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Abstract
During the COVID-19 pandemic, it became increasingly important to understand how licensed professional counselors used telemental health applications (apps) to establish therapeutic relationships in rural areas. In the past decade, technology has undergone significant changes in its purpose and design. During the COVID-19 pandemic, telemental health was a tool that provided access to mental health services by developing and sharing innovative and effective treatments. The literature suggested that telemental health apps are effective for providing counseling services to clients living in rural areas. Therefore, this technology provided added support to individuals who faced treatment barriers. In this generic qualitative study, data were collected and analyzed regarding the perceptions of therapeutic relationship development among licensed professional counselors using telemental health apps in rural areas during the COVID-19 pandemic. The data collected from the semi-structured interview were analyzed using inductive analysis, through which six themes emerged: (a) relational components of therapy, b) methods and approaches used to guide sessions, (c) client concerns about ethical and privacy issues, (d) barriers to engaging clients in the sessions, (e) the value of videoconferencing platforms to help connect with clients, and (f) evolving new roles and responsibilities. The themes that emerged helped answer the research question: “How have professional counselors used telemental health apps in rural areas to develop the therapeutic relationship during COVID-19?” Counselors may better understand, empathize, support, engage, connect, and develop therapeutic relationships with clients when utilizing these applications. In future research, it would be worthwhile to examine clients' viewpoints, since telemental health applications are designed with clients in mind. Also, associate-level professionals used telemental health to work with clients, and this experience may be useful to gain a perspective from counselors in training. Finally, when it comes to participation recruitment, it may be beneficial to reach out to various social networks, Listservs, and other professional organizations. Counselors may report different experiences regarding their engagement with clients.