Assessing therapist skills in teletherapy: the development and validation of the tele-facilitative interpersonal...

Objective: Teletherapy via videoconferencing has become common practice but has unique challenges. We aimed to develop and validate the first performance-based observer-rated measure of teletherapy skills: The Teletherapy Facilitative Interpersonal Skills Performance Task (Tele-FIS). Methods: We developed a set of 12 Tele-FIS video stimulus clips as simulations of four research-informed common therapeutic challenges in teletherapy: technology, distraction, boundaries and privacy, and emotional disconnection. A total of 153 therapists recorded interventions to the clips which were later rated on interpersonal skills. Results: The Tele-FIS performance task demonstrated good interrater reliability, internal consistency, test-retest reliability, and convergent validity. The Tele-FIS was positively associated with self-reported facilitative interpersonal skills, self-efficacy, attitudes towards technology, and observer-rated skills on a version of the FIS task that simulates in-person therapy. Therapists performed similarly on teletherapy clips of emotional disconnection and privacy issues compared to clips of in-person therapy. Therapists performed worse on Tele-FIS clips of technology and distraction challenges than in-person therapy clips. Conclusions: The Tele-FIS has potential as an assessment tool in skills training for trainees and licensed clinicians as well as future research about therapeutic work via teletherapy. Results are discussed to consider therapist skill and the use of practice-relevant materials in training.