Thanks to the digital age and technology, psychologists can now reach more people than ever before, especially those who are isolated.
Some people are reluctant when it comes to seeking out and consulting with a psychologist. Utilizing something like telepsychology can significantly reduce this fear and improve access to quality care.
The issue of improved access to care may be one of the best benefits overall when looking at this modality.
Telepsychology, teletherapy, and telemedicine are a growing trend because they provide many unique benefits to both the patient and the provider.
This article contains:
What is Telepsychology?
Telepsychology refers to the usage of psychology services delivered via video conferencing.
Telepsychology is becoming more common and can be a very attractive option for patients as well as therapists.
For people who are reluctant to seek psychological care, telepsychology offers the perfect venue.
This is also an excellent option for those who live in a small community or for those who fear people may talk about them if they seek care.
Those living remotely can also benefit from using telepsychology services.
What are the Benefits?
One of the key benefits of a service like telepsychology, is increased access to care for the disabled. For those with physical, medical, or mobility disabilities, telepsychology provides many things, including:
- Better access to quality care.
- Flexible scheduling.
- Access to care in one’s native language.
- Increased access to a disability specialist, if needed.
- Better access to remote areas or areas that don’t have proper mental health resources.
- Increased access for those with PTSD or agoraphobia – or for anyone who has difficulty attending an in-person session.
- More time for the patient to collect himself or herself and to think about their thoughts, feelings, and behaviors outside of therapy.
Telepsychology allows psychologists to see patients on the patients’ own terms, where they are much more comfortable.
What Does the Research Say?
According to Reese et al. (2016), the comfort level of the client is one of the best predictors for a positive therapeutic relationship.
An online approach may not be suited for everyone. If you aren’t comfortable with your therapist, it probably doesn’t matter if you engage in a session in person or online.
There are specific guidelines in place, and telepsychology should be used with caution for those who are severely mentally ill or for those at risk of hurting themselves. (APA, 2014).
In a review of research utilizing a variety of people, telepsychology was typically found to be an effective modality. (Hynes et al., 2009; Reese, Slone, Soares, & Sprang, 2015; Tuerk, Yoder, Ruggiero, Gros, & Acierno, 2010).
This same outcome also applies for practitioners utilizing Cognitive Behavioral Therapy techniques for things like depression or anxiety (Glynn, Randolph, Garrick, & Lui, 2010; Hailey, Roine, & Ohinmaa, 2008).
Research also indicates that the quality of the therapeutic relationship, as well as empathy, is consistent across different platforms. (Reese, 2016).
Frueh et al. (2007) suggest that clients continue to feel connected with their therapist even when in online settings, and this appears to be particularly true if the therapist is comfortable working online.
Advantages and Disadvantages
According to Godine and Barnett (2013), mental health services can be delivered in many ways, including:
- Email and telephone
- Real-time chat
- Cell phones
Videoconferencing is a “technological procedure that allows individuals to see and hear each other on a computer monitor or video screen in real-time” (Godine and Barnett, 2013).
Videoconferencing is much different than something like a real-time chat, telephone, or cell phone conversations because video conferencing allows users to view and speak to each other at the same time.
Asynchronous forms of communication, where there is a time delay in terms of response time, might include email, website chat interfaces, and text messaging via cell phones.
Advantages to Telepsychology include:
- Accessibility for those in remote and rural areas.
- Expanded hours of service beyond regular office hours.
- Direct and sometimes immediate service.
- Less inhibited clients allowing for more emotional involvement.
Some disadvantages, on the other hand, may include:
- Capacity for crisis intervention may be limited.
- Clients may develop a type of virtual identity to protect themselves (see virtual care).
- Some of the problems that may occur in face-to-face therapy may not be as easily dealt with virtually.
- Misunderstandings may be an issue due to a lack of non-verbal cues.
- Verification of the practitioner’s authenticity may be difficult for the client.
What You Need to Know as a Practitioner
Respecting and protecting the rights and privacy of patients is critical to a patient/therapist relationship.
One of the unique ethical guidelines in telepsychology states that the psychologist must provide information on local mental healthcare before treating a patient who is not local.
The psychologist must also advise the client of the risks and limitations of telepsychology. The patient’s privacy must always be maintained, and this is even more important in telemedicine.
The interactions between the patient and the psychologist must be protected, especially with online venues. With any psychological treatment, there are risks related to sensitive conversations, medical records, and personal information.
Psychologists must have the proper safeguards in place to ensure their practices are following HIPAA Privacy and Security guidelines.
What are HIPPA Guidelines?
HIPPA stands for Health Insurance Portability and Accountability Act of 1996. (HHS Office of the Secretary, Office for Civil Rights, & Ocr., 2013)
The Secretary of the United States Department of Health and Human Services requires it in order to protect the privacy and security of certain types of health information.
HIPPA has privacy rules and security rules to protect health information that is held or transferred in electronic form.
The overall goal is to protect the privacy of individuals while also allowing doctors and other providers to adopt new kinds of technology. All of this is meant to enhance the quality and efficiency of patient care.
