Editorial Perspective: The digital divide – inequalities in remote therapy for children and adolescents. Issue 1 (18th February 2022)

• Record Type: Journal Article
• Authors: Aisbitt, Georgina M.; Nolte, Tobias; Fonagy, Peter
• Other Names: Gega Lina guestEditor.; Martin Jennifer guestEditor.; Sayal Kapil guestEditor.; Thabrew Hiran guestEditor.
• Is Part Of: Child and adolescent mental health. Volume 28:Issue 1(2023)
• Page Start: 105
• Page End: 107
• Publication Date: 2022-02-18
• Subjects: Remote therapy -- telehealth -- therapeutic alliance -- mentalising -- epistemic trust -- inequality -- ethnic minority -- intersectionality; Adolescent psychology -- Periodicals; Child mental health -- Periodicals; Child psychiatry -- Periodicals; Child psychology -- Periodicals; Teenagers -- Mental health -- Periodicals; 155.405
• DOI: 10.1111/camh.12545
• Languages: English
• ISSNs: 1475-357X

Abstract

Abstract : COVID‐19 has triggered a shift towards remote delivery of therapy and, despite a number of benefits, it risks discriminating against young people already marginalised due to adverse early life experiences, poverty or ethnicity. This editorial perspective considers challenges for remote therapy, focusing on: the financial burden of telehealth; the necessity of safety to speak; and, how telehealth may exacerbate difficulties in therapeutic alliance formation by interfering with epistemic trust and mentalising. As well as compounding the inaccessibility for children who are subject to abuse, the implicit assumptions behind telehealth risk disproportionately excluding from therapy those from a low socioeconomic status, and who are from ethnic minorities. Suggestions are made for how these challenges may be addressed. It is argued that service design and delivery should seek to proceed with the practicalities and principles of engagement in mind and use this as an opportunity to improve parity of access, rather than risk further entrenching inequalities.