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The purpose of this study is to qualitatively explore the views and opinions of service users accessing remote therapy through a community forensic personality disorder service during the COVID-19 pandemic.

A qualitative exploratory approach was adopted. Nine community forensic service users accessing virtual/telephone therapy through a community forensic mental health service were interviewed using semi-structed interviews. Data was analysed using Braun and Clarke (2006) thematic analysis techniques.

Analysis resulted in three overall themes: experience of communication in the therapeutic relationship; impacts of the change to remote working and making the best of what we have. A further seven subthemes were developed. A range of advantages and disadvantages to remote therapy were highlighted.

This study was based on a small sample of service users accessing one community forensic service in England, and therefore caution should be taken when generalising the findings. All interviews were conducted remotely and thus may have only supported those who are able to engage in this way.

This paper has the potential to inform future remote therapy guidelines. Health services should consider keeping some elements of remote working and offering this as a choice to all service users.

This study is, to the best of the authors’ knowledge, the first study that attempts to explore the experiences of individuals accessing remote therapy within a forensic population who have personality disorders or traits.

The novel coronavirus and associated restrictions have resulted in mental health services across the UK having to adapt how they deliver psychological assessments and interventions. The purpose of this paper is to explore the accessibility and prospective acceptability of providing telephone and videoconference-mediated psychological interventions in individuals with intellectual disabilities.

As part of a service evaluation, a mixed-methods questionnaire was developed and completed by clients who had been referred for psychological therapy at an adult intellectual disabilities’ community health service in the north of England. All clients were assessed using the Red/Amber/Green (RAG) system by a consultant clinical psychologist for risk and potential suitability for indirect service delivery given their ability and needs.

Overall, 22 clients were invited to take part, of which, only seven (32%) were accepting of telephone or videoconference-mediated psychological therapy. Most of the clients were unable to engage in video-conference therapy and therefore, only suitable for phone therapy. This paper presents the remaining findings and discusses the clinical implications and unique considerations for intellectual disability services drawing on the existing literature.

This is the first paper that the authors are aware of, examining videoconference-mediated psychological therapy in this population. It is hoped the data will be used to help inform practice or policy when using such therapeutic approaches in adults with an intellectual disability.

Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID).

As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure.

Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy.

To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways.

Primary care psychological interventions for people with common mental health problems in England are primarily delivered through Improving Access to Psychological Therapies (IAPT) services. People with learning disabilities within IAPT have poorer key clinical outcomes than people who do not identify as having a learning disability. During the global COVID-19 pandemic remote consultations have accounted for nearly 90% of all contacts in IAPT services; this paper aims to report the effects of these on outcomes for people with learning disabilities.

Publicly available national data from the COVID-affected period are compared to the most recent available comparison periods that are not during the COVID pandemic. Data are presented graphically.

People with learning disabilities differ little from those with no disabilities on several key process and outcome variables, although their clinical recovery is very much lower than those without disabilities. People with learning disabilities appear to have been affected by the changes in service delivery in a similar way to those without learning disabilities.

Despite the shift to predominantly remote therapy delivery, outcomes for people with learning disabilities have not been differentially affected compared to those who have no recorded disability. The potential to learn what has worked and not worked in the delivery of remote interventions for people with learning disabilities is highlighted.

The purpose of this paper was to explore the well-being and experiences of working from home (WFH) for psychology staff across a range of specialties working within one health board in Scotland during the COVID-19 pandemic.

In total, 161 clinical psychology professionals took part in an online survey that explored experiences of WFH during the COVID-19 pandemic and assessed well-being during this period.

A number of challenges with WFH were identified, including challenges with carrying out clinical work (e.g. communication difficulties, risk assessment) and fewer opportunities for collaborative working and technical/equipment issues. During the WFH period, 46% experienced fatigue, 45% felt stressed and anxious and 30% felt lonely and isolated, compared to normal. Physical health complaints were also common with 37% experiencing aches/pains in back compared to normal and 40% experiencing headaches or migraines.

Remote therapy should be directed to those with less complex needs or who require straightforward assessments. There should be increased access to occupational health assessments and provision of ergonomic furniture when WFH, and all staff should be supported to access well-being resources available within the health board. Further evaluation should be carried out to support evidence-based practice of remote clinical work.

Few studies have explored the experiences of WFH and/or remotely from the perspectives of clinical psychologists in a Scottish health board. It is expected that this way of working will continue, albeit to a smaller extent; therefore, WFH policy will be informed by the findings.

Measures introduced to mitigate the spread of coronavirus-19 (COVID-19) may have contributed to an increase in waiting times for face-to-face psychological treatments. As adults with intellectual disabilities (ID) are more likely to encounter barriers when accessing remote therapies, it is important they receive appropriate support while waiting. To understand what care is needed, this service evaluation [aimed to] explored the experiences of service users with ID who have waited for treatment during the pandemic.

Seven individuals who had been waiting for psychological therapy during the COVID-19 pandemic, which included those waiting longer than the national health service target of 18 weeks, were interviewed. Data were analysed using framework analysis.

The following four key themes were identified: waiting has been “painful”, related to how service users continued to experience difficulties whilst they waited; tolerating the wait, highlighted that individuals understood the reasons for waiting; use of coping strategies where service users identified both internal and external strategies they had used to cope; and support and contact from the learning disability team, related to how individuals experienced the support they received from the service.

