RISE OF TELETHERAPY IN MENTAL HEALTH ASSESSMENT

While there was teletherapy before  the Covid-19 crisis, it skyrocketed during the pandemic as therapists and clients were left with no other choice.

How the pandemic has changed teletherapy

With the COVID-19 outbreak over a year ago, businesses around the world had to make the transition to a digital landscape – including clinicians.

Teletherapy,  unlike  traditional  face-to-face  therapy, is done via video calling over the Internet, and there has been a dramatic increase in the scope of this form of therapy due to the COVID-19 pandemic. More than half of mental health services reported an increase in demand during the pandemic, according to research. Telehealth has proved to be quite effective in meeting that requirement. While technology has increased access to treatment, particularly for patients in rural regions, practitioners must maintain quality standards to ensure that this technological progress does not compromise patient outcomes.

The collective nature of this crisis has taught us all the importance of maintaining our mental health as well as our physical. Today, and in a post-pandemic world, that surge in treatment options can only benefit a world where mental health awareness has never been higher.

How other counselors have adapted

Last year’s pandemic highlighted mental health care providers’ ability to adapt, creativity and flexibility as the world became isolated and concerns  regarding mental health have grown. Clinicians were forced to change  and  shift  their  perspective  almost  in  the blink of an eye as they navigated how best to meet the growing need for behavioral  health  services  by living  and  learning  with  patients  in  this  new, unknown environment.

Teletherapy has  swiftly  become  an  important element of nearly every healthcare organization’s operation, whether everyone in the industry is ready for it or not. There  was  considerable  skepticism before COVID-19 that virtual consultations could deliver the same level of care as in-person appointments. Furthermore, the sudden  change  has left many therapists grappling with technical issues, lack of support, and concerns about privacy and ethics. Even those who had previously been opposed to teletherapy have turned to this new set of skills and trained to meet their patients’ requirements. Many professionals had to swiftly adjust and work remotely while still providing effective, high-quality treatment.

Those who had not previously provided teletherapy needed to seek out proper training and get familiar with new telehealth guidelines. Numerous aspects of care delivery had to be relearned for this modality from risk assessment and safety management to maintaining eye contact and refining active listening skills when speaking with a patient over the phone or via virtual  platform.  Establishing  sensible boundaries between work and personal life became much more difficult when physicians worked from home. Fortunately, when faced  with  uncertainty,  one of the most important underlying skills of clinicians is the ability to be resourceful and adaptive.

Counsellors, who are committed to clinical best practices but who may be new to this mode of delivery, can ensure consistent quality via teletherapy by following these recommendations:

• Be confident that your skills and effectiveness can shine through telehealth, but do not underestimate that there is a difference in procedure. There are different skills used in practice over the phone vs. on video vs. in- person therapy.

• Seek out intensive tele-behavioral health training. The practice of teletherapy involves some practices, protocols, and  guidelines which differ from the traditional on-site therapy. It is possible to be an effective practitioner via teletherapy, as long as you learn how.

• Obtain multistate licenses to broaden your reach. Therapists can get multiple licenses, beyond just the state they live in, in order to meet the increasing  demand  for  mental health care and not be limited by geography.

• Remember that you are in charge of your license regardless of where you are or what practice or network you work for. Know the rules in the states where you conduct your practice: stay updated with your CEUs, get cross-licensed, and understanding your responsibilities.

Complete CEU Outlet’s 2-hour  course  to  make sure you are fully up to date on current guideline recommendations in practice for teletherapy approaches involving mental health risk & assessment; and understanding ethical/legal aspects.

• Being a  health  care  professional,  it  is  crucial  to stay current once the new information becomes available in order for you to keep providing proper service to your  patients.  Even  if  some  techniques are appropriate for  treatment  of  some  individuals, for others they  might  be  non-effective.  Therefore, you should be capable of prompt adjustments as telemedicine is currently on the rise.

How patients’ perception of teletherapy has changed

When COVID-19 began, the world had to quickly conform to the new circumstances.  Despite  having little (or no) experience with it, both patients and mental health care providers were forced to urgently transition to teletherapy. While teletherapy has emerged as a possibility, opinions differ among patients.

For some patients, remote consultations are more convenient and often  preferable  than  face-to-face ones as it can help patients with physical disabilities, anxiety disorders, autism,  post-traumatic stress disorder  or  people  with  obsessive-compulsive disorder (OCD). In some clients’ perception, deficit of traditional eye-to-eye sessions between  them  and their therapist creates  a  particular  gap,  that  may help them to open up and become more sincere.

“For patients who have  never  before  sought  care from a therapist due to various barriers —including concern about being seen at a physical  clinic—the option to obtain services online can  be  a  port  of entry into mental health care,” says Dhara Meghani, PhD, an assistant professor of clinical psychology at the University of San Francisco. Patients benefit from increased privacy and the opportunity to receive treatment without the stigma  of  being  seen  by others in a clinic or therapist’s office.

Teletherapy is not only a time saver, but it also allows patients  to  access  therapy  from  locations  that  may be more convenient. During the lockdown amid the pandemic, people were  able  to  start  or  continue therapy  without  leaving  their  homes.   Instead  of driving to a therapist’s office, the technology allows someone to  join  a  session  in  seconds  with  the  push of a button.

