Helping Give Away Psychological Science/Telepsychology

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This page is intended for clinicians who provide psychological services. If you are a patient or someone looking for information about receiving telepsychology services, you can find more information on Telepsychology Guide for Patients.

The coronavirus pandemic is causing a lot of clinics and clinicians to move to use telehealth. The rules around it are changing rapidly, as well. This page gathers information about how and what is involved in terms of practical considerations for the clinician, as well as tips and suggestions about how to make it work effectively. We have a suggestion box sharing herewhere you can drop links, add ideas, and comments. You also can make edits directly on this page or on the discuss page if you are comfortable with editing.

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Guidelines for conducting mental health services with technology[edit]

Getting started[edit]

Telepsychology is defined as the provision of psychological services using telecommunication technologies, which include telephones/smartphones, video conferencing, email, texting, and self-help materials (blogs, social media, etc.). The services can be delivered synchronously, with multiple parties interacting in real-time or asynchronously, with parties responding to one another at their convenience.[1]

Telepsychology offers convenience and can be helpful for coaching patients/clients between appointments. There are also circumstances during which it is not possible to see patients in person, and telepsychology is necessary for this continuity of care. This is an overview, including resources with more detailed information, to help practitioners provide telepsychology safely, effectively, and in alignment with professional standards.

In order to build competence in telepsychology, consider taking an online course to familiarize yourself with telepsychology and read American Psychological Association, American Psychiatric Association, and APPIC guidelines on the topic. To find recommendations and tips on conducting Telepsychology, read Recommendations for Policy and Practice of Telepsychology. Additional resources can be found on APA’s website.

Specific information on conducting teletherapy during COVID-19 can be found at Intro to Telepsychology in the Age of COVID-19 and Telepsychology in the Age of COVID-19, Telepsychology during a pandemic, Psychotherapists' attitudes toward online therapy during COVID-19 and Psychotherapists' experiences with telepsychotherapy.

Consent for telepsychology[edit]

It is important to introduce the idea of telepsychology and to give your patient/client an opportunity to ask questions about it and to make a choice about whether telepsychology is right for them.

  • Ask whether the patient/client has ever seen a doctor on a phone or computer. If the patient has not used telehealth, it may be helpful to refer to common lay technology (i.e., Facetime, Skype, or Zoom) and explain key differences.
  • Let patients/clients know why telepsychology is being used. For example, “mental health clinicians are using technology to meet with patients during the COVID-19 outbreak so that everyone can stay as healthy as possible,” or “I am using this so I don’t have to use a face mask to see you today.”
  • Let patients/clients know that the session will be happening in “real-time”
  • Discuss security and address any concerns about who else can hear or see them. Additional information regarding technical specifications should be available if requested. Some patients appreciate being reassured that the session is not “on the internet” in the sense that it can neither be openly viewed nor will it be placed online.
  • It is important to inform patients if a session is being recorded. If you want to record a session, then you must obtain explicit consent from the patient/client.
  • If your original consent for treatment did not include telepsychology (including communication by text message or email), it is important to talk with your patient/client about what telepsychology entails and to collect and document their consent for these services.
  • Some patients/clients may choose to consent to only some services (e.g., email and phone therapy, but not video).
  • You should create a new consent form or update your existing form and go over it with your patient/client over the phone. You can then email them a copy to sign and return to you. If it is not possible for them to print/sign the document, you can consider an online signing service, such as DocuSign or DocHub. Examples of consent for telepsychology can be found here and here.

Consent for resuming in person sessions[edit]

It also may be helpful to document informed consent when you and the client decide to resume in person sessions. The American Psychological Association has provided example consent forms here (article) and here (Word Document version of form itself).

Technology[edit]

Email[edit]

Email is a convenient, but not necessarily secure, method of communication. Some organizations provide encrypted email for their employees, which enables for the safe transmission of protected health information. Even when the message is encrypted, there are some risks to using email and other things of which to be aware. It is wise to have a conversation with your patient/client about how the two of you will use email. Some use email only for scheduling and other logistical things, whereas others will engage in coaching and other services by email. Many professionals include an agreement about email as part of their consent form. If this was not done initially, you might want to have a conversation with your patient/client and then send an email indicating your agreement. They can respond affirming the agreement, and this exchange becomes part of their record. Email is not secure. Even when encrypted, it can be forwarded or compromised in other ways. It can be helpful to include a message after the signature to remind patients of this.

