Hillary Smith

Date of Award

January 2022

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

John-Paul Legerski


The COVID-19 pandemic caused substantial disruptions and changes in mental health service delivery as community mental health clinics had to scramble to implement telehealth services to provide continuity of care under quarantine. For the current study, I conducted in-depth video interviews with ten clients from a community mental health training clinic who transitioned from in-person services to telehealth services. Twenty-one factors related to clients’ satisfaction with telehealth services and their perceived barriers to the treatment modality using a grounded theory framework. The majority of participants reported they were satisfied with telehealth but preferred to return to in-person therapy sessions with supplemental telehealth services as needed. Various benefits of telehealth were noted throughout the interviews, including increased ease of access, convenience, and having means of personal comfort during session (e.g., pets, musical instruments, etc.). Participants also identified ways in which telehealth can create barriers to effective therapy, such as privacy concerns, distractions, and technology challenges. Nine guidelines to enhance the effectiveness of telehealth services in the future are provided based on data collected in these interviews.