Below are snippets from the recently published article, the “Future of Telepsychology, Telehealth, and Various Technologies in Psychological Research and Practice” as recently published in Professional Psychology: Research and Practice, Vol 43(6), Dec 2012, 613-621. It was a joint project, authored by myself, Myron L. Pulier, Joseph P. McMenamin, Les Posen and myself. While it was written primarily for a psychology audience, the issues discussed in the article apply to all behavioral disciplines.
Two potent forces — the technological expansion of health care delivery and heightened consumer expectations–present psychologists with the imperative to efficiently and ethically leverage new tools and systems to enhance practice, research, education, training, and policy. Despite individual psychologists choosing to adopt or resist the profound changes in delivery of and demand for behavioral health care services, administrators, clinicians, and their professional organizations should recognize the nature, advantages, and dangers inherent in the changes, anticipate how technology will continue to transform practice, and prepare for the expected opportunities and challenges.
Technology does not bring unalloyed good news for psychologists. Patients sometimes prefer telephone and Internet-based interactions above in-person meetings with psychologists (Mohr et al., 2010), even though the quality of psychology resources directly available to consumers is inconsistent (Klein et al., 2010). Using technology, primary care physicians may achieve outcomes comparable to those of psychotherapists (Shandley et al., 2008). Consumers can independently access certain fully automated psychological tests and other interventions online (Andrews, Cuijpers, Craske, McEvoy, & Titov, 2010), but effectiveness and standardized, ethical administration generally need far more attention. There is thus a great need for higher-quality research (Hailey, Roine, & Ohinmaa, 2008; Whitten, Johannessen, Soerensen, Gammon, & Mackert, 2007), particularly in evidence-based methods for bringing treatment safely into the “unsupervised” setting of patients’ homes (Luxton, Sirotin, & Mishkind, 2010).
Psychologists currently are at a crossroads. Their future depends on the speed with which they organize to make themselves more relevant in the current technological marketplace. To date, their involvement with ICT lags that of other health care disciplines (Maheu et al., 2001; Maheu et al., 2004) as well as nonhealth care groups online. Each psychologist needs to decide whether, when, and how to leverage technology. Similarly, each professional association and organization needs to decide whether to allocate needed resources to shepherd technology adoption or to take a back seat to other disciplines.
A PDF of WORD Version of Article is Here
PLEASE NOTE: the copyright to this article belongs to the American Psychological Association. This version of our article may not exactly replicate the final version published in the APA journal. It is not the copy of record. I am authorized by the APA to make this single copy available to you through this website only. Please do not circulate this PDF. Rather, encourage your colleagues to come here and download. Your feedback is also welcomed in the comment section below.
Behavioral health is lagging when compared to other healthcare disciplines. Reluctant to deal with technology, many of us are employed in universities that have shunned research in technical arenas. Many of us are in small or independent practices, isolated from larger institutions that have now required computerization for decades. Many of us are older and claim to be “technophobic,” thereby ridding ourselves of any duty or interest in using technology.
Most of our regulators have also been focused elsewhere, tolerating antiquated and contradictory licensing laws across states as a necessary evil. State regulators often differ over minimal criteria for state licensure. They also are at odds regarding which state will enforce sanctions on errrant practitioners, and which state will bear the cost. It is notable that some have made significant strides, because these visionary leaders are sure to hold the solution for cross-border practice. For instance:
- A growing number of states have passed laws mandating third-party insurance reimbursement for telehealth on par with in-person care. See States Requiring Private Insurance Payers Reimbursement for Telehealth & Telemedicine.
- Massachusetts’ House of Representatives has passed a bill that may set the bar for other state regualotros to note. See Bellwether? Doctors Licensed Anywhere in the US to Consult, Diagnose and Treat Massachusetts Residents by Internet Video.
- We’ve also seen great strides, including federal support of some professional regulatory associations and their efforts to pursue research related to solving the dilemmas with licensure portability. See Association of State and Provincial Psychology Boards Receives Licensure Portability Grant from HRSA
- Attend the free webinar we have scheduled for January 21 to learn more about licensure. See 12 Licensing Facts You Probably Won’t Learn from Your Licensing Board about Practicing Over State Lines (Licensure Portability)
Those large professional associations that have developed standards or guidelines have focused on telehealth, without apparent inclusion of the many other aspects of technology that are developing in behavioral healthcare. See our summary page of telemental health ethical statements and guidelines. The Australian Psychological Society was the first exception noted to this rule. They began discussing issues related to other technologies almost a decade ago.
All this is happening in an environment where behavioral health is the largest unmet need in healthcare. For a broader statement of how behavioral healthcare is relevant to overall healthcare, listen to the December 2012, American Telemedicine Association webcast with Jay Sanders, MD and Jonathan Linkous: Telemedicine After Two Decades: Where Are We Going And When Are We Getting There? For a greatly abbreviated summary that unfortunately leaves out some key comments by Dr. Sanders about behavioral healthcare, see this mHISS article.
For those who follow the news in my Telehealth blog and our Institute’s TeleMental Health News newsletter, you know that behavioral health care is central to the success of all healthcare — but most behavioral health professions haven’t yet embraced the opportunity. Many of us haven’t been taught in graduate school to understand how our work as directly relevant to daily healthcare delivery and how we can help. As a result, many of us we remain isolated in our offices, shying away from the very tools that could help billions of people through the Internet (2 billion) and mobile phones (5.6 billion).
Where Can Behavioral Healthcare Professionals Start?
See my blog post called, Where Can Behavioral Healthcare Professionals Start to Prepare for Using Technology in Mental Health? for some ideas. Please leave your comments and ideas below.