1. Is the presence of telehealth described in Balogun, et. al. (2025) what you expected? Did the authors discuss a specific use of telehealth that surprised you? Why or why not?

Yes, my experience with online services has largely aligned with my expectations. Telehealth platforms play a critical role in bridging gaps for underserved communities, particularly those with limited resources and support systems. In my work with children, I have observed that the discretion afforded by online services is especially valued by young adolescents, who are often hesitant to attend in-person sessions. The flexibility in scheduling is another significant benefit, accommodating not just teenagers but also adults whose commitments and responsibilities might otherwise prevent them from seeking care.

Discretion is also crucial for individuals experiencing domestic violence; telehealth provides a safer, more autonomous means of accessing help, allowing individuals to seek support on their own terms. One particularly interesting aspect of telehealth is its impact on Indigenous populations. Hilty et al. (2013) found that culturally tailored telehealth interventions for Indigenous and minority populations led to improved therapeutic outcomes and higher client satisfaction. This underscores the necessity for culturally competent care in telehealth and highlights how platform-based services can address long-standing disparities in healthcare access.

Before engaging with telehealth, I had not fully considered its cultural dimensions, particularly the potential for real-time translation services. Such features are invaluable for Indigenous communities that speak specific languages or dialects, as finding qualified in-person translators can be challenging. Rather than relying on family members or waiting for a translator to become available, telehealth platforms can facilitate immediate, language-specific support, thereby enhancing accessibility and quality of care.

 

2. Did you agree with the discussion about the benefits of telehealth for vulnerable populations? Why or why not?

I agree with the discussion regarding the benefits of telehealth, particularly its ability to bridge service gaps for vulnerable populations. The elderly, for example, often depend on family members or caregivers for transportation and logistical support when attending appointments. My own experience with my grandmother highlights this challenge; she dislikes long car rides, and the effort required to attend in-person appointments can be physically and emotionally taxing. With broader access to telehealth, she could receive necessary care from the comfort and safety of her home, significantly improving her quality of life. Moreover, I resonate with the point that telehealth offers greater autonomy to clients, especially those facing safety concerns. For individuals navigating issues such as domestic violence or other precarious situations, the ability to access care remotely allows them to prioritize both their health and personal safety. Telehealth empowers clients by giving them more control over when and how they receive care, making the process more client-centered and responsive to individual circumstances.

 

3. Were there instances of the use of telehealth that the authors did not discuss that you believe they should have included?

While the author did touch on many topics, it felt very surface-level. I would have liked to see a deeper dive into the considerations of the impact of AI and over-reliance. This could mean the environmental impact of telehealth infrastructure or the ethical considerations of clients. In additon i would have liked to see more discussion on how empathy can be maintained in a virtual setting. How can social workers provide that comfort and human interaction through a screen? 

 

4. In your opinion, what was the most significant challenge regarding the use of telehealth

One of the primary challenges associated with telehealth is the persistent digital divide, particularly affecting individuals who are less technologically literate and those living in rural areas. This divide raises concerns about equitable access, as clients who struggle with technology may need to rely on others to navigate telehealth platforms. Such reliance can inadvertently compromise their privacy and autonomy, undermining one of the core benefits of remote care.

Another pressing concern is the increasing integration of artificial intelligence (AI) within telehealth. While advancements in AI offer opportunities to streamline administrative processes, such as appointment scheduling and data analysis, thereby enabling social workers to devote more time to direct client engagement (Balogun et al., 2025), this shift is not without significant risks. The potential for over-reliance on AI could lead to the depersonalization of care, as algorithms may not fully capture the complexities of human experience or the nuances essential to effective social work practice.

Additionally, the environmental impact of data centers, often situated in underserved communities, poses further ethical questions. The infrastructure required to support advanced telehealth technologies can sometimes exacerbate local disparities, creating new burdens for the very populations these services are intended to help. Social workers, therefore, find themselves navigating a precarious balance between leveraging technological efficiencies and upholding their ethical obligations to clients. Organizations risk creating harsher environments for clients if they become overly dependent on AI and technology, potentially deepening existing inequities rather than resolving them.

