Introduction

The COVID-19 pandemic in Australia forced organisations across the child, family and community welfare sector to shift many of their services online. Service providers and practitioners reported varied engagement and outcomes working with different client groups. From this sector feedback, positive anecdotes point to a promising ongoing role for telepractice as part of the continuum of care.

Many factors can affect the success of telepractice as a service delivery modality. A client-centred approach is needed that draws on research evidence where available. This will ensure that telepractice becomes an integral part of a blended model of service delivery into the future.

What are clients’ experiences of telepractice?

Evidence of clients’ experiences of telepractice in the child, family and community welfare sector is emerging and largely relies on qualitative research and anecdotal stories. We know from sector feedback from client surveys and practitioner anecdotes that clients have different experiences of telepractice. Some prefer it compared to in-person service delivery due to the convenience and flexibility it can provide.¹ Increased access has been noted for clients who are geographically isolated, living with a disability or experiencing social difficulties.²

There can also be barriers to access for clients who, for example, might not have appropriate devices or available data, or lack digital literacy.³ Services report that clients can have limited access to a space that ensures privacy or minimal distractions. Clients’ experiences can also be affected by practitioner comfort and capability using telepractice modes, which varies widely as, for many, it requires developing new skills.

What works to respond to the barriers and challenges they face?

In order to navigate this, clients’ context, needs and preferences in determining whether telepractice might be right for them, and under what circumstances, needs to be considered by the practitioner.

In addition, practitioners can begin to build their own skills in delivering telepractice, through adapting their in-person techniques based on what the evidence says works well via digital formats. Organisations can ensure they have systems in place to manage telepractice delivery, such as appropriate technologies and training protocols.

To help practitioners and organisations along this journey, we’ve been developing an online hub of evidence-based resources on telepractice, which houses a growing suite of tools and guides.

What are the implications for practice?

A tool has been designed to help practitioners carefully consider the client and practitioner environments when determining whether telepractice might suit their client’s needs. The importance of each factor considered will be different for each client, which is why we recommend they are considered by practitioners in collaboration with the clients themselves. The downloadable tool includes 35 questions across a number of areas, including:

Client focus

• Will a telepractice option provide welcome savings for the client (e.g. by avoiding transport or accommodation costs associated with in-person services)?
• Does the client experience any issues that may make engaging with in-person services problematic (e.g. social anxiety, agoraphobia)?

Practitioner focus

• Is the travel time associated with the type or purpose of visit excessive?
• Are there safety concerns around visiting the client in their own home (where applicable)?

Technology focus

• Do the client and practitioner have reliable connectivity?
• Do the client and practitioner have familiarity with the platform being used; for example, Skype, Zoom?

Service/program focus

• Does telepractice increase your ability to offer the service or programs in locations where there is a shortage of workers or services, or where low levels of in-person engagement mean a program won’t go ahead?

Conclusion

Telepractice can add to the suite of tools practitioners have available to reach and assist their clients. Making time to incorporate the evidence, and a client’s context, will enable professionals, services and the sector to realise the promise telepractice holds.

Further reading and related resources

• Telepractice basics 
  This webpage by the Parenting Research Centre answers commonly asked questions about telepractice.
• Is telepractice a preferred and/or viable option? 
  This form developed by the Parenting Research Centre can be used to help guide practitioners in negotiating with a client about whether telepractice is a preferred or viable option.
• The digital divide and remote service delivery 
  This CFCA webinar explored the digital divide and its impact on the remote delivery of child, family and community welfare services.
• The use of telepractice in the family and relationship services sector 
  This CFCA paper reviews the evidence for telepractice as a service delivery method in the family and relationship services sector. 

References

• 1 Harris, M., Andrews, K., Gonzalez, A., Prime, H., & Atkinson, L. (2020). Technology-assisted parenting interventions for families experiencing social disadvantage: A meta-analysis. Prevention Science, 21, 714–727.
• 2 Reimer, L. (2020). Family work in an online environment: Findings from the Fams ‘In conversation with’ session chats. Retrieved from fams.asn.au/wp-content/uploads/2020/07/Findings-from-Fams-In-Conversation-With-Sessions.pdf
• 3 Thomas, J., Barraket, J., Wilson, C., Rennie, E., Ewing, S., & MacDonald, T. (2019). Measuring Australia’s digital divide: The Australian Digital Inclusion Index 2019. Melbourne: RMIT University and Swinburne University of Technology, for Telstra. 

Acknowledgements

The Telepractice Hub is supported by the Victorian Government Department of Families, Fairness and Housing.