How Social Workers Can Adapt to Teletherapy

By Sarah Gaffey, LCSW

By nature, social workers are facilitators of change and transformation. Not only do they have the overall goal to positively transform patients’ well-being, but they do so by continually leveraging and adapting to their evolving and complex social systems. This past year, the pandemic spotlighted social workers’ adaptability, creativity, and flexibility as the world went under lockdown and behavioral health concerns rose. Social workers were forced to change and shift perspective practically overnight as they navigated how to best support the growing need for mental health services, while living and learning alongside patients in this novel, unknown environment.

Telehealth quickly became a crucial part of almost every health care provider’s operations, whether everyone in the industry was ready for it or not. Prior to COVID-19, there was some resistance around the idea that virtual appointments could provide the same quality of care as an in-person visit. In addition, some social workers faced difficulty finding proper telehealth training or solving other logistical issues, like ensuring the technology and devices they used were HIPAA compliant. However, even those who had previously been resistant to teletherapy pivoted to embrace this new skill set and format in order to reach the needs of their patients. Many clinicians had to quickly adapt and operate remotely, while ensuring they continued to deliver effective quality care.

This transition did not come without its challenges. Those not already accustomed to offering teletherapy needed to find proper training and learn new telehealth guidelines. Numerous aspects of care delivery had to be relearned for this modality, from assessing risk and managing safety to maintaining eye contact and honing active listening skills while speaking with a patient over phone or video. As clinicians worked from home, establishing thoughtful work-life boundaries became an even more complex issue. Almost all aspects of patients’ social systems and relationships were uprooted in some way, and clinicians were faced with maintaining a presence as a support and guide in this unknown territory while experiencing many of the same changes themselves. Fortunately, a core underlying skill of social workers is the ability to be resourceful and adapt when faced with uncertainty.

At the height of the pandemic, a study showed that more than one-half of mental health services saw an increase in demand. Telehealth has proven to be hugely impactful in helping to meet that need. While it has allowed for greater access to care, especially for patients in remote areas of the country, providers need to uphold standards of quality so this technological advancement does not sacrifice patient outcomes. Social workers who are committed to clinical best practices but who may be new to this mode of delivery can ensure consistent quality via teletherapy by following these recommendations:

Be confident that your skills and effectiveness of social work can shine through telehealth, but do not underestimate that it is different. There are different skills used in practice over the phone vs. on video vs. in-person.
Seek out comprehensive telebehavioral health training. There are techniques, protocols, and guiding principles that are unique to the modality. It is absolutely possible to be an effective social worker via telehealth, as long as you learn how.
Expand your reach through multistate licenses. Therapists are able to get multiple licenses, beyond just the state they live in, in order to meet the increasing demand for mental health care and not be limited by geography.
Remember, no matter where you are or what practice or network you work for, you’re in charge of your license. Know what regulations are in the state(s) in which you practice: keep up with your CEUs, get cross-licensed, and be aware of the responsibilities.
Don’t be on an island by yourself—know that there is support out there and find a community of like-minded social workers and supervisors to connect with and learn from.
Seek out networks and organizations that value utilization of evidence-based practices and focus on high-quality outcomes for patients.
Use the flexibility you have as a social worker and practice self-awareness. Know when things are getting to be too much and need adjustment, both personally and professionally.

The widespread adoption of teletherapy has helped break down many of the physical barriers of accessing care, along with the stigma, doubt, and logistics of getting to a therapist’s office. As this mode of delivering care persists, social workers will need to embrace evidence-based best practices and seek the support and tools they need to deliver care that drives real outcomes and improvements for struggling patients. By adhering to these practices, the field of social work can facilitate an exciting paradigm shift: Beyond simply expanding access, it can lead the way to setting high-quality standards in behavioral health.

— Sarah Gaffey, LCSW, is vice president of clinical services at AbleTo. Gaffey, who has been leading care delivery for AbleTo for more than seven years, is focused on ensuring that every AbleTo participant receives the highest quality of clinical care and makes positive, long-lasting change.