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This study developed and validated the Telepsychology Facilitators Scale (TFS), a novel measure that uses the theory of reasoned action and technology acceptance model as frameworks to assess factors that influence psychologists' openness to using telepsychology. At the beginning of the COVID-19 pandemic, an online sample of 2,619 psychologists completed initial items considered for the TFS, along with a measure assessing their actual use of telepsychology. The sample was split in half, with a preliminary exploratory factor analysis ultimately revealing a 13-item general scale with four distinct subscales (Positive Attitudes, Facilitating Infrastructure, Organizational Support, and External Policies). Higher scores on each subscale positively correlated with psychologists' percentage of patient treatment conducted with telepsychology. The exploratory factor analysis subscale structure was subsequently supported via confirmatory factory analyses of a four-factor structure and bifactor structure (tested separately) with the other half of the sample, revealing adequate model fit for both models and similar convergent validity. The TFS may help the field assess the potential barriers and drivers of telepsychology use among psychologists and be used to inform future organizational and policy efforts to increase telepsychology implementation and use across health service settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Telepsychology has the potential to help mental health service providers reach millions of people in rural areas or those limited by other factors. This study examined pre-COVID-19 deterrents reported by psychologists who did not use telepsychology. Participants were 1,400 psychologists with an average of 26.3 ( SD = 11.18) years in practice who were currently practicing within the United States but did not currently use telepsychology. All 50 states were represented as well as Washington, DC. The most commonly reported deterrents, from most to least frequent, were insufficient training, client safety/crisis concerns, privacy, legality, ethics, reimbursement, efficacy, prohibitive organizational policies/culture, and insufficient demand. Logistic regression analyses suggested that psychologists' deterrents varied based in part on demographic and practice characteristics. Psychologists practicing within medical centers or Veterans Affairs facilities were less likely to indicate safety, privacy, legal issues, ethics, and efficacy as a concern. Older psychologists were less deterred by reimbursement issues and more concerned about effectiveness. Those using cognitive-behavioral approaches were less likely to report efficacy and safety concerns. Cisgender men were less likely to be deterred by safety or privacy issues, and White psychologists were less likely to indicate safety as a deterrent. Additional telepsychology training and information for psychologists may increase its use and foster improved mental health care access for populations unable to attend in-person sessions. A more focused approach to training and implementation of telepsychology that considers the needs and concerns of the target psychologist group could benefit organizations promoting its use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).