According to the World Health Organization, one in four people globally will be affected by mental health issues at some point in their life.[1] Despite available treatments and their increasingly high success rates, it seems not everyone who suffers will ultimately benefit from them. It is estimated that around two-thirds of people with a known mental health condition never seek professional help.

More is known today about mental and emotional wellbeing and the importance of taking care of the mind than ever before, yet something is still holding people back. Some attribute it to the stigma associated with seeking treatment, others argue that it is largely caused by the lack of awareness about the importance of mental health and even more so by the lack of means and adequate access to professional services.[1] One promising solution to addressing these concerns is the emerging field of telepsychology.

But can it really help?

What Is Telepsychology?

The American Psychological Association defines telepsychology as the “provision of behavioral and/or mental health care services using technological modalities” – they can be either a way to replace or be used alongside traditional methods under a blended care model.[2]

Common means of communication used in telepsychology include video conferencing, phone, chat, e-mail, and mobile applications specifically designed to provide users with psychological support. They also include self-help platforms like websites or blogs that offer psychological resources and patient education, as well as complete virtual office platforms that manage every aspect of the practitioner/client interaction from intake and assessments to treatment planning, appointment scheduling, insurance claims, and billing.

When used effectively, telepsychology tools have the ability to augment traditional face-to-face services, promoting greater client engagement.

When used effectively, telepsychology tools have the ability to augment traditional face-to-face services, promoting greater client engagement. Applied to its fullest potential, telepsychology promises to enhance treatment outcomes, improve progress monitoring, increase the ease of use in all aspects of service provision, and enable access to resources at almost any time, and in any context.

But most importantly, telepsychology can help overcome some of the most common barriers prevent patients from seeking essential treatment.

Examples include:

  • Distance
  • Disability
  • Other medical conditions
  • Stigma
  • Monetary and time constraints, and
  • Provider-specific preferences of potential clients.  

How Does Telepsychology Work?

Telepsychology tools can still be employed even if the person is seeing a therapist regularly. The concepts of blended or virtual care, where traditional methods are combined with telepsychology and used in an alternating fashion, is based on the premise that this is currently the best form of psychology practice available today because different types of tools can be used according to client’s individualized needs and preferences.

For instance, a practitioner can see a client once a week alternating between in-person and virtual sessions, communicate via email on an as-needed basis and assign homework between sessions by encouraging clients to use a mood tracker app and to access psychoeducational modules online.

Carefully tailored telepsychology tools can amplify communications and client engagement through frequent feedback and support. They can also help solidify the therapeutic alliance through encouraging client autonomy. And finally, they can help sustain motivation through ongoing mastery-building and confidence-boosting self-monitoring tools.

Some Important Notes

It should be noted that telepsychology does not necessarily mean using a tool for therapy purposes. In a clinical sense, the APA and other mental health institutions stress that these tools should be used by licensed psychologists and therapists either as a way to keep in touch with their patients outside of the practice or to help them learn how to manage their conditions.

There are many applications on the market that appear to offer mental health support; but are not, in fact, based on clinically tested and empirically validated modes of treatment and don’t go far past well-meaning generalities and shallow self-help. For that reason, the domain of telepsychology needed to have a set of clear guidelines by which to conduct its practices.

The Joint Task Force for Telepsychology Regulation

The American Psychological Association, the Association of State and Provincial Psychology Boards, and the APA Insurance Trust all provided input and guidance to build the Joint Task Force for the Development of Telepsychology Guidelines for Psychologists.[3]

The Task Force tried to identify unique aspects of telecommunication technologies and how they can enhance psychological services. In their research, two key components were identified:

  • The psychologist’s knowledge and ability to use these technologies is vital; and
  • The patient needs to have a full understanding of the increased risk of loss of privacy as a result of using these technologies.

As a result, telepsychology is seen as beneficial only when the technologies can be effectively used and are understood by psychologists or therapists.

Additionally, it is very important for the patient to understand that, although these technologies have increasingly stronger measures of security, there will always be some risk of one’s personal information being accessed either through human error or hacking. With these concerns in mind, the Task Force developed a set of 8 Guidelines to help monitor and regulate this new psychology tool.

8 Guidelines for Telepsychology

These guidelines are created as a tool to help psychologists shape their telepsychology practices but do not describe specific actions to take regarding the content of the therapies. They are designed to help practitioners offer the same level of services through the use of telecommunications technologies as they normally would through traditional face-to-face methods.

