Lecture 3 Flashcards
TelehealthE
APA 2002 introduction/applicability: ethics code applies to activities in a variety of contexts - in personal, postal, telephone, internet, technology. Also be familiar with state laws, e.g. have to be licensed in AL to practice in AL.
Guidelines for the practice of telepsychology
APA adopted in 2013. Defined as using telecommunication technologies. Can be real-time or delayed, stand-alone or supplemental to other therapy. Guidelines include competence of the psychologist, standards of care (not much different than f2f), informed consent (put in additional risks and benefits), confidentiality of data and information (these issues are amplified), security and transmission of data and information, disposal of data and information and technologies, testing and assessment, interjurisdictional practice (doing this across state lines - have to check with own state’s regulations and the laws of states clients are in, only 4-5 states entered the reciprocity agreement but needed 7).
Society of media psychology and technology
Division 46 of APA
Practice parameters for telepsychiatry with children and adolescents, practice guidelines for video-based online mental health services, telemental health standards, guidelines and statements
Just know it exists
Journals
Journal of media psychology, media psychology review, media psychology. Also there’s a media psychology research center.
Telephone therapy
Been around the longest. Challenges: lack of control over the environment - you don’t know what the client is doing or who is with them. Privacy and confidentiality - not sure who might pick up the phone, might give them and ID they have to provide, also don’t know if client could be recording the call or if the call is being intercepted (can affect how comfortable you feel if you know it might e being recorded). Therapeutic alliance - harder to develop over the phone (can get distracted). Therapist adjustment - don’t have nonverbals, can’t just let it break down into a normal conversation. Ethical and legal issues - jurisdictional. Crises - have to know where they live to get the police, knowledge of resources in their community. Research - reasonable effectiveness, not that much different than face to face.
E-therapy
Only 50% of people with problems seek help. Who is providing? Only 10% of e-therapy is done by psychologists, most is social workers, counselors, LMFTs. Unclear how much of this is supplemental vs only doing this. Who could benefit? Bed-ridden people, elderly, severe social anxiety, severe phobias. Therapeutic implications - could be the person reveals more sensitive issues. Could also be meaner since it’s electronic. Confidentiality/legal - same with phone stuff.
E-therapy advantages
More accessible, may increase disclosure of sensitive information, initiate contact when convenient, reduced cost, contact can be more frequent, therapy can be in the moment.
E-therapy disadvantages
Technological problems, participants miss non-verbal cues, frauds, cultural differences are missed, cannot be as certain of a client’s understanding. Crises need handled.
Apps
Engaging, user-friendly, self-paced, can track progress anytime and anywhere, can provide real-time intervention. But risks involving privacy and confidentiality. Most lack encryption, don’t always inform user about what is sent to the developer. Proliferation of development - 2,000 out there on relationships, 1,500 on anxiety, 1,000 on depression. PTSD coach is in 80 countries. 2016 - NIMH awarded 400 grants for app development. Some research with positive findings but not enough research yet (can be used to augment therapy).