Phone[edit]

Most practitioners are comfortable communicating with patients/clients through the phone to set appointments and occasionally check-in. Conducting therapy over the phone can be more complicated. A few things to keep in mind:

  • Make a plan with your patient/client ahead of time, so that they are prepared for the call and are situated in a quiet, private place.
  • Set expectations, so that your patient/client knows how long the call will last and whether it will be a “typical” therapy session over the phone or something else (e.g., a short check-in).
  • If you are using a cell phone, make sure you have adequate reception to limit call disruptions.
  • Consider using a hands-free headset, so that you can take notes.
  • Find a quiet, private place to conduct the call, so you are not distracted and there is no background noise.
  • Prepare materials you might need ahead of time. For example, make sure you have your notepad and a pen. If you use worksheets or other materials, make sure your patient/client has a copy ahead of time, so you can review it together.

Video Conferencing[edit]

Videoconferencing is a nice alternative to phone for communicating with patients/clients and particularly for conducting therapy or assessment. It also presents some extra challenges for people who are not familiar with the technology. Although recent circumstances have led to the relaxation of HIPAA for the provision of teletherapy. In order to assure the Health Insurance Portability and Accountability Act (HIPAA)-compliance of a software tool, it is important to have a Business Associate Agreement with the service provider. A business associate is someone who performs functions or provides services on behalf of a covered entity which requires them to have access to protected health information. HIPAA Rules typically require business associates and covered entities to enter into Business Associate Agreements. This contract establishes the permissible uses and disclosures of protected health information and ensures that the business associate will uphold these rules and take appropriate measures to safeguard protected health information from any non-permitted uses or disclosures. The first step is choosing a platform to use. There are several options (e.g., Skype for Business / Microsoft Teams, Updox, VSee, Zoom for Healthcare, Doxy.me, Google G Suite Hangouts, Meet, Cisco Webex Meetings/Webex Teams, Amazon Chime, GoToMeeting, Spruce Healthcare Messenger), a few popular ones are described below.

Better Connection Tips: To reduce technical issues with video conferencing services, clear your browser history (under the History menu for most internet browsers), and close all unnecessary windows and applications before and during sessions; encourage your patient to do the same. If you are experiencing delays, try using cloud web-based services (e.g. Zoom), instead of peer-to-peer services (e.g. doxy.me), as they tend to have fewer bandwidth-related issues.[2]

Doxy.me[edit]

  • Both free and premium versions are available and easy-to-use on all devices.
  • All versions are fully functional, HIPAA compliant, and include a Business Associate Agreement at no cost.
  • The premium options give providers the freedom to customize features including the waiting room, logo, text and videos.
  • Other benefits to the premium options include real-time support, file transfer, payment processing and text and email notifications. Premium costs $35 per month for individual providers and $50 for clinics per provider.
  • Doxy.me operates using any web-browser; there is no installment or download necessary for provider or patient
  • It may not be best for those with average to weak internet connections, but for those with higher speed connections, it will provide high-quality audio and video.
  • Check out these tips for a better experience while videoconferencing with Doxy.me.

thera-LINK[edit]

  • A HIPAA compliant option that provides a Business Associate Agreement
  • It can be used on all devices.
  • There are three packages: Basic plan, at $30, per month, offers five sessions a month for one provider and a scheduler. The Plus plan and Ultimate plan, at $45 and $60 per month offer unlimited monthly sessions, secure file sharing, advanced payment and scheduling options, and office manager accounts; the Ultimate plan also includes client notes, secure messaging and a branded portal.
  • theraLINK requires both providers and patients to have their own login.
  • theraLINK is relatively easy to navigate and offers the ability to customize aesthetic features such as imagery and music options for the waiting room.
  • theraLINK can only be used on WiFi and on devices that are well-charged or can be plugged into a power source and may be harder to master than other options.

Zoom[edit]

  • A video conferencing platform that is not tailored specifically for mental health, but is popular for business and education, so many people are familiar with it
  • Its Healthcare business plan is HIPAA compliant and includes a Business Associate Agreement. Plan costs start at $200 per month.
  • Zoom is customizable and works on all devices, though it may not be suited for low bandwidths.
  • Due to the cost, Zoom may be best for those who have midsize to large practices which require the tool to have multiple functions (i.e. training, recording, seminars, etc.).
  • Zoom’s popularity has also made it a target for mischief. "Zoombombing" is when an uninvited participant uses Zoom’s screen-sharing feature to disrupt meetings.
    • It is important to take steps to ensure that your video call is secure and accessible only by you and your client, this includes keeping the link private and setting a password. View additional guidelines here.

