Teletherapy

TELEMENTAL HEALTH

The use of the internet and/or telephonic based videoconferencing for communication has seen a dramatic increase.  As part of this change in technology, psychiatrists and psychotherapists have developed protocols for the use of this technology to provide services to patients unable to attend face to face sessions due to distance or other issues.

Recently, the National Board for Certified Counselors NBCC,  the largest certification agency in the United States for Masters Level counselors in the United States has begun a certification program for Distance Counseling.  I am a Distance Certified Counselor DCC.

The strengths of telemental health include well-documented patient and provider satisfaction for a range of services, strong support for the reliability of clinical assessments (eg, neuropsychological testing, clinical interviews, and mental status exams) relative to face-to-face assessments and evidence that patients would choose to receive it if it was available and would improve their access to care. In addition, research has documented the effectiveness of Telepsychiatry to treat specific mental health diagnoses such as depression and anxiety disorders as well as its effectiveness with specific populations including incarcerated patients, children and adolescents, rural populations and older adults.

The scope of use of Telemental services has included: evaluations, consultations, case management, disease prevention, legal hearings, forensic evaluation, neuropsychological evaluation, individual, family and group therapy, home, outpatient, nursing home and inpatient care.  Of the scope of clinical issues which have been treated, according to the director of the telemedicine lab for the State of South Carolina in a personal communication, providers have seen the full range of pathology documented in the DSM-IV-TR.  The only limitations have been the treatment of severely psychotic patients. In addition to the extensive work with adults, literature reviews of Telepsychiatry over the past 10 or more years have found studies treating depression, anorexia, conduct disorder, and attention deficit disorder in children and adolescents.

Telepsychiatry has been used for both consultations to render second opinions and as a method to provide primary direct clinical services. Studies of the reliability, clinical outcomes and patient satisfaction with telepsychiatric services have been conducted with children, adults and geriatric patients. In general, the outcomes of all of these studies, has been positive.

Ongoing research is being conducted on a large scale by organizations such as the VA to continue to establish the clinical viability of the use of Telemental health services.

My background in Telemental health is diverse.  I developed a program for telepsychiatric services for one of the country’s largest health care organizations.  I have also provided Telemental heath services to patients through my private practice during the last 10 years.

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