How Does Providing Telehealth Alter the Delivery of In-Person Therapy?

Although telehealth outcomes have been widely studied, less is known about how providing telehealth influences therapists' subsequent in-person clinical practice. This qualitative study examined how marriage and family therapists (MFTs) described changes in their in-person work following telehealth experience. Forty-two MFTs completed an online survey including demographic items, a Likert-scale item assessing perceived impact on in-person services, and an open-ended prompt about changes noticed during in-person therapy. A subset completed follow-up virtual interviews. Data were analyzed using reflexive thematic analysis. Findings indicated that telehealth functioned as a formative professional experience, shaping in-person practice through heightened embodied attunement, increased observational precision, more intentional communication, expanded intervention flexibility, and refined clinical decision-making. Participants also reported enduring logistical changes related to scheduling, boundaries, and modality selection. Developmental stage influenced how these changes were integrated. Results suggest telehealth experience represents an important dimension of therapist development, with implications for training, supervision, and hybrid care.