Get ready for your telepsychology session[edit]

Advice for clinicians on how to prepare for your telepsychology session
  • Some clinicians make the mistake of not preparing for a telepsychology session because it may feel more informal than an in-person session. However, it can be more challenging to keep a client engaged in telepsychology, and it is especially important to set an agenda and to have your goals for the session planned ahead
  • As noted above, you may want to use worksheets or other materials in your session. These can be emailed to the patient/client ahead of time. You may also want to use the “share your screen” feature that most video conferencing services provide. Other features might include a “whiteboard” or chat functions that can help you to share materials with your patient/client
  • If you want to use some of the special features, be sure to pilot them beforehand, so you know how everything works

Prepare your space and practice[edit]

  • Make an effort to minimize potential distractions in your environment. This means things that will be visible in the background to your patient/client and things that may distract you during the session
  • Pick a spot that is quiet and private. Try to use the same space week-to-week to facilitate familiarity and an office-like experience
  • Remember that lighting is critical; backlighting will darken your face. Position your device so you have adequate front lighting or add front lights.
  • Make sure you are comfortable and have everything you need (water, notes, etc.) before you start
  • Turn off all email and messaging notifications on your computer and cell phone and encourage your patient/client to do the same
  • Many video conferencing programs have a "Virtual Background" option where you can use an image to block out the background
  • Ensure your video is sufficiently “zoomed in” for the patient to see your facial expressions
  • Try to maintain a constant gaze into the camera, rather than frequently looking away at your computer or notes. It can be tough to maintain a constant gaze while on a video call, but there are ways you can simulate eye contact with your patients with just a few tricks.
  1. Try to focus on a point behind the camera lens; this will focus your eyes and make it clearer where you are looking. Much of perceived eye contact through video calling is related to the rotation of your eyes. The further back you sit, the less your eyes need to rotate, so sit further from the screen and zoom in closer to your face if you need to.
  2. Center the video of your patient/client under your webcam, so when you look at their eyes, you are looking directly into the camera
  • If possible, use picture-in-picture feature (e.g., where you can see both yourself and the patient) to see how you are being viewed by the patient, or if there is something distracting in the background (e.g., your cat!)
  • Ask a friend or colleague to do a practice session with you before you attempt a video session with a patient/client - there will be early snafus, and it is good to figure them out before you are in a real session
  • Wear office-appropriate clothing
  • If possible, give yourself a break between sessions to stretch or take a brief walk
How to be prepared for your telepsychology appointment.

Prepare your patient/client[edit]

  • As with phone calls, encourage your patient/client to find a quiet and private space for the session
  • Using a laptop or desktop computer is likely to be more comfortable, but a smartphone can also be used
  • Set the client’s expectations for the session and send any materials (e.g., worksheets, mood rating scales) ahead of time
  • Make your expectations clear as well, including that the patient/client arrive on time, complete their homework, have the room set-up in advance to minimize distractions, and dress appropriately
  • Make a contingency plan, in case the technology doesn’t work
  • At the beginning of the session, ask patients if they would like to see your office. Using the camera’s zoom and pan features or manually moving your device, you can give patients a virtual tour of your workspace to assure them that no one else is present and to provide context to the clinical setting
  • Immediately discuss any technical difficulties noticed as they arise during the introduction. For instance, if there is a slight lag in audio that makes it seem as if you and the patient are talking over each other, you can suggest adding a small pause after each statement

Guidelines for conducting teletherapy[edit]

General guidance for behavioral activation when stuck inside:

  • Be creative about ways to be active
  • Model behaviors you would like patients/clients to try (e.g., yoga, stretching, jumping jacks)
  • Create a pleasant activities schedule based on what can be done at home

Below are some resources for how to adapt psychotherapy while practicing physical distancing and via telecommunication instead of in-person sessions and practice:


Appropriate clients[edit]

Meeting virtually may not be appropriate for all patients/clients. Some may not be comfortable with the technology or may have privacy concerns. Other patients/clients may be high risk, which can lead to safety and liability issues when communicating with them through email, phone, or video. It is important to consider these issues and to discuss other options with your patient/client.

