Teletherapy is the Future Norm

teletherapy

Teletherapy will be part of normal practice for psychologists in a decade, predicts leading online therapy educator Marlene Maheu, PhD.

Psychologists must embrace the change or be left behind, warns Sherry Benton, PhD, ABPP, founder of the teletherapy company TAO Connect.

“We in the behavioral world are the last holdouts for technological change in health care,” said Maheu, executive director and founder of the Telebehavioral Health Institute. “Technology is evolving, and I firmly believe we will be connecting with one another in many new ways in the future.” Maheu oversees telebehavioral health training at the institute and has been involved with teletherapy as a clinical psychologist herself since 1994.

Benton, a psychologist and former director of a large university mental health clinic, became convinced a few years ago that adding teletherapy to psychology practices could help millions of people living in areas underserved by mental health specialists. After testing the concept with college students in 2014, she launched TAO Connect to provide teletherapy to college and university counseling centers.

Both Maheu and Benton believe that psychologists who want to provide counseling via video conferencing, email or telephone need to educate themselves first about the practice. Maheu’s institute offers classes, as do the American Psychological Association and other organizations and companies.

“It’s critical to get training,” Benton said. “There are so many things you might not think about.”

That includes having a license to practice in the state where the patient is, having a crisis management plan for online patients, knowing how to keep consultations with a patient private and knowing how to rewrite consent-to-treat forms for patients you may never see in person, she said.

Equally important, Maheu said, is figuring out what population you want to serve online and identifying a way to get paid for your online work. If you work with at-risk youth and want to serve that community online, figure out what agency might pay you for the online work. Or if you want to work online with senior citizens in nursing homes, there are online employers who will hire you to do that, she said.

Similarly, if you are in private practice and want to add online work, health insurance could be your payer, she said. “This is not about reinventing yourself, but doing what you’re already good at with technology,” Maheu said.

Numerous online therapy companies have popped up in recent years, including TalkSpace, BreakThrough, BetterHelp, and iCouch, and many enlist a variety of therapists, including psychologists, to work full or part time as outside contractors.

Each company is different and any psychologist who wants to associate with one should investigate the firm carefully, Benton said. “You want to look at how they work, what your reimbursement rate is, what’s expected of you – basically what’s their deal and does it fit with the way you want to work,” she said.

TalkSpace is one of the largest and mainly provides counseling sessions through texting. BreakThrough and BetterHelp both offer videoconferencing with therapists and BetterHelp also offers messaging, live messaging chats and telephone sessions with therapists.

iCouch, while it offers therapist referrals, concentrates on providing services for therapists who want to practice online. Those include videoconferencing, therapy marketing, scheduling and billing services.

Benton’s company is similar, offering private practitioners a suite of tools they can use for their own online services. They include HIPPA-compliant video conferencing, education modules for patients, administrative tools and secure messaging.

“We just license our materials; we don’t actually hire psychologists,” Benton said. “But our tools allow psychologists to help more patients and to help their income.”

Psychologists can offer patients shorter therapy sessions, such as 20 minutes, and augment that with patient education sessions from TAO, she said. “Even after a psychologist pays for TAO they really can increase their income,” she said.

One of the newest entries into the market is LARKR, a video therapy app that launched in October through the Apple App Store. LARKR links therapists with patients for 50-minute sessions on mobile devices. The site, at larkr.com, is seeking 10,000 certified mental health therapists to join its ranks, according to its press information.

Plenty of information is available online for psychologists who are considering trying online therapy.

iCouch has several blogs that suggest ways to get started: (Add “online therapy available” to your business cards and website; ask current clients if they’d be interested in trying a session online; try online therapy several times so you become comfortable with the technology).

The APA has a 19-page Guidelines for the Practice of Telepsychology on its website that encourages psychologists to get specific training and includes information about confidentiality, informed consent and interjurisdictional practice.

This article is included in the online continuing education course Therapy Tidbits – March/April 2018. Click here to learn more.