To the best of the authors’ knowledge, this service evaluation is the first to explore the experiences of service users with ID waiting for psychological therapy during the Covid-19 pandemic. Results guide suggestions on improving support whilst they are waiting to help prevent further decline.

Many mental health clinicians have delivered services digitally in response to the COVID-19 pandemic. Emerging research suggests that, despite some initial discomfort, therapists appear to adjust to remote working. The purpose of this study is to explore the views of clinicians working within a fully digital organisation towards digital service provision.

Clinicians (N = 52) providing digital mental health assessments and treatments at Healios anonymously completed a mixed-methods questionnaire.

In all, 85% of participants enjoyed working remotely and 71% thought they would continue to work online over the next 5–10 years. Of the participants, 40% reported low confidence in online work’s efficacy before working remotely, but 96% reported confidence at the time of questionnaire completion: suggesting confidence increased with experience. An exploratory “inverted” factor analysis generated a two-factor solution, grouping clinicians into two factors based on key views. Factor 1 was predominantly characterised by satisfaction with training received and factor 2 by quality of technical experiences (encountering problems less often and greater personal confidence in resolving them). Qualitative feedback described some benefits of, and barriers to, digital service provision. Clinicians reflected on a perceived change in cultural norms, with more openness to digital services following the COVID-19 pandemic. On a personal level, teletherapy was viewed more favourably with increased personal experience.

Clinicians’ confidence in providing services digitally is discussed, with reference to how this may be affected by extent of remote working experience and availability of technical support. Staff well-being within the digital workspace is also discussed.

The adoption of telephone-delivered mental health services (TDMHS) for scaling collaborative care or addressing access to mental health services in routine primary care practice is gradual despite the needs of the population. Although there are multi-level factors associated with efficient implementation of collaborative care, there is limited understanding of clinicians’ perceptions, experiences and acceptability providing mental health treatment exclusively over the telephone. The purpose of this paper is to explore behavioral health clinicians’ delivery of mental health services over the telephone within primary care settings.

This qualitative study explored behavioral health professionals’ perceptions and experiences providing remote, TDMHS. Convenience sampling was used to recruit 11 clinicians in New York, California and Arizona who provided collaborative care services to patients exclusively over the telephone. Semi-structured interviews were conducted, and analyzed using qualitative content analysis methods.

Three main themes and associated subthemes emerged from the analyses. The first theme was participants’ perceptions of TDMHS prior to implementation relating to patient characteristics, patient engagement and comparison to in-person therapy. The second main theme identified was participants’ experiences implementing TDMHS with subthemes relating to benefits, quality of care, gaps in care and concerns implementing TDMHS. The final theme that emerged from the analysis was participants’ perceived acceptability of TDMHS by patients.

The small sample size limits the generalizability of these findings.

Mental health services delivered over the telephone are perceived as feasible and acceptable by behavioral health clinicians.

This study contributes to gaps in research about behavioral health clinicians’ beliefs, uptake and acceptability toward mental health services delivered exclusively over the telephone.

The dermatology service on the islands of Orkney, with a population of approximately 22,500, was taken over by National Health Service (NHS) Tayside in August 2018. This paper aims to provide an overview of the planning and review of a highly efficient and effective dermatology service for a rural island population.

The service includes visiting dermatology consultants, enhanced electronic referral vetting, skin surgery services, a General Practice (GP) with extended role (GPwER) in dermatology, specialist virtual clinics, urgent advice for inpatients at the local district general hospital and remote systemic therapy monitoring. A new phototherapy service has been set up in an island GP practice.

Local GPs and consultant dermatologists find the enhanced vetting service useable, efficient and educational. Between August 2018 and November 2022, there have been 1,749 referrals. Of these referrals, 60% were seen in clinic or a GPwER surgery, with 40% managed remotely by providing advice back to the referring GP. The number of consultations performed by the GPwER has grown over the past 3 years, and in the last year, it accounted for more than 50% of patient appointments. The waiting time has been significantly reduced using this model.

This remote service uses an integrated approach of teledermatology (TD) whilst offering continual in-person services using local capabilities including a GPwER and island general surgeons. New treatment facilities are provided to the island population. Continual educational feedback to the primary care referrer is provided, and it enhances relationships that greatly aid the high-quality dermatology service provided.

The COVID-19 pandemic has affected psychotherapy practice. A common change is a move to online sessions over video calls. In their therapeutic community (TC) for those with personality disorders, the authors have used video calls but not all clients could work in this way. The authors decided to meet patients outside and walked with them while adhering to government guidelines. This study aims to present the authors’ experience with one client who was interviewed afterwards about the experience.

A total of 10 walking therapy sessions of 60-min duration were conducted with the patient. After the sessions, both the patient and therapist were interviewed about their experience. The resulting interviews with both patient and therapist were thematically analysed independently by both authors.

There were common themes to both the client and therapist’s account following thematic analysis. These were: modelling and normalising in the real world, replacing what COVID-19 had taken away from the TC experience, changes at home, therapist disclosure, outcomes and good endings and being outside of the clinical environment.

The authors have presented a single case of the patient and therapist experience of outdoor therapy sessions in a TC context response to the COVID-19 pandemic. The findings are not generalisable and can only provide a suggestion at the positive potential for working in this way. The authors hope that the positive effects of outdoor therapy noted here may inspire other clinicians to consider similar novel approaches in their work.

This study describes a novel way that a TC has adapted to the COVID-19 pandemic.