Methods: An electronic survey was developed and distributed to a convenience sample of practicing social work professionals (n=585) through a national listserv. Survey creation was guided by literature, practitioner expertise, consultation from two national professional organizations, cognitive interviews (n=4) and a pilot group of social workers (n=26). The survey included closed and open-ended items and utilized a mixed-method approach. Descriptive analyses were used to depict use of tele-behavioral health and bivariate analyses assessed differences between groups. Open ended responses were analyzed using inductive thematic analysis.
Results: Participants (n=585) completed the survey in 49 states as well as D.C. and Puerto Rico. The sample was predominately white (90%), cisgender female (88%), averaged 54 years in age (SD=13.5), and had worked at their highest degree for 19 years (SD=12). Nearly 88% were licensed in their state, 65% worked in private practice, and 95% reported their organization provided mental health and/or substance use services (31%). Before COVID-19, only 28% of the sample reported using tele-behavioral health, while 34% reported their organization had tele-behavioral capabilities. Since COVID-19, 92% of respondents reported using tele-behavioral health; 95% indicated their organization now had tele-capabilities. Of those who used tele-behavioral health prior to COVID-19, average use increased from 21% to 88%. About half of respondents received training since COVID-19 whereas only 23% had received prior training. Training has been provided by employers (41%), professional organization(s) (42%), a tele-health resource center (15%), a social/program of social work (10%), or local/state/national government (7%). Most respondents indicated at least one barrier to tele-behavioral health use, with client barriers being the most common (73%). Overall, 84% of respondents intended to use tele-behavioral health beyond the pandemic.
Conclusions and Implications: COVID-19 has altered the usage of tele-behavioral health and social workers appear willing to continue providing tele-behavioral health services. Based on study findings, we propose the following recommendations: 1) Ensure parity and reimbursement for tele-behavioral health; 2) Train current and future social work social work practitioners in tele-behavioral health; 3) Provide supports to engage clients use of tele-behavioral health.