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Telebehavioral Health Competencies

Authors: Marlene M. Maheu & Kenneth P. Drude & Katherine M. Hertlein & Ruth Lipschutz & Karen Wall & Donald M. Hilty


The Coalition for Technology in Behavioral Science (CTiBS) has developed an interprofessional, evidence-based, measurable framework for telebehavioral health (TBH) competencies. The paper presents the development of the CTiBS TBH framework, identifies the theoretical rationale and need for such competencies; outlines methods used; provides two detailed discussions of applications; presents a tabulated form of the framework, then discusses limitations and future research. In the CTiBS TBH competency framework, the term telebehavioral health is meant to include telemental health and e-therapy.

The TBH competency framework is offered as an initial working document to identify and organize discreet, measurable telebehavioral practices derived from a review of the literature, technological advances and day-to-day clinical practice. It reflects core knowledge, skills and attitudes needed for competent telebehavioral health practice. The competency framework is directly applicable to psychiatry/medicine, psychology, social work, counseling, marriage/family, behavior analysis and other behavioral sciences.

The CTiBS TBH framework organizes seven topic domains and five subdomains according to competency level i.e., Novice, Proficient or Authority. In turn, each competency level is categorized into 51 discrete telebehavioral objectives, which are then distinguished by 149 cumulative and measurable telebehavioral practices. The seven TBH competency domains identified by CTiBS include:

1) Clinical Evaluation & Care, with three subdomains addressing Assessment & Treatment, Cultural Competence & Diversity and Documentation & Administrative Procedures;

2) Virtual Environment & Telepresence

3) Technology

4) Legal & Regulatory Issues

5) Evidence-Based & Ethical Practice, with two subdomains addressing Standards and Guidelines and Social Media

6) Mobile Health and Apps and

7) Telepractice Development.