1. The Competence of the Psychologists

Those who will provide telepsychology services must strive to take all necessary steps to ensure they are competent: both with the use of the technologies they plan to implement and in their assessment of the potential impact on their patients. All telepsychology professionals must apply the same level of care and standards of practice as they do in any of the traditional methods.

They must also assess and evaluate their competences continuously, get appropriate training and remain up to date on the latest enhancements to teletherapy technologies being used, just as they would through professional continuing education in their respective field of expertise.

2. The Standards of Care

Therapists and care providers should make every reasonable effort to make sure that ethical and professional standards of care and practice are met during their use of telepsychology tools, just as they do when delivering in-person services.

It’s important for therapists to first assess if the mobile app or technology is appropriate to use for a particular patient prior to adopting it. If they do adopt it, then it may be necessary to modify it to meet the particular requirements of the patient.

Telepsychology tools must bring an added value to the person’s therapy and general wellbeing, so the tool itself must accommodate their particular circumstances.

3. Informed Consent

Psychologists must get and document the informed consent of the patient regarding the use of telepsychology services. The process must be fully explained to the patient, and the professional should define the framework in which the tool shall be used. For instance, if you tell your patient you will continue some of the therapy sessions via chat, you should establish a clear time and date for when this will take place.

4. Confidentiality of Information

Professionals must take reasonable measures to protect the confidentiality of the patient when employing telepsychology tools. It is important to inform the patient of the potential risk of their information being accessed by different parties and this should also be included in the consent form.

Patients must understand that there are limits to confidentiality, and risks of the information they share through these tools may be disclosed in certain conditions or may be accessed by third parties. Additionally, this guideline also stipulates that it is the psychologist’s responsibility to research appropriate tools that will also offer high levels of security in communication, and how patient data is transmitted and disposed of. Examples include HIPAA-compliant videoconferencing tech and 3rd party-audited document storage providers.

Inviting clients into a virtual office is no different than hosting them in one’s brick and mortar office location in person; the responsibility to protect privacy and confidentiality rests with the practitioner. Patients must be warned of the limitations and risks associated with using technology.

5. Security of Transmission of Data

Psychologists should conduct a risk assessment to identify any vulnerable areas where the data of their patients may be accessed by third parties. Once these areas are known, it is the responsibility of the professionals to employ in-house safety measures to prevent outside parties from accessing their patient information.

6. Disposal of Data

Therapists must make reasonable efforts to dispose of any information gathered through these techniques in a way that protects the privacy of the patient. It’s vital to create procedures for the secure destruction of data or information, as well as set strict guidelines of when some of the patient information may be shared, with which parties, and the way it can be shared securely.

7. Testing and Assessment

If a psychological test or assessment is conducted through a telepsychology tool, psychologists must ensure the integrity and validity of the procedure. They are also encouraged to not take these tests as they are, and modify them to make sure the results can then be considered for analysis.

For instance, the therapist may ask the person to take the test or assessment in a particular environment, where they know they feel more comfortable. In an environment that can cause anxiety, for instance, the results of the test may not be relevant, and the assessment may need to be repeated.

With testing and assessments done outside of the practitioner’s office, the control is taken out of the hands of the practitioner and therefore environmental considerations have to be taken into account to assure tests or assessments integrity and validity.

8. Interjurisdictional Practice

Care providers should be familiar and comply with relevant laws when providing telepsychology services to patients across jurisdictional and international borders. The expansion of telepsychology tools has allowed many practitioners to find and work with patients that do not physically reside in the vicinity of their practice but live across state lines or even borderlines.

Telepsychology providers must know and understand the local law that regulates the provision of such services. Most state-issued licenses require that professionals practice only within state boundaries. Professional associations and state licensing boards publish such regulations on their websites and can provide this information to the public.   

Carefully tailored telepsychology tools can amplify communications and client engagement through frequent feedback and support

The Limitations of Telepsychology

Although there are studies that confirm using telepsychology as an extension of traditional therapy methods is beneficial, it’s important to note that this field also comes with a set of limitations health providers must be aware of.[4]

One study published in 2011 focused on therapy via telephone, and although it found this method to indeed be beneficial for the majority of patients, it also identified a set of challenges:

  • Lack of control over the environment the patient is during the session;
  • Privacy and security concerns associated with the remote location of the patient;
  • Limited ability to form a connection with the patient;
  • Not effective in crises and not recommended for patients with severe mental conditions.[5]

More challenges can surface based on the individual needs or requirements of the patient. It remains important for the therapist to assess continually whether these practices are adequate for their patients, and what modalities of treatment and communication will be most effective and safe.

