Mental Health Therapy Efficacy Differences as a Function of the Delivery Method of Telehealth or In-person
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Authors
Cunningham, Jeanna
Issue Date
2026-04
Type
Dissertation
Language
en
Keywords
Healthcare Innovation & Delivery , Mental Health , Delivery , Telehealth
Alternative Title
Abstract
This quantitative causal-comparative study examined whether perceived therapeutic efficacy differs between in-person and telehealth delivery of outpatient mental health counseling. The research addressed the lack of clarity about how the rapid expansion of telehealth during the COVID-19 pandemic may have influenced clients’ perceptions of treatment effectiveness. Grounded in social psychology theory, the study explored how relational processes and perceived interpersonal quality shape clients’ experiences of therapy across modalities. A purposive sample of 70 adults receiving services at a Utah outpatient clinic participated, with 35 completing in-person counseling and 35 using telehealth. Therapeutic efficacy was measured with the Session Rating Scale (SRS), and an independent samples t-test compared mean scores across groups. Results showed no statistically significant differences between modalities, indicating that clients perceived therapy to be equally effective whether delivered in person or remotely. These findings support existing research showing comparable outcomes across modalities and extend the literature by providing post-pandemic data from a general outpatient population. Implications highlight the need for clinicians to develop hybrid-competence skills and routinely incorporate alliance-based feedback tools into telehealth sessions. Future research should examine mechanisms—such as therapeutic alliance, psychological presence, and relational attunement—that may explain why efficacy remains stable across delivery methods, as well as explore how different client subgroups experience modality in a permanently hybrid mental health landscape.