Patients/Clients who are not comfortable with technology[edit]

Signs that telepsychology is a good fit for your clients.

Many patients/clients may be unfamiliar with videoconferencing and hesitant to use this technology for mental health services. Plan to spend some time answering questions and helping them to get set-up prior to your appointment.

  • Ask if there is a software they already use to communicate with family or other providers, try to use the same one, if possible
  • YouTube is a good source for how-to videos about setting up a video conference
  • Your patient/client may also have friends/family who can help them get set-up, encourage them to seek help

Patients/Clients who have privacy concerns[edit]

  • Some patients/clients may not have access to a private space in their home. Help them brainstorm other options. For example, can they sit in their car? Or go to a quiet place in a local park?
  • Others may be concerned about the possibility that communication (whether email, phone, video) will be breached in some way. You can help with these concerns by making sure to use HIPAA-compliant services and encrypted email. However, if the patient/client is not comfortable with telepsychology, it is important to have alternative options for them; this may mean referring them to another provider who is offering in-person services.

High-risk patients/clients[edit]

Patients at high risk for suicide present special concerns for telepsychology[5]. Taking the steps below will help ensure that you are able to adequately manage risk.

  • Update emergency contact information before providing any telepsychology services.
  • Make sure you know the patient/client location (address, apartment number) at the start of the session in case you need to contact emergency services.
  • Make a plan for how you will stay on the phone with the client while arranging emergency rescue if needed. It may be helpful to recruit a colleague who can support you during this process (i.e., call 911 on your behalf). Do not hang-up on the patient/client if there is an imminent risk.
  • The circumstances that make telepsychology necessary (e.g., illness, injury) may also increase suicide risk, it is important to continue to assess suicidal thoughts and behaviors on a regular basis.
  • Risk may also increase if the patient/client has access to lethal means while house-bound. Reviewing and updating existing safety plans to account for current circumstances is wise.
  • As part of safety planning, work with the patient/client to identify the closest emergency facility and how they could get there if necessary.
  • Consider making a plan for more frequent check-ins until risk abates.
  • Provide crisis hotline numbers like the National Suicide Prevention Lifeline: 1-800-273-8255 and they can Text HOME to 741741 to connect with a Crisis Counselor to help at Crisis Text Line.
  • Provide disaster distress helplines like SAMHSA's free 24/7 counseling via 1-800-985-5990, they can text: "TalkWithUs" to 66746, or visit DisasterDistress.samhsa.gov to help them maintain and improve their mental health during distress.
  • More information for working with high risk patients is available:
  1. Telehealth tips for suicidal clients
  2. Telehealth treatment for suicidal patients
  3. Zero Suicide Guidelines
  4. Guidelines for telepsychology with youth at risk for suicide or self injury
  5. The COVID-19 pandemic and treating suicidal risk

Working with children[edit]

Telepsychology with youth can be effective but requires some special considerations[6][7][8][9]. Adolescents are likely to be comfortable with phone or video, but it may be a challenge to get them to focus on you and limit distractions. Younger children may also be distracted by their environment or may struggle to stay engaged. It may be necessary to modify your typical approach to work effectively with youth. Check out this video that covers the basics of telepsychology with youth. If you conduct groups with youth this video may also be helpful.

Setting the scene[edit]

  • Encourage caregivers to minimize distractions in the room where the young patient/client will be completing the session by:
    • Removing toys, books, extra screens/electronic devices/games, pets, and food
    • Providing a clear desk/table space
    • Notifying everyone in the home that the child will need privacy and quietness especially if the child is undergoing testing[10]
  • Young patients prefer a “less formal” room set-up, so you may wish to avoid having a table between the patient and the video-recording device (or you and the video-recording device)
  • Ask the guardian to make sure that the youth wakes up at least an hour before the session, has eaten, used the restroom at least 15 minutes beforehand and taken their prescribed medications[10]
  • Consider the best seating arrangement.[11] Young children can sit next to a caregiver, between the caregivers, on a caregiver’s lap, or in front of the caregiver in either their own chair or on the floor
  • You may want to ask the caregiver to put a blanket on the floor to indicate the "therapy boundary" that the child needs to stay within during the session
  • If possible, larger rooms tend to work best with younger patients, so they can move around. In addition, if a child's motor skills, play, exploration, and movements are being assessed, the room should be large enough for this activity to fit within the camera frame
  • Adolescents may prefer to be seen without a caregiver present
  • Establish that you are seeing the patient/client in real-time. Young children may enjoy seeing you mimic their gestures, or comment on what they are wearing
  • Socialize youth to the videoconferencing system, and highlight that it might take time to acclimate to the technology and ‘‘not talk over each other’’
  • Give patients an opportunity to ask questions before starting the session
  • Ask children or caregivers to prepare some toys, drawing materials or other supplies that you may want to work with during the session at least 24-hours ahead of time and send them a reminder. Try to recreate your office as much as possible [12]