For more information, you can visit the U.S. Department of Health and Human Services.
For those in the U.K. or anywhere in the European Union, other rules apply. The GDPR or General Data Protection Regulations are a set of compliance regulations and requirements that apply to any organization that deals with data provided by citizens of the European Union. (GDPR Vs. HIPAA – Noting The Differences., n.d.).
The guidelines are similar to HIPPA guidelines in the fact that they are designed to protect the patient.
Some key points to the GDPR are:
- Strict adherence to patient consent when getting personal details.
- Rule that guides how long a healthcare provider can hold onto patient information.
- Rules pertaining to high-security storage.
All of these guidelines are designed to ensure that patient data is not compromised in any way, shape or form. These guidelines are important to be aware of if you are considering utilizing telepsychology software and services.
Thanks to Telepsychology, many psychologists now have a unique opportunity to see patients from all over the globe. As a result of that, they need to be aware that there may be different laws and licensing requirements depending on their location.
Until there is a national licensure system that allows doctors to treat anyone, anywhere, the psychologist needs to be aware of the rules.
The best rule of thumb to follow is to do your homework and be aware of whatever specific regulations apply to you and your practice before utilizing this type of platform.
Types of Telepsychology
Different types of telepsychology could include:
- Cyber therapy (virtual reality).
- Telerehabilitation or video assistance.
- Telemonitoring in chronic and insidious disease disorders.
- Self-applied programs and web-based tests.
Cyber therapy or virtual reality therapy is being used more and more. It is also referred to as virtual reality exposure therapy. This type of therapy allows the patient to enter a virtual world where they can learn to better manage their condition.
Let’s say that Paul is experiencing PTSD from a traumatic event. His psychologist would like to try virtual reality exposure therapy to help Paul deal with his PTSD in a safe, controlled and monitored environment.
His psychologist could use technology such as a virtual headset, to gently guide Paul through a traumatic experience little by little.
Telerehabilitation – John has recently had surgery and he has been out of rehab for 2 weeks. While he is recovering nicely, his psychologist would like to be able to check-in with John on a daily basis. A practice like telerehabilitation is perfect for this because John can easily do a 5 or 10-minute daily check-in via video.
Telemonitoring – Chris is confined in a chamber due to his contagious disease. His psychologist is worried about his mood and state of mind and would like to be able to monitor Chris. Using telemonitoring Chris’s doctor can chat with him daily using telepsychology to ensure Chris maintains a positive attitude.
Self-applied programs – Sally is worried that her anxiety is getting out of hand, but she isn’t quite ready to see a psychologist or begin taking medication. She would like to be able to self-manage her anxiety before taking that next step. Sally could use some kind of web-based test to determine if her anxiety needs to be addressed in a different manner. She could also go online and find some self-applied programs like deep breathing or simple meditation practice that could be helpful as well.
Some of the most common platforms available for telerehabilitation or telemonitoring are listed below.
Top 10 Most Popular Telepsychology Platforms
Knowing what software to utilize can help you be fully prepared if you plan on trying out this modality with your clients or patients.
The ideal telepsychology software would provide a wide range of solutions, from diagnosis and assessment to both group and individual therapy.
Many platforms are multi-functional as well, providing not only telepsychology services but also services for supporting interactions between psychologists and primary care providers and other healthcare providers.
Most reputable telepsychology platforms provide software that is HIPPA complaint as well, whereas a generic platform like Skype does not support that.
Clocktree is a telemedicine platform that works on any computer device with Internet access and a camera. It is HIPPA compliant and an excellent way to attract more clients.
Clocktree is easy to use from both the clinician and client end.
The payment model is a useful model for group practices who only need to use video software for a few hours a month. At the time of writing, Clocktree was free to use for up to 10 hours/month. After that, there is a fee.
Clocktree lets you put unlimited users on your practice’s Clocktree account. Some of the features include:
- Scheduling and Reminders
- Secure Messaging
- Library and HIPPA Secure Storage
- Client History and Notes
Doxy.me is a simple, free, and secure platform for telepsychology. It is HIPPA compliant, free to use, and there are no downloads required.
Some of the features include:
- Live Chat
- Patient Queue
- Waiting Room
- Patient Check-In
- Mobile app
Although Doxy.me is simple to use and free for solo and small practices, larger clinics can pay for a version with a lot more components.
VSee is an online telemedicine platform that serves over 1,000 companies, including Walgreens, DaVita, Trinity, and more.
The VSee platform was founded in 2008 by two Ph.D. students from Stanford University, who were looking for ways to make working remotely much more straightforward.
VSee is funded by the National Science Foundation, in-Q-Tel and Salesforce.com.
- VSee Messenger
- VSee Clinic and Virtual Waiting Room
- VSee SDK – Digital Health app
The platform is an excellent video software option designed specifically for telemedicine.
The free Pro account offer is only for solo practices.
This platform provides a HIPPA compliant telepsychology solution that connects mental health providers with patients to provide high-quality remote care.
