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Text Messaging Therapy in Telehealth

What’s TBHI’s Position about Text Messaging Therapy?

Text messaging is a new technology that is used more than any other telecommunication medium worldwide. It is here to stay and therefore most likely to become part of the average clinician’s communication repertoire in the next decade. However, as with any text-based communication service, there is the potential that a relationship with a patient can take a turn for the worse when communication is truncated by removing visual and auditory input, or when the communication is somehow altered electronically by the technical error.

Three Issues in Text Messaging Therapy

  • First, there is greater room for error when communication is limited to a short and simple text message is exchanged with or without additional inputs from other experiences of the client or patient. By that, we are simply stating the obvious that communication is enriched by in-person, multi-media-based exchanges that can include the telephone, video conferencing, email, art, music, dance, and possibly even old-fashioned letters and dairies.
  • Technical errors with text messaging therapy also can occur. As with any other modality, errors can be on the user’s incorrect input and unfamiliarity with the technology’s features. They can also include errors in the integrity of the data. It can be corrupted or it can be distorted in transmission, reception, or storage.
  • The majority of clinicians have not yet obtained professional training to deliver text-messaging services. They are unaware of the evidence base supporting different types of text-messaging services. They also are often guessing at how to comply with legal and ethical mandates.

Text messaging then, limits the amount of information being transmitted more than any other telecommunication modality. Technology is not yet 100 percent reliable in that technical data-related errors that are reported every day. When used in the context of behavioral care, text messaging therapy can make it much more difficult to read a patient’s emotional cues than in-person encounters. On the other hand, as a telecommunication modality, it reaches more people, in less time, with less effort than any other — and thereby may very well have a viable role in behavioral health care.

In sum, our position at TBHI is that those of us who choose to use text messaging have a responsibility to develop competency in texting prior to utilizing it with people who rely on our professionalism to guide their behavioral care.

Offering Text Messaging Therapy?

Therapists are finding that clients are increasingly asking for text messaging in therapy. TBHI’s online training event entitled, “Text Messaging Therapy? 12 Risk Management Considerations to Keep You Out of Hot Water” will review basic risk management approaches to using text messaging as the basis for clinical care. It will outline 12 ways in which text messaging therapy may expose you and your client or patient to undue risk including HIPAA-compliant text messaging, types of text messaging services, and ethical codes that relate to text messaging. It will also clarify considerations for accepting employment from online text messaging therapy companies.

 

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