Maintaining engagement[edit]

  • It is important to leave adequate time to build rapport and adjust to the new circumstances when working with youth [13]
  • If you are using or creating worksheets or other visual activities, consider allowing the patient to choose the colors/fonts/pictures in order to provide them with some control.
  • Use exaggerated expressions and gestures if needed to engage the youth (virtual high fives, thumbs up, etc.).
  • Children may enjoy drawing pictures that they can then share through the camera while telling a story. These drawings may help you assess children’s attention, fine motor skills and creativity. Children may also use play figures (e.g., dolls, action figures) to demonstrate their ability for symbolic play and reveal their thought content.
  • For younger kids, ask them to share their favorite things about home — toys, books, blankets, etc. insofar as these can be related to clinical activities and are not disruptive.
  • For older kids, ask if they have any art, journaling, music, or anything else to share with you. Consider engaging adolescents by exploring an online site, such as YouTube or Facebook through screen sharing
  • Children and teens may appreciate getting to know clinicians as well. Consider using a brief question and answer game to share some facts about you and gathering information about your patient. For example, you and your patient can take turns answering: “What is your favorite TV show?”, “What is your favorite color?”, “What is your favorite food?”, “How many siblings do you have?”
  • Mirror the language patterns of the youth and handle any threats to rapport with genuineness (including using informal language).
  • Arts-based therapeutic methods may help engage younger patients. You can have the patient show you their work on the camera or use screen share options to create art together (based on your platform’s capabilities).
  • Consider sharing handouts and working through them in session if your platform has the functionality (e.g., Zoom screen share with editable documents or PowerPoints).
  • Try utilizing different functions to increase engagement (e.g., Zoom has a “whiteboard” feature where a patient and clinician can draw together or play tic-tac-toe). Check with technology services at your site for specific training/tips on functionality for your platform.
  • A hyperactive child or a child on the autism spectrum may have difficulty remaining in the camera frame. Consider keeping the caregivers in frame and call the child back to the camera when they need to answer a question.
  • If an anxious or defiant youth refuses to sit within the camera frame, try to use typical behavior management strategies first. Then, prior to the next session, ask the caregiver to turn off the self-monitor image and seat the youth farther away from the camera so as to remain in the frame. Another strategy is to allow the youth to have more privacy for part or all of the session.
  • Especially with younger patients, recognize that staying engaged via telehealth is challenging. Adjust your expectations of how long sessions may last if you are having a hard time keeping your patient engaged.
  • Consider incorporating games or other activities as appropriate. There are online games available that can be helpful for maintaining interest such as Board Game Arena or PlayingCards.io
  • Research shows that youth’s satisfaction with telehealth will likely increase with repeated use; youth who were initially anxious about telehealth showed decreased distress in about 10-15 minutes[14].
  • It is important to continue conversations related to technical difficulties, unique challenges, or positives that come from using telehealth throughout the treatment course. Keep asking!

