{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T21:24:50Z","timestamp":1785533090648,"version":"3.56.0"},"reference-count":103,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Video-based psychotherapy (VBT) became an essential modality during the COVID-19 pandemic, enabling outpatient care despite social distancing measures. Yet little is known about how usage continued and acceptance evolved after the pandemic. Most existing research is cross-sectional, pandemic-focused, and rarely integrates technology acceptance with clinical process quality and therapist heterogeneity to explain sustained postpandemic VBT use.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study examined the postpandemic sustainability of VBT among German outpatient psychotherapists. Guided by UTAUT-T (unified theory of acceptance and use of technology for therapists), we investigated VBT use, acceptance-related predictors, perceived clinical process quality, and therapist acceptance profiles using cross-sectional and longitudinal perspectives.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a repeated cross-sectional, partially longitudinal postal survey among licensed German outpatient psychotherapists during the COVID-19 pandemic (T1: July 2020-January 2021) and postpandemically (T2: March-May 2024). The final T2 sample included 296 psychotherapists; 117 participated in both waves. VBT sustainability was assessed through usage status and intensity. Technology acceptance was measured using the UTAUT-T, and clinical process evaluations were assessed using items based on Grawe\u2019s general change mechanisms. Analyses included regression models, longitudinal within-person tests, group comparisons, and person-centered cluster analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Postpandemic VBT use was reported by 68.2% (202\/296) of psychotherapists. In retrospective comparisons, use remained above prepandemic levels but below the pandemic peak (4.4% [13\/296] prepandemic; 81.1% [240\/296] during the pandemic;\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n 2<\/jats:sub>\n =357.2,\n P<\/jats:italic>\n <.001, Kendall\n W<\/jats:italic>\n =.64). In the longitudinal subsample, weekly VBT sessions declined from 5.81 during the first pandemic wave to 1.51 postpandemically (\n \u03c7<\/jats:italic>\n \n \n 2<\/jats:sup>\n 2<\/jats:sub>\n =47.9,\n P<\/jats:italic>\n <.001, Kendall\n W<\/jats:italic>\n =.41). UTAUT-T constructs explained 66.6% of the variance in behavioral intention (R\u00b2=.666), with therapy quality expectation as the strongest predictor (\u03b2=.513,\n P<\/jats:italic>\n <.001). Behavioral intention predicted postpandemic VBT use (odds ratio 6.56, 95% CI 4.31\u20109.99;\n P<\/jats:italic>\n <.001) and usage intensity (\u03b2=.414,\n P<\/jats:italic>\n <.001). Prior pandemic VBT use and regulatory awareness predicted postpandemic use beyond behavioral intention. Therapists rated VBT as less effective than face-to-face therapy (\n z<\/jats:italic>\n =13.14,\n P<\/jats:italic>\n <.001,\n r<\/jats:italic>\n =0.77), and only 35.8% (106\/294) perceived core therapeutic change mechanisms as equally supported. Cluster analysis based on UTAUT-T identified 3 clusters, associated with postpandemic VBT use (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n 2<\/jats:sub>\n =131.1,\n P<\/jats:italic>\n <.001,\n V<\/jats:italic>\n =.67) and significantly differing in pandemic VBT use, age, therapeutic approach, regulatory awareness and restrictions, and perceived equivalence of Grawe\u2019s therapeutic change mechanisms.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study extends previous pandemic-era and cross-sectional VBT research by examining sustained postpandemic use under more voluntary routine-care conditions and by integrating technology acceptance, clinical process quality, and therapist heterogeneity. The findings show that VBT has become a sustained but selectively used component of German outpatient psychotherapy rather than a universal replacement for face-to-face treatment. Postpandemic use is shaped by perceived clinical meaningfulness, prior experience, regulatory awareness, and therapist acceptance profiles. Implementation efforts should move beyond technical access and support clinically differentiated, profile-sensitive VBT use through targeted training, clear regulatory guidance, and shared decision-making with patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/82972","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:10:05Z","timestamp":1781583005000},"page":"e82972-e82972","source":"Crossref","is-referenced-by-count":0,"title":["Postpandemic Use of Video-Based Psychotherapy Among German Outpatient Psychotherapists: Repeated Cross-Sectional and Partially Longitudinal Survey Study"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3009-9027","authenticated-orcid":false,"given":"Julia","family":"Rosenbaum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2432-7791","authenticated-orcid":false,"given":"Thomas","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3561-3428","authenticated-orcid":false,"given":"Jana","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5304-6069","authenticated-orcid":false,"given":"Michael","family":"Spaeth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2020.100317","article-title":"The COVID-19 pandemic: the \u201cblack swan\u201d for mental health care and a turning point for e-health","volume":"20","author":"Wind","journal-title":"Internet Interv"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.3389\/frvir.2020.576421","article-title":"Therapists make the switch to telepsychology to safely continue treating their patients during the COVID-19 pandemic. 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