Related Online Continuing Education Courses:

E-Therapy: Ethics & Best PracticesE-Therapy: Ethics & Best Practices is a 3-hour online continuing education (CE) course that examines the advantages, risks, technical issues, legalities and ethics of providing therapy online. E-therapy can be used to address age-old problems, such as how to reach out to those who might not otherwise avail themselves of psychotherapy services even though they are in acute need. At the same time, it is clear that many providers have embraced the new technologies without a firm grasp on the new and serious vulnerabilities that are introduced when their patients’ personal health information goes online. Included in this course are sections on video therapy, email, text messaging, smart phone use, social media, cloud storage, Skype, and other telecommunications services. This course is focused upon the ethical principles that are called into play with the use of e-therapy. Among them the most obvious concern is for privacy and confidentiality. Yet these are not the only ethical principles that will be challenged by the increasing use of e-therapy. The others include interjurisdictional issues (crossing state lines), informed consent, competence and scope of practice, boundaries and multiple relationships, and record keeping. In addition to outlining potential ethical problems and HIPAA challenges, this course includes recommended resources and sets of specific guidelines and best practices that have been established and published by various professional organizations. Course #30-87 | 2016 | 52 pages | 20 posttest questions

Ethics and Social MediaEthics and Social Media is a 2-hour online continuing education (CE) course that examines the use of Social Networking Services (SNS) on both our personal and professional lives. Is it useful or appropriate (or ethical or therapeutic) for a therapist and a client to share the kinds of information that are routinely posted on SNS like Facebook, Twitter, and others? How are psychotherapists to handle “Friending” requests from clients? What are the threats to confidentiality and therapeutic boundaries that are posed by the use of social media sites, texts, or tweets in therapist-client communication? The purpose of this course is to offer psychotherapists the opportunity to examine their practices in regard to the use of social networking services in their professional relationships and communications. Included are ethics topics such as privacy and confidentiality, boundaries and multiple relationships, competence, the phenomenon of friending, informed consent, and record keeping. A final section offers recommendations and resources for the ethical use of social networking and the development of a practice social media policy. Course #20-75 | 2016 | 32 pages | 15 posttest questions

Preventing Medical Errors in Behavioral HealthPreventing Medical Errors in Behavioral Health is a 2-hour online continuing education (CE) course that examines the ways in which clients can be harmed in mental health practice, and the many strategies for anticipating and avoiding such undesirable outcomes. This course is intended to increase clinicians’ awareness of the many types of errors that can occur within mental health practice, how such errors damage clients, and numerous ways they can be prevented. Its emphasis is on areas within mental health practice that carry the potential for “medical” errors. Examples include improper diagnosis; breaches of privacy and confidentiality; mandatory reporting requirements; managing dangerous clients; boundary violations and sexual misconduct; the informed consent process; and clinical and cultural competency. There are major new sections on psychotherapy in the digital age, including the use of social networking systems, the challenges of maintaining and transmitting electronic records, and engaging in the practice of teletherapy. *This course satisfies the medical errors requirement for license renewal of Florida mental health professionals. Course #21-18 | 2018 | 38 pages | 15 posttest questions

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Video Chat Therapy and Virtual Doctor Visits are Becoming Much More Mainstream

By Taylor Tepper

Video Chat Therapy and Virtual Doctor Visits are Becoming Much More Mainstream This articles talks about how teletherapy is becoming much more mainstream – fast. Also notable is that more states are requiring health insurers to cover telemedicine, or virtual doctor visits by phone, text, or video link.

When you need help with depression, anxiety, or any other mental health condition, finding affordable care can be a challenge. A shortage of qualified doctors and therapists means just getting an appointment can be tough. Plus, since finding in-network care can be harder than it is for medical care, you may have to shoulder a hefty portion of the price of your treatment. Now an emerging trend in health care may offer some relief.

More and more states are requiring health insurers to cover telemedicine—doctor visits that are conducted by phone, text, or video link—and more companies are adding the service as an employee benefit. Almost all large employers will offer telemedicine over the next four years, according to a recent National Business Group on Health survey.

Last year UnitedHealthcare, the nation’s largest insurer, announced that it would offer “virtual physician visits.” The Department of Veterans Affairs has invested $1 billion in tele-health.

Telemedicine increasingly includes mental illness treatment. In May, Walgreens teamed with Mental Health America and MDLive to create a portal where you can access more than 1,000 mental health providers. Consultations start at $60, and you can use the video chat service from anywhere.

“Virtual therapy can be as effective as traditional therapy,” says Willis Towers Watson senior health management consultant Allan Khoury, especially for people who don’t want to be seen walking into a therapist’s office, or don’t have one nearby.

A 2011 study out of the University of Amsterdam that was published in Studies in Health Technology and Informatics found that “online cognitive behavioral treatment is a viable and effective alternative to face-to-face treatment.” A 2015 large-scale review of various tele-health practices by the Cochrane Effective Practice and Organisation of Care Group reported that outcomes for those seeking mental health treatment remotely—along with other medical conditions—were no different than for those who got in-person care.