4 Telepsychology Platforms to Consider

There are a number of telehealth platforms that psychology practitioners can register with and offer services through. They provide lists of professionals to potential clients in very much the same way health insurance providers do.

They allow people to connect with experts in various fields that may specialize in the treatment of specific conditions or use solutions potential clients may have a preference for. Descriptions of some of the best-known telehealth platforms are included below.

App

Details

Doc.com

This platform offers 24/7 healthcare services by connecting people will doctors of various specialties, including psychologists and psychiatrists through Doc Emotions. It uses video call technology, allows for up to four consultations per month completely free of charge, and incorporates blockchain technology for added security.

Name

Doc.com

Price

Free

Good For

Professional Consultations, Telehealth

Website

https://doc.com/

App

Details

TalkSpace Telepsychology

Talkspace is a platform and an app specifically designed for talk therapy. It combines video conferencing with text therapy, where users are not limited to sessions but are free to chat with their therapist at their convenience. The platform matches potential clients with licensed therapists and allows them to choose the payment plan that best suits them. For text, payment plans start at $65 a week, and increases from there based on how many video sessions the client would like to participate in.

Name

TalkSpace

Price

$65+ weekly

Good For

Licensed therapy, One-on-one counseling

Website

https://www.talkspace.com/

App

Details

Amwell

Amwell is another platform that connects users with healthcare specialists in various fields, including therapists. It is designed for on-demand care, so no appointment is necessary. Clients are matched with a practitioner who will assess their condition and recommend a treatment plan using high-quality video conferencing software available in a mobile app as well. Using Amwell can be an effective way to identify a health problem for those who do not yet have a diagnosis. One consultation costs around $69, while the national average for a consultation is around $100 or more. The platform allows patients to verify insurance coverage, and even order medication if such is prescribed by their doctor. 

Name

Amwell

Price

$69+ per consultation

Good For

Telehealth, Professional Consultations

Website

https://amwell.com/

App

Details

Ginger.io Telepsychology

Mental health app Ginger.io offers individual plans and monitors progress towards wellbeing. The platform pairs clients with therapists and counselors to chat with or talk to via video, depending on the type of plan chosen. It is accessible at any point in the day and provides self-guided content.

Name

Ginger.io

Price

Free

Good For

Emotional Coaching, Teletherapy, Telepsychiatry

Website

https://www.ginger.io/

Disclaimer: It’s important to note that while all these platforms can help clients match instantly with a healthcare provider of their choice, one should not turn to them in case of an emergency. In situations where one struggles with suicidal thoughts or any form of medical crisis, it is best to call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Conclusion

Innovations in web-based technologies are rapidly improving every aspect of our lives, and it no surprise that more and more frequently, both patients and therapists are using telepsychology platforms and other remote-access technologies to receive and offer therapy and counseling. 

Although more research into its effectiveness needs to be done in order to have a full view of its benefits and limitations, telepsychology tools can certainly help patients. This is especially true when combined with traditional therapy measures, whilst e-therapy platforms alone can be beneficial when no other service is available. 

Where do you see the future of mental health take us? How willing are you to give it a try today?

References

  1. ^ World Health Organization. (2001). Mental disorders affect one in four people. Retrieved from https://www.who.int/whr/2001/media_centre/press_release/en/ .
  2. ^ APA. (2020a). What are Telehealth and Telepsychology?. Retrieved from https://www.apa.org/pi/disability/resources/publications/telepsychology
  3. ^ APA. (2020b). Guidelines for the Practice of Telepsychology. Retrieved from https://www.apa.org/practice/guidelines/telepsychology
  4. ^ Langarizadeh, M., Tabatabaei, M. S., Tavakol, K., Naghipour, M., Rostami, A., & Moghbeli, F. (2017). Telemental health care, an effective alternative to conventional mental care - A systematic review. Acta Informatica Medica, 25(4), 240.
  5. ^ Brenes, G. A., Ingram, C. W., & Danhauer, S. C. (2011). Benefits and Challenges of Conducting Psychotherapy by Telephone. Professional Psychology, Research and Practice, 42(6), 543.

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