1. What, if anything, surprised you about the response of the practitioners? Why did it surprise you (or not)?

Unsurprisingly, many practitioners have readily embraced telehealth, given its benefits. Telehealth enables providers to see more clients and extend their services beyond traditional geographic boundaries, increasing overall access to care. The flexibility in scheduling is also a significant advantage, as practitioners can accommodate more clients within a single day. Unlike in-person sessions, where late arrivals due to traffic or transportation issues can disrupt the schedule and shorten appointments, telehealth minimizes these logistical challenges. Clients can log in from virtually anywhere, making it easier to maintain punctuality and continuity of care. These efficiencies benefit both clients and practitioners, contributing to the positive response and widespread adoption of telehealth within the field.

 

2. Was the use of telemental health at the rate you expected? If yes, why did you think that, and if no, why not?

The dramatic increase in telehealth usage from the pre-COVID to post-COVID era was striking, though not entirely unexpected. The pandemic fundamentally altered daily life in ways that are likely irreversible, intensifying public anxiety about exposure to illness and prompting many to become more cautious about leaving their homes. As a result, it is understandable that patients would gravitate toward telehealth, drawn not only by safety concerns but also by the convenience of avoiding travel to a doctor’s office. This shift has proven mutually beneficial: practitioners can accommodate more clients within a given day, while patients save time and reduce the stress associated with commuting. The widespread adoption of telehealth reflects a broader transformation in healthcare delivery, one that prioritizes accessibility, flexibility, and patient comfort. The pandemic may have accelerated this trend, but its advantages suggest telehealth will remain a central component of care moving forward.

 

3. There were variations regarding the use of telemedicine going forward. Talk about two of the factors that affected whether a practitioner thought they would continue using telemedicine.

Insurance coverage has become a significant factor influencing the adoption and sustainability of telehealth services. As noted by Zhu et al. (2024), providers who anticipated increased use of telemedicine after the pandemic were more likely to serve patients paying out-of-pocket. This presents a concerning barrier, as most clients cannot afford to pay out-of-pocket and instead rely on state-sponsored healthcare coverage. The reluctance of some practitioners to accept insurance, often due to the complexities and administrative burdens of billing, risks excluding vulnerable populations from accessing care. While this challenge exists for both telehealth and in-person services, it remains unclear why telehealth, in particular, is facing such resistance regarding insurance acceptance. Furthermore, although telehealth has demonstrated improved access and better outcomes in rural communities, these gains could be jeopardized if insurance barriers persist. 

Another important factor identified by practitioners is their own comfort and proficiency with telehealth technology. Many express concerns about their ability to maintain client satisfaction and deliver efficient care in a virtual environment. Engagement and responsiveness are critical, and some clients may require higher levels of support that are best delivered in person. This reality prompts practitioners to carefully weigh the benefits and limitations of telehealth when considering its continued use. Ensuring that telehealth remains accessible and effective will require addressing both insurance-related challenges and practitioner readiness to provide high-quality care remotely.

 

4. What is your personal feeling about using telehealth in your practice? Why do you have that opinion?

Telehealth has the potential to serve as a valuable complement to traditional in-person therapy, offering flexibility and convenience for both clients and practitioners. Its capacity to extend mental health services to underserved populations is a significant advancement, helping to address longstanding gaps in access to care. Yet, despite these strengths, important concerns remain regarding the quality of human connection that can be fostered through a screen. The therapeutic alliance, rooted in empathy, trust, and genuine interpersonal connection, can be difficult to cultivate in a virtual environment, raising questions about the efficacy of telehealth for certain clients.

Another pressing issue is the digital divide: disparities in digital literacy and access to reliable technology can perpetuate, or even exacerbate, existing inequities. For telehealth to be truly effective and equitable, there must be efforts to ensure accessibility for all clients, regardless of their technological proficiency. This includes not only providing user-friendly platforms but also educating clients on how to navigate them confidently.

Ethical considerations are equally critical. Practitioners must be diligent about using secure, reputable platforms to protect client privacy and data. Building digital trust is essential, as is empowering clients with the knowledge necessary to safeguard their own information and participate meaningfully in remote care.

Finally, the growing integration of artificial intelligence within telehealth presents a double-edged sword. While AI can improve efficiency and administrative processes, overreliance may introduce new risks, including the depersonalization of care, potential job displacement, and environmental harms from data centers often located in already marginalized communities. Striking a balance between technological advancement and ethical responsibility will be key to realizing the full promise of telehealth without inadvertently deepening existing disparities.