‘It's Hard to Look Past the Accessibility’: Service Provider Perspectives on Implementing Telehealth for Alcohol and Other Drug Counselling as a Health Service Innovation

Introduction: Offering telehealth services is an opportunity to reduce barriers to accessing and attending face-to-face alcohol and other drug (AOD) treatment. However, little is known about how telehealth options have been implemented by AOD services. 

Methods: Key informant interviews were conducted with 20 senior staff members from government and non-government AOD treatment services in Australia with current or previous experience in delivering AOD counselling face-to-face and via phone and/or video, and thematically analysed. 

Results: Interviewees described implementing telehealth flexibly alongside face-to-face counselling, with choice of mode shaped by client needs and preferences. Telehealth was valued for increasing the service's ability to reach under-served clients and for allowing clients to access services from a place of psychological safety. However, service providers were less certain about the comparative safety and effectiveness of delivering counselling through telehealth, especially when delivered over the phone. Telehealth was viewed as relatively compatible with current processes for face-to-face delivery, including processes for staff skill development. 

Discussion and Conclusions: Telehealth has been implemented alongside face-to-face counselling to increase access and meet client preferences. Further evidence regarding risk assessment and client outcomes via phone and video is needed to support broader diffusion of this innovation.