Telebehavioral Health, Telemental Health, e-Therapy and e-Health Competencies: the Need for an Interprofessional Framework
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Telebehavioral health (TBH) in the form of synchronous video is effective, well received and a standard way to practice. Current guidelines and policies discuss the importance of good clinical, technical, and administrative components to care. A review of the TBH evidence-based literature across psychiatry/medicine, psychology, social work, counseling, marriage/family, behavioral analysis, and other behavioral sciences found no common TBH competencies across disciplines. The scope of professional guidelines and standards about technology are broad (e.g., practice of telepsychology; Internet and social media use in social work practice), to mid-range (e.g., American Telemedicine (ATA), American Counseling Association (ACA)), to narrow (e.g., preliminary “guidelines” for asynchronous communication such as e-mail and texts). There is only one set of competencies for telepsychiatry, which discusses skills, training and evaluation. These competencies suggested (1) novice/advanced beginner, competent/proficient, and expert levels; (2) domains of patient care, communications, system-based practice, professionalism, practice-based improvement, knowledge and technological know-how; and (3) pedagogical methods to teach and evaluate skills. Revisions to this framework and technology-specific competencies with additional domains may be needed. A challenge to competencies across disciplines may be finding consensus, due to varying scopes of practice, training differences and faculty development priorities. Disciplines and organizations involved with TBH need to consider certification/accreditation and ensure quality care.
KeywordsTelebehavioral health Telemental health e-therapy Competencies Competency framework Interprofessional Interdisciplinary
The study was based on information and input from The Coalition for Technology in Behavioral Science, The American Association of Clinical Social Workers Office on Policy, American Association of Marriage and Family Therapists, American Counseling Association, American Psychiatric Association and the Board of Trustees Committee on Telepsychiatry, American Psychological Association and The American Psychological Association Legal Office, The Association of State and Provincial Psychology Boards, National Association for Alcoholism and Drug Abuse Counselors (now called, the Association for Addiction Professionals or AAP, National Association of Social Workers, and American Telemedicine Association and the Telemental Health Interest Group.
Compliance with Ethical Standards
Conflict of Interest
The authors report no financial conflicts of interest. Co-author Marlene Maheu runs the for-profit Telebehavioral Health Institute (https://telehealth.org/about-draft/), which expressly sells Certification Programs (see https://telehealth.org/faq/, http://telehealth.org/telemental-health-certification) that this paper is expressly advocating for in its Abstract. Tracy Luoma is Executive Director at Optum Behavioral Health Salt Lake County. And Richard Long runs a potentially commercial supervision site that could potentially benefit from certification processes (see http://mentalhealth-connect.com/process for pricing). The authors alone are responsible for the content and writing of the paper.
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