A Mental Health Provider's Guide to Telehealth

Providing Outpatient Videoconferencing Services

Jonathan G. Perle

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000364613
• Edition: 1
• Topic: Psicología
• Subtopic: Psicoterapia

This book works as a guide to videoconferencing practice for psychological providers through a broad, simplified, and practical overview of pertinent factors. It is a consolidation of research literature and professional experiences of practicing, teaching, and studying videoconferencing.

It begins by defining key concepts such as telehealth, telepsychology, and other related terminology and examining the role of telehealth in addressing ongoing mental health disparities. An overview of existing videoconferencing practices, guidebooks and general recommendations, as well as specifics of ethical and legal factors are discussed. The book then details numerous essential factors of videoconferencing practice that are directly applicable to psychological care, including considerations of computer system, video camera, display screen, microphone, videoconferencing platform, bandwidth and latency, and room setup, along with self-care practices. The appendices provide readers with links to resources, checklists, and other documents to guide their practice.

Psychologists, counselors, and other mental health providers will find this user-friendly, research-informed guide indispensable when implementing online treatment and teletherapy.

1Defining Telehealth, Telepsychology, and Associated Terms

While the term has become ingrained into society over the last decade as an alternative or supplement to face-to-face (F2F) services, the verbiage used to describe “telehealth” is far from simple. If one were to review peer-reviewed research articles, books, documentation from guiding organizations, and findings from a basic internet search, they would encounter dozens of terms used to describe telehealth processes, as well as a range of associated definitions that vary in detail and focus.

Historical Variability in the Terminology of Telehealth

To account for the uses of technology in healthcare services, numerous terms and phrases have been created (Table 1.1). From the literature, the majority of terms can be grouped into those using prefixes of either “internet-,” “e-,” or “tele-.” For example, “internet therapy,” “e-therapy,” and “teletherapy” often similarly and broadly refer to the process of providing therapy services through a digital medium. These terms are further supplemented with “online therapy,” “distance therapy,” and “web therapy.” As illustrated by this example, many terms exist to describe similar constructs, with the terms often being used interchangeably within the literature. Potentially due to this inconsistency, no universal nomenclature exists. Nevertheless, the most contemporarily accepted term to describe the integration of technology with healthcare services is simply “telehealth.”

Table 1.1Mental health-focused telehealth verbiage

Tele-		e-		Internet-		Other
Telehealth		e-therapy		Internet therapy		Behavioral telehealth
Telepsychology		e-health		Internet interventions		Online therapy
Telepsychiatry		e-psychology		Internet-delivered CBT		Distance counseling
Telebehavioral health				Internet-delivered care		Distance therapy
Teletherapy						Web psychology
Telemedicine						Web therapy
Telecare						Digital therapy
						Digital interventions

Historical Challenges with Defining Telehealth

Even though the name “telehealth” has become increasingly accepted over time, the defining of the term has evidenced additional variability. More specifically, due to so many organizations and researchers attempting to provide a definition, a multitude of variations has ensued, including those proposed by the World Health Organization (WHO, n.d.), Health Resources and Services Administration (HRSA, 2019), Military Health System (MHS, n.d.), US Department of Veterans Affairs (VA, n.d.), American Psychological Association (APA, 2013), American Medical Association (AMA, 2020), American Counseling Association (ACA, n.d.), National Association of Social Workers (NASW; Felton, 2020), the American Telemedicine Association (ATA, n.d.), and countless others (Table 1.2). The nonuniversality of what encompasses telehealth has created challenges for researchers and providers to identify and understand what guiding information is available. Unfortunately, such confusion has persisted across considerable time. For example, Baker and Bufka (2011, p. 405) wrote, “A review of relevant state and federal laws reveals inconsistencies even in the terminology used to describe provision of services via technology with some referring to ‘telehealth,’ others to ‘telemedicine,’ and others using additional terms,” while in 2018, telehealth guidebooks for billing continue to indicate that, “You may hear [terms such as telehealth, telemedicine, and others] used interchangeably as they are broadly defined as using technology to deliver healthcare from a distance” (Coding Institute, 2018, p. 3).