It provides an intuitive, user-friendly interface that requires little training. All that is needed to get started is a computer or other compatible device, a webcam, a microphone, and an Internet connection.
The average visit is estimated to save 30-45 minutes per visit, which is a significant cost saving overall.
The interface allows the physician to review a patient’s personal information, their history, their pharmacy preferences, method of insurance as well as their health record.
The Mend platform is another HIPPA secure telemedicine platform. It has robust reporting as well as patient management.
It offers SMS appointment reminders, digital intake and other forms, integrated patient self-scheduling, and a 99% connection rate. There are no downloads to connect to the platform, and the software is easy to install. The software is compatible with all top devices as well.
DrChrono can be used to provide patients with clinical help in the comfort of their own homes.
The platform provides online scheduling and is HIPAA compliant. It also offers video conferencing, which reduces wait time in the clinic and improves the patient experience.
The software provides online scheduling, automated appointment reminders, a HIPPA compliant patient portal, and integrated billing.
TheraNest is another provider of online therapy. The software has a mobile app, a client portal, progress notes, treatment plans, discharge notes, as well as custom forms.
This software package offers telehealth solutions that are focused on the mental and behavioral health space.
The online practice management solution includes HIPAA secure video, scheduling, payment built-in, secure messaging, and client session notes. The software also provides file sharing, and a directory listing for clients to find you.
SimplePractice is another telehealth provider offering a fully integrated video solution. The software provides a calendar, notes, billing, and client communication all combined in one system that also allows you to schedule and conduct unlimited sessions with the click of a button.
The software offers a mobile app, entirely paperless intakes, custom notes and forms, secure messaging, free appointment reminders, integrated payments, and a beautiful client portal which is HIPAA compliant.
This application provides a white-label platform, which can be utilized as your own.
The software includes a mobile app, telemedicine, and remote care plans for those with chronic conditions.
Also included are practice management, a branded patient portal, and the ability to create a website with a unique domain name.
A Take-Home Message
Telemedicine and telepsychology are the waves of the future. Thanks to the digital age, more and more people can now receive desperately needed mental health services and psychological counseling.
Technology is reshaping how we look at mental health care. Telemedicine is ideal for those who either can’t get out or those who are reluctant to receive psychological services.
Telepsychology can be utilized within a variety of practices, including solo practices and group practices.
Telepsychology is removing the stigma that used to be associated with mental health treatment, which is a very good thing for patients as well as healthcare providers.
- Free, HIPAA-Secure Online Therapy Software (2019 Update). (2019, August 12). Retrieved from https://personcenteredtech.com/2016/02/16/free-online-therapy-software-compared-usefulness-ease-security-support-hipaa/
- Frueh, C., Monnier, J., Grubaugh, A. L., Elhai, J. D., Yim, E., & Knapp, R. (2007). Counselor adherence and competence with manualized cognitive-behavioral therapy for PTSD delivered via videoconferencing technology. Behavior Modification, 31, 856866.
- Glynn, S. M., Randolph, E. T., Garrick, T., & Lui, A. (2010). A proof of concept trial of an online psychoeducational program for relatives of both veterans and civilians living with schizophrenia. Psychiatric Rehabilitation Journal, 33, 278-287.
- Godine, N., Barnett, J. (2013). The Use of Telepsychology in Clinical Practice: Benefits, Effectiveness, and Issues to Consider. International Journal of Cyber Behavior, Psychology and Learning (IJCBPL) 3(4)
- Hailey, D., Roine, R., & Ohinmaa, A. (2008). The effectiveness of telemental health applications: A review. Canadian Journal of Psychiatry, 53(11), 769-778.
- Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D., & Francis, J. (2009). Use of health information technology to advance evidence-based care: Lessons from the VAQUERI program. Journal of General Internal Medicine, 25, 544-549.
- Know Basic Guidelines for Telepsychology. (2017, August 15). Retrieved from https://www.aapc.com/blog/39515-know-basic-guidelines-for-telepsychology/
- Reese, R. J., Slone, N. C., Soares, N., & Sprang, R. (2015). Using telepsychology to provide a group parenting program: A preliminary evaluation of effectiveness. Psychological Services, 12(3), 274282.
- Reese, R. J., Mecham, M. R., Vasilj, I., Lengerich, A. J., Brown, H. M., Simpson, N. B., & Newsome, B. D. (2016). The effects of telepsychology format on empathic accuracy and the therapeutic alliance: An analogue counselling session. Counselling and Psychotherapy Research, 16(4), 256-265. doi:10.1002/capr.12092
- Tuerk, P. W., Yoder, M., Ruggiero, K. J., Gros, D. F., & Acierno, R. (2010). A pilot study of prolonged exposure therapy for posttraumatic stress disorder delivered via telehealth technology. Journal of Traumatic Stress, 23, 116-123.
- What are Telehealth and Telepsychology? (n.d.). Retrieved from https://www.apa.org/pi/disability/resources/publications/telepsychology
- What Is Telepsychology. (2019, August 29). Retrieved from https://psychologypedia.org/what-is-telepsychology/