- Telehealth provides a way for diagnosing and assessing a variety of individuals and various disorders. It provides an alternative way for individuals to receive treatment amongst a variety of situations. While there are many advantages for using telehealth, there are also disadvantages. For example, telehealth does not provide face to face contact, therefore making physical observations difficult. Evaluating the patient requires various assessments, thus making a correct diagnosis may be difficult. Although telehealth may produce challenges for assessing mild, moderate, and severe mental health disorders, the practitioner can modify assessment procedures which may assist in making a correct diagnosis when using telehealth to conduct assessments (Luxton, Pruitt & Osenbach, 2014). It also allows individuals to be assessed when travel or location is a concern. The professional must ensure they are following ethical principles and telepsychology guidelines as outlined in Joint Task Force for the Development of Telepsychology Guidelines for Psychologists (2013) in attempt to stay in compliance with laws and regulations while conducting telehealth services. Evaluating the situation according to APA guidelines is the best place to start according to Harris & Younggren (2011). This includes conducting a risk benefit analysis of conducting telehealth interventions versus other options. Every situation and the severity of the mental health condition varies, therefore it is the responsibility for the psychologist to assess the client and make a decision based on what is best for the client. For example, if the client should be referred to alternative interventions rather than telehealth due to the severity of the mental health disorder, then this needs to be communicated.
Research has been conducted on integrating evidence-based practices by telehealth. Gros et al. (2013) conducted studies using evidence-based practices by telehealth versus traditional in-person treatments and reported that outcomes were very close to equivalent. The differences that were reported were minor differences and were inconsistent across studies. In addition, technology such as the use of smartphones allows behavioral health care more accessible, efficient, and interactive as well as improving the distribution of evidence-based treatments (Luxton, McCann, Bush, Mishkind & Reger, 2011). Although telehealth is being used more and more as technology advances, it is important to continue research and consider best options for the client.
The population identified in week one were individuals in adulthood. This includes young adults in search of a career path as well as adults already established in their career looking to advance in their current career or in search of a new career. Based on the client focus, specialty, and treatment preferences, clients could be assessed in a variety of ways. The use of traditional in-person, telephone, texted based, virtual, or video telehealth could provide appropriate options for individuals. While all these options provide services in a variety of ways, it really comes down to the needs of the client. Individuals who prefer traditional therapy options and are within traveling distance, this may be an appropriate option for them. Sometimes individuals may not be comfortable with alternative therapy sessions such as using video and they may prefer traditional sessions. The psychologist would also be able to observe behaviors in person, which provides an advantage. Individuals who choose to discuss therapy sessions over the phone may be an option as well. However, there may be some draw backs as sometimes it can be difficult to gain a complete understanding about the situation for various reasons. Sometimes the phone may be static or it may be difficult to hear one another, therefore there may be some confusion. In addition, client behaviors would not be able to be observed. Text based sessions may be an option as well, but the client would need to be aware that the information may not be secure using this method. In addition, it may be a longer process as typing typically takes longer than having a verbal conversation. Text based may allow the client to gather their thoughts and review them prior to sending the information. This may provide the client additional time to think about things and how they want to portrait themselves. The drawback would be that the psychologist would not be able to observe behaviors and would not hear the clients voice as verbal communication such as their tone of voice, grammar, etc. may provide valuable information. Finally, virtual and video telehealth may also be appropriate for clients. This allows the client to engage in services in a comfortable environment and alleviates any travel. The psychologist would be able to conduct various assessments and observe behaviors. The professional would be able to speak with the client, observe behaviors, and conduct a session while being able to visually see the client. According to Baker & Bufka (2011) the psychologist must assess and communicate the benefits and risk that telehealth may pose with the client as well as having an understanding about when electronic-based interventions should be used and for whom. The use of telehealth technology at various levels increases the quality of life for diverse individuals (Miller, 2006).
As discussed, all of the above delivery methods have risks and benefits. It is essential prior to conducting any therapy session to obtain informed consent. In addition, it is also essential to communicate with the client privacy, security, and confidentiality. While the psychologist makes every attempt to maintain confidentiality and secure patient’s privacy, it must be communicated that delivering information using technology does not ensure the information will remain secure and private. In addition, personal and professional boundaries must be established as well as avoiding potential harm to the client and at times there may be an interruption of services. For example, information may get lost in cyberspace or at times the internet may not be working, thus causing an interruption in services. Communicating risks and benefits with the professional and client is essential and indicates attempt to uphold ethical standards and code of conduct.
Baker, D. C., & Bufka, L. F. (2011). Preparing for the telehealth world: Navigating legal, regulatory, reimbursement, and ethical issues in an electronic age. Professional Psychology: Research and Practice, 42(6), 405-411. doi:10.1037/a0025037
Gros, D. F., Morland, L. A., Greene, C. J., Acierno, R., Strachan, M., Egede, L. E., … & Frueh, B. C. (2013). Delivery of evidence-based psychotherapy via video telehealth. Journal of Psychopathology and Behavioral Assessment, 35(4), 506. doi:10.1007/s10862-013-9363-4
Harris, E., & Younggren, J. N. (2011). Risk management in the digital world. Professional Psychology: Research and Practice, 42(6), 412-418. doi:10.1037/a0025139
Joint Task Force for the Development of Telepsychology Guidelines for Psychologists. (2013). Guidelines for the practice of telepsychology. American Psychologist, 68(9), 791-800. doi:10.1037/a0035001
Luxton, D. D., McCann, R. A., Bush, N. E., Mishkind, M. C., & Reger, G. M. (2011). mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice, 42(6), 505-512. doi:10.1037/a0024485
Luxton, D. D., Pruitt, L. D., & Osenbach, J. E. (2014). Best practices for remote psychological assessment via telehealth technologies. Professional Psychology: Research and Practice, 45(1), 27-35. doi:10.1037/a0034547
Miller, T. W. (2006). Telehealth issues in consulting psychology practice. Consulting Psychology Journal: Practice and Research, 58(2), 82-90. doi:10.1037/1065-9222.214.171.124 ReplyReply to Comment
- COLLAPSE SUBDISCUSSIONJanine BulmerJanine Bulmer
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