Although it removes hurdles such as transportation and  commuting  time,  it  also  introduces technological obstacles that people do not have to deal with when receiving therapy face-to-face. Not every home may have access to a computer or smartphone, and those that do may not have stable (or any) internet connectivity. And some patients, especially the elderly or those who cannot use technological tools, can make teletherapy confusing and intimidating for them.

For some,  face-to-face  appointments  are  very important because they allow eye contact  and  build trust between caregivers and patients. Replacing traditional therapy eliminates the social activity and physical closeness  in  a  trusted  relationship,  which often plays a role in healing.

Even though teletherapy  is  instrumental  in emergency situations such as COVID-19, it should not take over in person therapy in the long-term perspective — at least not for  all  categories  of patients.

Trends in teletherapy – its effectiveness

Although teletherapy has been around for several years, the pandemic has  forced  therapists  and mental health professionals to modernize  their working  methods  to  provide  their  services virtually. Many people now work  from  home  and while  social  distancing  measures  are  in  place, both therapists and clients turn to  phones  and laptops to get work done and communicate with others. The upsurge in teletherapy shows that it is immensely  popular,  with  both  clients  and therapists  reporting  positive  experiences,  but  it has not been without its challenges.

For clients seeking therapy, many praise teletherapy at a time when they most need support and guidance, as the pandemic has worsened the mental health and well-being of many. The obvious advantage for the client is the convenience and availability of online therapy. Some people may live in rural areas or during a pandemic in self-isolation, so being able to visit through video calling platforms such as Zoom is highly desirable.  In  addition,  if  teletherapy becomes significantly  more  effective  and affordable, it could reduce waiting lists for face- to-face treatment, which is a major concern for mental health services in many countries.

Now  that  teletherapy  has  become  commonplace due to isolation and while maintaining social distancing, it  could  lead  to  a  more  acceptable online mental health system. This rise in online therapy, in addition  to  media  coverage  of  the impact of COVID-19 on  mental  health,  could  also lead to reduced social stigma and increased acceptance. This is vital  because  increased acceptance will allow more people to seek help and prevent people from living without an undiagnosed mental disorder.

Teletherapy can be used for a variety of treatments, but research shows that the easiest way to move from face-to-face to online treatment is through cognitive behavioral therapy  (CBT)  and psychotherapy. Online therapy for therapists is not only convenient, but also provides an opportunity to see the client in his own home, which gives an additional insight into their family life and who they are. Thus, this additional information can lead to a better understanding of the client and the therapist to provide more precise and specific advice.

However, many psychologists point out that despite the video call and the visit to  the  client’s  home, there are other details that are perhaps more important that may be overlooked. Sometimes a person’s behavior can be more eloquent than what they are doing (or not saying),  so  quiet  tears, shaking hands,  and fidgeting,  which may be normal non-verbal communication in the  therapist’s  office, are likely not to be detected  during  an  online therapy session. With the rise of teletherapy, one of the problems reported by therapists is significant technological  and  logistical  challenges,  after  all, they were trained as therapists, not computer technicians.

While clinicians can manage a random Zoom call, it is  much  more  difficult  to  arrange  multiple video calls throughout the day with different clients, some of whom may be late and have poor Wi-Fi connections, which can  disrupt  the  quality and flow of the conversation between therapists. and the client.

In general, most forms of therapy can be carried over to online therapy sessions and still be effective, however there are a few caveats here. Individuals who may have more serious mental health problems or who are more at risk of self- harm are less likely to practice teletherapy and will benefit more from therapy in the office when they meet in person.  In  addition,  depending  on the therapy or even the therapist himself, therapeutic  skills  traditionally  developed  in person cannot be automatically translated into online therapy skills.

Final Thoughts:

Perhaps the pandemic was the  push  that  was needed to create change, because although teletherapy has been around for many years, it is slowly developing and  gaining  popularity.  COVID- 19  has  meant  that  companies  and  individuals need to be  able  to  adapt  quickly,  and  therapy  is no exception, so of course the need to adapt  is fraught with challenges. If these problems were addressed  and  rectified  by  institutions, governments,   and  companies,   both  the  quality and  quantity  of  teletherapy  sessions  would improve, which would benefit more people.

REFERENCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049904/ https://edit.cms.gov/files/document/medicare-telehealth- frequently-asked-questions-faqs-31720.pdf https://www.thenationalcouncil.org/press-releases/demand- for-mental-health-and-addiction-services-increasing-as-covid- 19-pandemic-continues-to-threaten-availability-of-treatment- options/ https://www.liebertpub.com/doi/10.1089/cyber.2020.29196.edit orial#B4 https://www.forbes.com/sites/forbestechcouncil/2020/07/21/tel etherapy-and-digital-health-arent-just-stopgaps–theyre-the- future-of-mental-health-care/?sh=14491a743904 https://www.psychologytoday.com/us/blog/breathing- room/202003/teletherapy-tips-clinicians https://positivepsychology.com/teletherapy/ https://www.apa.org/monitor/2020/07/cover-telepsychology https://mhanational.org/teletherapy-during-covid-19-what- research-says https://www.verywellmind.com/americans-turn-to-online- therapy-for-strength-5085208