With employers still determining coverage levels, costs are evolving, says Khoury, who has seen an initial 90-minute session go for $200, with subsequent 30-minute follow-ups priced at $90, similar to in-person costs.

One reason people go without therapy is that there are simply are not enough qualified doctors and nurses to treat mental illness. Nearly 103 million Americans live in area designated as having a shortage of mental health professionals. That’s 63% more than those who don’t live near a primary care doctor, and twice as many as those without speedy access to a dentist, according to the U.S. Department of Health and Human Services.

Read More of the Original Article: http://time.com/money/4589987/therapy-telemedicine-phone/

Related Online Continuing Education Courses

This course is focused upon the ethical principles that are called into play with the use of e-therapy. Among them the most obvious concern is for privacy and confidentiality. Yet these are not the only ethical principles that will be challenged by the increasing use of e-therapy. The others include interjurisdictional issues (crossing state lines), informed consent, competence and scope of practice, boundaries and multiple relationships, and record keeping.In addition to outlining potential ethical problems and HIPAA challenges, this course includes recommended resources and sets of specific guidelines and best practices that have been established and published by various professional organizations.
Ethics and Social Media is a 2-hour online continuing education (CE) course that examines the use of Social Networking Services (SNS) on both our personal and professional lives. Is it useful or appropriate (or ethical or therapeutic) for a therapist and a client to share the kinds of information that are routinely posted on SNS like Facebook, Twitter, and others? How are psychotherapists to handle “Friending” requests from clients? What are the threats to confidentiality and therapeutic boundaries that are posed by the use of social media sites, texts, or tweets in therapist-client communication?

 

Ethics & Boundaries in Psychotherapy is a 3-hour online continuing education (CE) course intended to give psychotherapists the tools they need to resolve the common and not-so-common ethical and boundary issues and dilemmas that they may expect to encounter in their everyday professional practice in the 21st century. Among the topics discussed are definitions of boundaries; resolving conflicts between ethics and the law; boundary crossings vs. boundary violations; multiple relationships; sexual misconduct; privacy and confidentiality in the age of HIPAA and the Patriot Act; ethics issues with dangerous clients; boundary issues in clinical supervision; ethics and cultural competency; ethical boundaries in use of social media; ethical practice in teletherapy; fees and financial relationships; and a 17-step model for ethical decision making.

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. Our purpose is to provide high quality online continuing education (CE) courses on topics relevant to members of the healthcare professions we serve. We strive to keep our carbon footprint small by being completely paperless, allowing telecommuting, recycling, using energy-efficient lights and powering off electronics when not in use. We provide online CE courses to allow our colleagues to earn credits from the comfort of their own home or office so we can all be as green as possible (no paper, no shipping or handling, no travel expenses, etc.). Sustainability isn’t part of our work – it’s a guiding influence for all of our work.

We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within one week of completion).

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APA’s Telepsychology 50-State Review & Guidelines

By the American Psychological Association

Telepsychology Review & GuidelinesThe trend toward telepsychology — the use of communication technologies in the provision of psychological services — has the potential to reduce hospitalizations, increase access to mental health care and save lives. But there are also limitations and restrictions on the use of telepsychology. Statutes and regulations governing the provision of telepsychology services vary greatly from state to state.

Over the past few years, a growing number of states have passed or updated laws or rules governing telepsychology practice. The increasing volume of laws pertain to both delivery of and payment for telepsychology services.

In light of these developments, the APA Practice Directorate’s Office of Legal & Regulatory Affairs has updated the Telepsychology 50-state review (previously called the Telehealth 50-state review) to guide psychologists in navigating the regulations and provisions in their state.

Telepsychology 50 state review (PDF, 1.01MB)

At its late July 2013 meeting, the APA Council of Representatives approved new Guidelines for the Practice of Telepsychology. A Joint Task Force on the Development of Telepsychology Guidelines for Psychologists, comprised of members representing APA, the Association of State and Provincial Psychology Boards and the American Psychological Association Insurance Trust (APAIT), was formed in 2011 to create guidelines for the practice of telepsychology.

The new telepsychology guidelines (PDF, 113KB) are available on the APA Practice Organization’s Practice Central website.

If you have any questions, please contact the APA Office of Legal & Regulatory affairs or call (202) 336-5886.