A Head Start in the Long Race: Therapists Are Learning to Adapt Their Therapeutic Skills Within Teletherapy.

During the rapid shift to teletherapy at the start of the COVID-19 pandemic, psychotherapists encountered numerous challenges and reported lower levels of skills in teletherapy compared to in-person therapy. This study aimed to (a) examine psychotherapists' self-rated skills in teletherapy compared to in-person therapy and whether the discrepancy between the two psychotherapy formats has changed since the pandemic and (b) assess psychotherapists' perception of their and their colleagues' compliance with teletherapy guidelines. Using a repeated cross-sectional design, we collected data from two independent national samples of therapists and trainees at two different time points: Spring 2020 (early pandemic; N = 440) and in Summer 2021 (mid-pandemic; N = 345). Although psychotherapists' self-reported skills in teletherapy were significantly lower than those in in-person therapy both during early- and mid-pandemic, the relative differences between the two psychotherapy formats decreased in 2021. Nearly two thirds of the sample (65.22%) self-reported compliance with all teletherapy guidelines (cross-state line practice, informed consent, proper tools, data release, and data storage). Psychotherapists, who were older, were nonstudents, had more years of clinical experience, and worked in private practice were more likely to fail to comply with the teletherapy guidelines. These findings suggest that although psychotherapists' self-reported skills in teletherapy improved over time during the pandemic, the perceived differences between teletherapy and in-person therapy remained. The necessary practice of teletherapy during the pandemic may have allowed familiarity and adaptation of their therapeutic skills. However, intensive and specialized training is needed for psychotherapists to provide teletherapy ethically and effectively. Public Significance Statement: By comparing two independent samples of psychotherapists in Spring 2020 and Summer 2021, this study found that psychotherapists were learning to adapt their therapeutic skills in remote settings. However, psychotherapists continued to report lower levels of skills in teletherapy versus in-person therapy in 2021, albeit to a lesser degree, suggesting that there remains a long race ahead toward full competence in teletherapy. Specialized, intensive, and hands-on training that focuses on skills, techniques, and difficult situations related to teletherapy is urgently needed. [ABSTRACT FROM AUTHOR]