Table 1.2Definitions adopted by organizations

Organization		Definition
American Counseling Association (ACA, n.d.)***		Telebehavioral health, or distance counseling, is the use of a digital platform that provides secure, encrypted, audio-video conferencing to communicate with a client in real time. This does not include nonsynchronous (not real-time) texts, calls, digital chats, emails to and from counselors and their clients.
American Medical Association (AMA, 2020)*		Telehealth includes a variety of tools and platforms that allow clinicians to connect with one another as well as with patients. Telehealth between patients and clinicians is most commonly seen as: 1. Synchronous: real-time, audio-video communication that connects physicians and patients in different locations; real-time audio and telephone communication. 2. Asynchronous: store-and-forward technologies that collect images and data to be transmitted and interpreted later; remote patient-monitoring tools such as blood-pressure monitors, Bluetooth-enabled digital scales, and other wearable devices that can communicate biometric data for review (which may involve the use of mHealth apps).
American Psychological Association (APA, 2013)**		The provision of psychological services using telecommunication technologies.
American Telemedicine Association (ATA, n.d.)*		Technology-enabled health and care management and delivery systems that extend capacity and access.
Health Resources and Services Administration (HRSA, 2019)*		The use of electronic information and telecommunication technologies to support and promote long-distance clinical healthcare, patient and professional health-related education, public health, and health administration. Technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Military Health System (MHS, n.d.)*		Telehealth is the use of telecommunications and information technologies to provide health assessment, diagnosis, treatment, consultation, education, and health-related information across distances.
National Association of Social Workers (NASW; Felton, 2020)****		Telemental health is the practice of delivering clinical healthcare services via technology-assisted media or other electronic means between a practitioner and a client who are located in two different locations.
National Telehealth Policy Resource Center (NTPRC,...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• List of Figures
• List of Tables
• Author Biography
• Preface
• Acknowledgments
• 1 Defining Telehealth, Telepsychology, and Associated Terms
• 2 Mental Health Disparity and the Utility of Videoconferencing Telepsychology
• 3 Guidebooks and Recommendations for Ethical and Legal Practice
• 4 Factors to Consider in Order to Ensure an Ethical and Legal Videoconferencing Practice
• 5 Videoconferencing Logistics: Overview
• 6 Videoconferencing Logistics: System Considerations
• 7 Videoconferencing Logistics: Video Camera Considerations
• 8 Videoconferencing Logistics: Display Screen Considerations
• 9 Videoconferencing Logistics: Microphone Considerations
• 10 Videoconferencing Logistics: Videoconferencing Platform Considerations
• 11 Videoconferencing Logistics: Bandwidth and Latency Considerations
• 12 Videoconferencing Logistics: Room Setup Considerations
• 13 Videoconferencing Logistics: Video Tips
• 14 Videoconferencing Logistics: Audio Tips
• 15 Videoconferencing Logistics: Documentation
• 16 A Stepwise Summary of the Videoconferencing Process
• 17 Self-Care Practices
• 18 (Brief) Answers to Common Questions About Videoconferencing Practice
• 19 Conclusion and Next Steps for Providers
• Appendix A: Acronyms Used in This Book
• Appendix B: Helpful Videoconferencing-Specific Definitions
• Appendix C: Consolidated Mental Health Resources: Formal Guidelines and Recommendations from Guiding Organizations
• Appendix D: Consolidated Mental Health Resources: Helpful Documents, Websites, and Toolkits
• Appendix E: Consolidated Mental Health Resources: Helpful Organizations
• Appendix F: Helpful Journals and Books
• Appendix G: Continuing Education Programming
• Appendix H: Summary Overview of Processes for the Utilization of Videoconferencing
• Appendix I: Comprehensive Videoconferencing Provider Checklist
• Appendix J: Simplified Videoconferencing Provider Checklist
• Appendix K: Videoconferencing Coloring Pages for Children
• Appendix L: Preparing for Videoconferencing Patient Handout
• Index