Additional resources[edit]

  1. Comprehensive guide for supporting children and families
  2. Telehealth testing with children: Important factors to consider
  3. Yale Child Study Family Resources and Suggestions for Coping with Coronavirus
  4. COVID-19 resources for people with I/DD or ASD
  5. Interventions and activities for children and youth teletherapy
  6. First Aid for Feelings: A Workbook to Help Kids Cope During the Coronavirus Pandemic
  7. Webinar on family mental health during the pandemic
  8. Book for young children about coronavius
  9. Guided Imagery audio clips for kids
  10. COVID 19 Resources for Parents of Children With Intellectual or Other Developmental Disabilities
  11. Helping Children and Families Cope with the COVID-19 Pandemic
  12. Considerations for telepsychology with youth at risk for suicide or self injury
  13. Telepsychology with children and families

Conducting assessment[edit]

Conducting assessment through telepsychology may seem challenging, but with some exceptions, it is possible to continue to incorporate assessment in your practice. In some cases, it may be necessary to split an appointment to conduct some assessments via telepsychology and save others for when an in-person meeting is possible. APA has issued multiple statements on psychological and neuropsychological testing, important considerations when conducting teleassessment, and [1], including information about reimbursement and billing. There are also guidelines for conducting assessment with youth.

Self-report[edit]

Many practitioners administer self-report rating scales to assess patients over time. These are relatively easy to continue:

  • Self-reports can be emailed to patient/clients to be completed and sent back
  • Self-reports can be administered through HIPAA-compliant survey tools
  • Self-reports can be read to the patient and they can respond orally

Interview-based[edit]

  • Diagnostic interviews and clinical rating scales are often feasible to administer via telepsychology
  • Behavior ratings may be more difficult to ascertain, though, so it is important to consider the information you need to collect and plan accordingly. If a certain interview relies on behavior observations, consider whether there is an alternative that may be more appropriate

Cognitive/Achievement and Neuropsychology[edit]

  • Tests of cognition are likely to be the most difficult to administer via telepsychology.
  • Given the importance of administering these tests under circumstances similar to those under which the norms were established, it is important to look into data supporting the administration of specific tests with telepsychology.
  • Some tests have online versions. Although there would likely be additional costs associated with this approach, it is likely to be easier and more valid than adapting tests intended to be administered in person
  • The Inter Organizational Practice Committee (IOPC)​ workgroup has released guidelines for teleneuropsychology (Tele-NP) that may be helpful.[15]
  • IOPC has also released provisional recommendations and guidance regarding teleneuropsychology during the pandemic Practice Guidelines and Recommendations for Tele-NP

Legal considerations[edit]

As noted above, it is important that your patient/client understand the potential risks of telepsychology (e.g., confidentiality, safety) and that they consent to the provision of services using telepsychology. In addition to patient consent, it is incumbent upon the provider to follow the rules related to HIPAA and other legal and professional guidelines. Although some of these rules have been relaxed due to the COVID-19 crisis, it is best to confirm the current rules before engaging in telepsychology.

It is important to keep in mind that the rules about telepsychology are typically governed by states, so you should be familiar with the rules in the state where you are licensed and practice as well as the state(s) where your patient/client may be at the time of the service.

Reimbursement and fee collection[edit]

Physicians and Other Clinicians CMS Flexibilities to Fight COVID-19

Services delivered via phone or video are billed under a separate code and, under typical circumstances, may be reimbursed at a different rate than in-person services. Medicare has modified its rules and will cover a wider range of telepsychology services, including testing and group therapy, during the COVID-19 crisis. Private health insurance providers may follow the government, but in order to ensure reimbursement, practitioners should check with individual payers prior to providing services and submitting bills.

Practitioners in private practice may be used to collecting fees by cash or check. Alternative methods for payment may be preferable for telepsychology. Patients/clients can mail a check, but the practitioner should consider where the check is sent and whether they are comfortable receiving payment at their home address. Electronic payment methods avoid this complication, but not all patients/clients will be comfortable transferring funds. Providing some education about the pros/cons of electronic payment and coaching on how to implement it will be helpful. A few options include:

  • Zelle is a payment method that moves funds between bank accounts. It works across different banks and is integrated into many banking apps
  • PayPal is a more flexible option that can link with both credit cards and bank accounts. It also includes accounts for both businesses and individuals, which may be appealing for some who plan to collect fees electronically on an ongoing basis.
  • Venmo is a popular payment tool that allows users to send funds from their bank account or from their Venmo account (if they have been paid by others through Venmo). An important consideration with Venmo is that payments are not necessarily private. You can set your preferences to be private, but if this is not done, others on the app can see payment exchanges.

If your practice is significantly affected by the COVID-19 crisis, you may be able to get a business loan.

Information for Trainees[edit]

Trainees should follow the guidelines set by their institution and rely on their supervisors to provide instruction and support. Additionally, the Council of Chairs of Training Councils (CCTC) published guidelines related to training during the COVID-19 crisis. Self care is also important to pay attention to during this challenging time when may aspects of training may be in upheaval.

