Texting in behavioral healthcare?
It has been reported that 72 percent of cell phone users also send text messages. Another survey reported that 73 percent of physicians text other physicians about work.
Text messaging is the communication of choice for Millennials (Generations Y and Z), those born since the early eighties, many of whom regard phone conversations and email as obsolete and old-fashioned modes of communication. In fact, texting is the most frequently used communication channel used by teens to communicate with friends, both old and new. A Pew Research Center survey on teens, technology, and friendship reported that “phone calls are an important way that teens connect, particularly with their closest friends.” (Pew, 2015)
Many young people text each other while sitting in the same room. In contrast, many therapists avoid giving patients their cell phone numbers because of concern over security issues and the lack of research on how texting in behavioral health affects the professional relationship. Some professionals also just don’t want patients to access them casually after office hours.
Texting in Behavioral Healthcare
Despite many professionals’ reluctance to text message with patients, many routine clinical tasks are already being replaced with a variety of technologies including text messaging. Texting is convenient and quick, and the technology is usually within reach without requiring a computer. It is quiet, immediate, and delivered by telephone systems rather than spotty computer connections. It is easy-to-read and device-neutral; in that, it can be conducted by phone, desktop computer, or tablet. Furthermore, many young people have no landline as they only subscribe to mobile phone services. The accuracy of inflection by tone and rapidity in voicemail are lost in texting. Is texting adequate for psychotherapy?
Text Messaging Therapy?
As our younger generations leave for college, attain their education and training, and go on to start their own therapeutic practices, they will undoubtedly be changing the way we work. We are already faced with leagues of practitioners who consider texting part of their everyday communication. The direct and instantaneous communication offered by texting replaces the often time-consuming formalities that often make answering one’s voicemail a time-drain.
Many behavioral care professionals of today already succumb to consumer demand for services from professionals who communicate with popular tools. Adoption of technology may be essential to avoid professional extinction as the marketplace for psychotherapy includes more digital natives whose world has included technology since birth. How can one, therefore, legally and ethically conduct text messaging therapy?
As with any emerging mode of communication, the considerations of texting and relying on mobile devices are only beginning to come to light. Professionals in the United States, unlike their Australian colleagues, have yet to sit down and establish a uniform set of guidelines that will influence how to use texting in professional settings. Nonetheless, the need for such guidelines is becoming more evident with each passing year.
The tendency of the larger national membership associations has been to promulgate technology-related guidelines that outline general principles, without detailing their application to text messaging in particular. They give a fair amount of detail about the need to exercise caution, and to utilize informed consent. They outline the important ethical risks involved in distance care and how they need to be communicated.
However, in 2017, the Coalition for Technology in Behavioral Science (CTiBS) published related competencies. These competencies can be useful for clinicians wanting more specific guidance.
However, TBHI has developed an online training event to help you think through 12 risk management strategies to consider when conducting 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.