Telehealth Tips
While some of you have been using teletherapy for a long time, many therapists have had to switch over very quickly from in-person consultations, to online or telephone consultations. Below are tips that can be of use to you in providing teletherapy, whether you have been practicing it for a long time, or you are brand new to the process. Also be sure to check out our related pages on Teletherapy Regulations and Teletherapy Software. If you would like to share information with us to post, please email Ann Lundberg, NCB Logistics and Communications Coordinator, at [email protected].
“Post COVID-19 Re-entry with Blended/Hybrid Telehealth” (Posted 8/2/2021):
By Eugene F. Augusterfer and Richard F. Mollica
First, let us start by defining blended or hybrid telehealth. As the name suggests, blended or hybrid telehealth is a combination of traditional face-to-face clinical encounters blended with virtual or telehealth encounters. When possible, it is best to have an initial meeting face-to-face, then move to telehealth meetings. Studies and experience have demonstrated that while using telehealth, occasional face-to-face meetings mixed with telehealth meetings is more efficacious. “New patient visits, even those that perhaps are safe to perform virtually, may benefit from face-to-face encounters to familiarize patients with their care and build a trusting relationship”.1 (Reeves JJ, Ayers JW, Longhurst CA, Telehealth in the COVID-19 Era: A Balancing Act to Avoid Harm, J Med Internet Res, 2021 Feb; 23(2): e24785). To read more click here.
Also, regarding the use of telehealth, Eugene Augusterfer, Deputy Director and Director of Telemedicine of Harvard Global Mental Health: Trauma and Recovery Program, discussed the efficacy, cost savings, and time savings to clients and shared two studies regarding this topic.
- Augusterfer, E. (2020) The Role of Telemental Health, Tele-consultation, and Tele-supervision in Post-disaster and Low-resource Settings (https://pubmed.ncbi.nlm.nih.gov/33247315/. Current Psychiatry Reports Nov. 28,22(12):85
- Shore, J, Brooks, E., An Economic Evaluation of Telehealth Data Collection with Rural Populations (https://pubmed.ncbi.nlm.nih.gov/17535944/). Psychiatry Online June 2007.
Eugene reported studies show that an initial visit face-to-face before doing telehealth with some periodic face-to-face is best. For more information see: Drissi, S (2021) A Systematic Literature Review on e-Mental Health Solutions to Assist Health Care Workers During COVID (https://www.liebertpub.com/doi/10.1089/tmj.2020.0287). Telemedicine and e-Health June 7, Vol. 27, No. 6.
“Measuring Results: The Shift to Telehealth During COVID” (Posted 8/2/2021):
CVT published this blog post by Sabrina Roowala, MPH, program evaluation specialist, and Jennifer Esala, Ph.D., research associate, made interesting discoveries as they analyzed research results from before and after CVT’s U.S. programs moved to telehealth as a result of the pandemic.
Tips on screening potential new clients remotely (Posted 6/25/2020):
Alison Beckman, M.S.W., L.I.C.S.W.
Senior Clinician for External Relations
One of the SoT programs recently asked me a question about best practices when it comes to screening potential new clients remotely. I turned to Jenna Nomeland, MSW, LICSW who, as part of her role at CVT, coordinates and conducts most of our screenings of new potential clients in St. Paul. Here is what she had to say:
I have been offering phone and zoom sessions for potential client screenings, leaving it to client choice. However, I have nudged zoom sessions stating “it is a way to see who you are talking with rather than just hearing my voice and this may make it more comfortable.” So far, the majority of potential clients (if they have the technology) have opted to do video call screenings. I have guided them on setting up zoom on their phone as we talk during our initial conversation when setting up our future appointment. I believe this has also helped with rapport building.
I have observed that getting a comprehensive torture history is more challenging for several reasons. I have found myself feeling more hesitant with them giving a complete narrative (as they often do in the office) due to my inability to regulate in the same way and my concerns related to privacy with a potential client’s living situation. I have found that stating, “I am going to ask you direct questions to minimize the time we have to spend talking about the past at this time” has been helpful language. Then I will go directly into, “have you ever been arrested or held against your will”, “do you know for what reason”, “who arrested you” etc. and put together the narrative that way while gathering the necessary info for eligibility. I get far less information up front, but definitely enough to make a determination and do our best to maintain the safety and comfort for clients.
Lifeline Teleheath discount program
- Our friends at ORR have shared this information on a federal benefit that can help your clients access telehealth services. (Posted 6/25/2020)
- For other downloadable consumer resources, please see USAC’s Consumer Outreach Page. (Posted 6/25/2020)
- You can also access a Past Consumer Advocate Webinar and other training materials on USAC’s Webinars Page. (Posted 6/25/2020)
- For questions about the Lifeline Program, call the Lifeline Support Center at (800) 234-9473 or email [email protected]. (Posted 6/25/2020)
Watch Eugene Augusterfer’s presentation and interview Telemedicine in Mental Health (Posted 7/13/2020)
Telemedicine in Mental Health from HealTorture on Vimeo.
Click here for the PowerPoint from the presentation. (Posted 7/13/2020)
Telehealth Protocols: This is a brief summary of the recommended protocols from Eugene Augusterfer’s presentation. (Posted 7/13/2020)
Telehealth Room Setup Checklist: This is a brief checklist of things to keep in mind as you set up your tele-health work space and prepare for your online session. (Posted 7/13/2020)
General Provider Telehealth and Telemedicine Tool Kit Centers for Medicare & Medicaid Services (CMS) (Posted 7/13/2020)
Grant Programs (Posted 7/13/2020)
- The FCC COVID-19 Telehealth Program: The COVID-19 Telehealth Program provides $200 million in funding, appropriated by Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, to help health care providers provide connected care services to patients at their homes or mobile locations in response to the COVID-19 pandemic. Unfortunately, this program is closed for new applications as of June 25, 2020. However, there is the likelihood that other Telehealth grants will become available as the COVID-19 pandemic continues.
- Your State and County: Keep an eye out for opportunities through your own state’s department of health or human services or your county health department.
Articles
There are numerous articles available online on how to conduct tele-health therapy, below are a couple.
- 2013 APA Guidelines for the Practice of Telepsychology (Posted 7/13/2020)
- Making Eye Contact Over Video in Telemental Health Services (Posted 7/13/2020)