Videoconferencing psychotherapy: determining acceptance, drivers and barriers of use

With increasing digitalization in psychotherapy, some healthcare interactions are transitioning to online services. This study examined the acceptance of videoconferencing psychotherapy (VCP) among patients affected by mental health disorders and healthy controls, identifying drivers and barriers.

A cross-sectional survey study was conducted from February to October 2024 in North Rhine-Westphalia, Germany. Participants were recruited via outpatient clinics, online study platforms, and psychotherapy-related social media. Inclusion criteria were age ≥ 18 years, German language proficiency, and internet access. Sociodemographic, medical, psychotherapeutic anamnesis, and information and communication technologies (ICT) related data were collected. Acceptance of VCP was assessed using an extended Unified Theory of Acceptance and Use of Technology (UTAUT) model.

Of N = 483 participants, 47.6% (n = 230) reported high, 34.2% (n = 165) moderate and 18.2% (n = 88) low acceptance. Significant predictors included digital overload (β = .14, p = .006), depressive symptoms (β = .11, p = .033), current psychotherapy: outpatient (β = -.34, p = .003), concern: effectiveness (β = -.47, p < .001), concern: emotional expression (β = -.25, p < .001), and the UTAUT predictors: social influence (β = .28, p < .001), performance expectancy (β = .32, p < .001) and effort expectancy (β = .15, p = .001). Explained variance of the final model was 72.9%.

The moderate to high acceptance indicates that VCP could supplement psychotherapeutic care addressing the global treatment gap. Identified drivers and barriers highlight factors that should be considered to enable broader implementation.