Trajectories of Anxiety in Black-Identifying Individuals in Telehealth Versus In-Person Counseling Treatment

Abstract

Treatment modalities for anxiety have been at the forefront of research in the field of psychotherapy. However, the disparities in treatment outcomes for the Black American population are often overlooked. Existing literature regarding innovative modalities for anxiety treatment is dedicated to the experience of the majority population. Alternative service delivery modalities such as telehealth need to be explored as an appropriate method of treatment for this marginalized population. The purpose of this study was to investigate the trajectory of anxiety in a clinical sample of Black Americans, within different treatment modalities, and to produce a comparison of said modalities. This dissertation answers the questions: Does the service delivery modality (in-person versus telehealth) significantly influence the trajectory of anxiety symptoms? And do trajectories of anxiety scores for Black individuals significantly decrease as a result of service delivered via telehealth?

In this retrospective work, data from both a behavioral health program delivering in-person treatment and a counseling clinic providing telehealth was analyzed utilizing a Hierarchical Linear Model to answer the questions above. 85 participants, all self-identifying as Black, completed the Generalized Anxiety Disorder Screener (GAD-7) along their treatment at either clinic in a span of 21 months, for a total of 539 measurement points to be analyzed in the statistical model.

Results revealed that there was no significant difference between telehealth and in-person treatment in terms of in average initial scores or rates of change in anxiety scores. Participants within both groups entered treatment with similar levels of anxiety and experienced a decrease in their anxious symptomology within a similar pace. Additionally, findings indicate that within the telehealth group the average anxiety scores for participants also significantly decreased as a result of telehealth treatment, granted that participants were able to receive about 18 sessions.

Practitioners can be confident that providing telehealth treatment for Black clients results in equitable and effective care. These results add to the body of knowledge of culturally sensitive and appropriate treatment modalities. This study also allows for further exploration of the mental healthcare disparities that the Black American population faces, and how the field can rectify these gaps.