In your initial post, provide an evaluation of the efficacy of using telehealth with mild, moderate, and severe mental health disorders:
With the ever-increasing expansion and utilization of technology as a primary form of communication, many medical services are being offered and administered through telecommunication practices. One such developing service is telepsychology. But what is telepsychology? Well, telepsychology is defined as the delivery of psychological assistance(s) employing telecommunication tools (Joint Task Force, 2013). When it comes to the efficacy of using telehealth with mild, moderate, and severe mental health disorders, the (2009) Virtual Clinic video revealed that this is exactly the sort of populations that these services are targeted for. However, worth noting is that telehealth services are not meant to assist people who are severely suicidal. People with these sort of tendencies need to seek in-person professional help. Moreover, evidence-based online therapy is proven to be effective and beneficial, as long as clients are properly assessed as part of it (Arnott, 2009). However, there are still areas which must be investigated, for instance, more evidence needs to be presented regarding the employment of evidence-based psychotherapy in relation to certain mental health disorders as well as underserved populations (Gros et al., 2013).
As part of your evaluation, assess the integration of evidence-based practices into the telehealth trend in psychology:
Many evidence-based practices relating to telehealth largely revolve around the use of cognitive-behavioral therapy. This is done by taking everything known about CBT and transferring it to the online atmosphere where it is readily available to patients and clinicians alike. Patients still undergo standard practices, such as questionnaires to assess the symptoms, thoughts and feelings they are experiencing, etc. Once questionnaires are completed, patients then undergo a diagnostic interview primarily via telephone. These sort of services enable the clinician to better judge whether the patient is suffering mildly, moderately, or severely, and whether or not seeking help virtually or in-person is best for the patient. As we learned in the Virtual Clinic video, those who are receiving telehealth services are typically required to complete lessons and homework each week to monitor their progress. Many studies conducted surrounding disorders like major depressive disorder, anxiety disorder(s), PTSD, eating disorders, etc. have illustrated that telehealth services, particularly ones that involve CBT, showed significant pre- to post-treatment reductions in myriad symptoms (Gros et al., 2013; Luxton et al., 2014). Moreover, the integration of evidence-based practices into the telehealth trend in psychology appear to harness many benefits for both patients and clinicians. As maintained by Luxton et al. (2014):
Telehealth-based assessments allow practitioners to conveniently monitor symptoms and other health variables between in-person or telehealth treatment sessions. Further, telehealth-based psychological assessment may improve care satisfaction and overall health outcomes by providing services that are specialized for the patient’s needs (p. 32).
Other benefits include the convenience of participating in services at home, lower costs, and accessibility in rural and remote areas where there may not be enough clinicians to handle in-person cases.
Consider the population, specialty, and treatment preferences you identified in the week one Creating a Specialist Website interactive assignment, and assess the appropriateness of using telephone, text-based, virtual clinics, and/or video telehealth given your client focus, specialty, and treatment preferences:
In the week one interactive assignment, I selected to be a clinical psychologist that works with clients from diverse populations; this includes age, culture, gender, etc. The specialties I selected included: anxiety, depression, relationships, and trauma. While telehealth may be appropriate for adult populations, I would feel uncomfortable providing telehealth services to clients under the age of 18. Youth populations struggling with conditions like anxiety, depression, and trauma, in my opinion, would be benefitted more in an in-person therapy environment. There is also the fact that there are not many, if any, studies documenting the efficacy of telehealth services to underage populations. Youth populations would seemingly need a specifically designed online atmosphere in order for treatment and therapy services to be effective. For instance, a virtual clinic for youth would need to be designed in such a way that was comprehensible to diverse learning and developmental levels across age brackets.
Analyze ethical and professional issues you might encounter and explain the risks and benefits of using these delivery methods with your identified treatment population:
Some ethical and professional issues to consider would include: Interjurisdictional issues, confidentiality, ethical and informed practice, and insurance issues. When working with clients tele-communicatively, there may be instances where clients seek help that are from out of the state the clinician practices in. If this happens, clinicians need to be aware that they are providing services to the patient under the laws of the patient’s residence. This can pose ethical issues if the clinician is not licensed to practice in that particular state, or authorized to practice in other jurisdictions. Ethical issues involving confidentiality become more complex when utilizing telecommunication/telepsychology. There has been some debate over whether or not telepsychology via Skype is HIPAA compliant and further ethical guidelines need to be developed and widely established in order to have a clearer understanding of how to navigate ethical and scientific standards in the online atmosphere. Nevertheless, informed consent should always be obtained and documented to ensure clinicians are staying on the straight and narrow path. Finally, the issue of insurance comes to mind in the sense that it is imperative to know whether or not the services a professional is providing will be covered. I think for people who reside in more rural areas, having telepsychology covered by insurance would be particularly important. In terms of risks and benefits, for my identified treatment population, I think the benefits would come in the form of convenience, lower costs for care, and less travel time. However, by using telepsychology, I run the risk of not picking up on important cues that I would generally get if I were to meet with a patient in-person. For instance, a patient may tell me they are doing better with their depression and anxiety via telecommunication and I would ultimately have to take their word for it. However, say that person isn’t doing as well as they claim and this would typically be seen in their non-verbal cues, such as a disheveled appearance, excessive fidgeting, etc. Thus, perhaps a combination of in-person and telehealth services would best suit some individuals more than others in my treatment population.
References:
Arnott, I. (Producer). (2009). Virtual clinic (Links to an external site.)Links to an external site. [Video file]. Retrieved from https://fod.infobase.com/OnDemandEmbed.aspx?Token=47751&aid=18596&Plt=FOD&loid=0&w=640&h=480&ref
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
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., 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
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