms of anxiety and depression, with no significant differences between the two groups. Videoconference-based CBT demonstrated high patient satisfaction rates and enhanced treatment accessibility. The findings support the feasibility and efficacy of delivering CBT for mood and anxiety disorders through videoconferencing platforms (Stubbings et al., 2013). Discussion The reviewed articles collectively highlight the potential benefits of online therapy for individuals with anxiety disorders. The qualitative investigation reveals that online therapy can be convenient and effective, but it requires special attention to building a strong therapeutic alliance and addressing technological challenges. The randomized controlled trials provide empirical evidence that telephone-delivered CBT and videoconference-based CBT are both effective in reducing anxiety symptoms, emphasizing the importance of telehealth interventions 4

in expanding treatment accessibility. The combination of qualitative and quantitative research offers a comprehensive understanding of online therapy for anxiety. Qualitative investigations uncover the nuances and subjective experiences of therapists, enhancing counseling practice by providing insights into optimizing the therapeutic process. On the other hand, randomized controlled trials provide empirical evidence of treatment effectiveness, informing evidence-based decision-making in professional counseling practice. Effective writing and publication in counseling and psychological research demand clarity, rigor, and relevance. The articles reviewed demonstrated clarity in their research questions, methodologies, and results presentation. Rigor was evident through randomized controlled trial designs, appropriate sampling, and data analysis techniques. Lastly, relevance was maintained within these articles by addressing important clinical questions and contributing to the field's knowledge on anxiety treatment modalities . Conclusion Online therapy, including telephone-delivered and videoconference-based cognitive behavioral therapy, shows promise in effectively treating anxiety disorders. Qualitative and quantitative research provides valuable insights into therapists' experiences and empirical evidence of treatment effectiveness. By combining both qualitative and quantitative approaches, counseling professionals can gain a comprehensive understanding of online therapy's implications and enhance their practices to better serve clients with anxiety disorders. 5

References Brenes, G. A., Miller, M. E., Williamson, J. D., McCall, W. V., Knudson, M., & Stanley, M. A. (2012). A randomized controlled trial of telephone-delivered cognitive-behavioral therapy for late-life anxiety disorders. The American Journal of Geriatric Psychiatry , 20 (8), 707– 716. https://doi.org/10.1097/jgp.0b013e31822ccd3e Kotera, Y., Kaluzeviciute, G., Lloyd, C., Edwards, A.-M., & Ozaki, A. (2021). Qualitative investigation into therapists’ experiences of online therapy: Implications for working clients. International Journal of Environmental Research and Public Health , 18 (19), 10295. https://doi.org/10.3390/ijerph181910295 Langarizadeh, M., Tabatabaei, M., Tavakol, K., Naghipour, M., & Moghbeli, F. (2017). Telemental health care, an effective alternative to conventional mental care: A systematic review. Acta Informatica Medica , 25 (4), 240. https://doi.org/10.5455/aim.2017.25.240- 246 Mechanic, O. J., & Kimball, A. B. (2019, April 5). Telehealth systems . Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459384/ Mulvaney-Day, N., Dean, D., Miller, K., & Camacho-Cook, J. (2022). Trends in use of telehealth for behavioral health care during the COVID-19 pandemic: Considerations for payers and employers. American Journal of Health Promotion , 36 (7), 1237–1241. https://doi.org/10.1177/08901171221112488e Stubbings, D. R., Rees, C. S., Roberts, L. D., & Kane, R. T. (2013). Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: 6

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