Supervision[edit]

Supervision can be especially valuable when initiating a new approach to mental health services - including telepsychology. Trainees should be sure to maintain a consistent supervision schedule with their clinical supervisor, and even licensed practitioners may want to seek supervision from someone experienced in telepsychology until they feel comfortable with it. Although some aspects of supervision can be conducted without modification (e.g., session planning, self-report about a previous session), other aspects require some change, similar to modifications that are necessary for providing services. Fortunately, evidence suggests that telesupervision can be just as effective as supervision received in person Seek guidance from your program to ensure supervision continues to meet APA or other professional requirements. The APA posted considerations for training clinics conducting telesupervision during COVID-19. The Association for Behavioral & Cognitive Therapies has released videos on strategies for effective telesupervision and on the experience of being a trainee conducting telepsychology.

Observation[edit]

  • Many programs are set-up to video or audio record assessment and therapy sessions so that supervisors can watch/listen to them later and provide feedback. Some video conferencing programs allow for the recording of sessions, which is helpful, but before using this option, make sure that:
  1. The video service is HIPAA-compliant and that the recording is stored in a HIPAA-compliant fashion
  2. The video is shared with the supervisor in a HIPAA-compliant way (e.g., secured file sharing program)
  • Sessions can also be audio recorded, particularly if done through speakerphone, but the way the audio file is shared with the supervisor must be HIPAA-compliant

Progress Notes[edit]

  • Many organizations use an electronic medical record (EMR) to store notes. If you have access to this from outside the office, no change in your typical approach may be necessary.
  • Other organizations have paper records or EMR that is not accessible outside. In these cases, it is still important to document what occurred in your sessions.
  • Be sure you have a HIPAA-compliant way of storing these notes until you have access again to the EMR and can store them properly. This could be an encrypted digital folder or in a paper file.

Telepsychology Services[edit]

If you are not comfortable or able to provide telepsychology services, consider referring patients/clients to an alternative provider to ensure they are able to get the help they need when you may not be available.

Research on the effectiveness of telepsychology[edit]

Nuvola apps bookcase.svg Type classification: this is a reading list resource.

Research comparing clinic-based psychotherapy to video-based services have largely found that therapy delivered via telecommunication has similar outcomes. Similarly, although the administration of assessment can be more complicated, in may cases valid results can be achieved. Below is a list of references comparing in-person and tele-services.

Psychotherapy[edit]

APA Division 12 (Society of Clinical Psychology) compiled a list of publications on teletherapy. The publications are grouped by disorder (e. g. Depression) or directed focus of the therapy (e.g. Couples and Family Therapy). This systematic review also provides a helpful summary.

Anxiety

Arnberg, F. K., Linton, S. J., Hultcrantz, M., Heintz, E., & Jonsson, U. (2014). Internet-delivered psychological treatments for mood and anxiety disorders: A systematic review of their efficacy, safety, and cost-effectiveness. PloS ONE[16]

Brenes, G. A., Ingram, C. W., & Danhauer, S. C. (2012). Telephone-delivered psychotherapy for late-life anxiety. Psychological Services, 9(2), 219.[17]

Carpenter, A. L., Pincus, D. B., Furr, J. M., & Comer, J. S. (2018). Working from home: An initial pilot examination of videoconferencing-based cognitive behavioral therapy for anxious youth delivered to the home setting. Behavior Therapy, 49(6), 917-930.[18]

Durland, L., Interian, A., Pretzer-Aboff, I., Dobkin, R. D. (2014). Effect of telehealth-to-home interventions on quality of life for individuals with depressive and anxiety disorders. Smart Homecare Technology and Telehealth, 2, 101-119.[19]

Khatri, N., Marziali, E., Tchernikov, I., & Shepherd, N. (2014). Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: A pilot study. Clinical Interventions in Aging, 9, 765.[20]

McCall, T., Bolton, C. I., McCall, R., & Khairat, S. (2019). The Use of Culturally-Tailored Telehealth Interventions in Managing Anxiety and Depression in African American Adults: A Systematic Review. Studies in Health Technology and Informatics, 264, 1728-1729.[21]

Rees, C. S., & Maclaine, E. (2015). A systematic review of videoconference‐delivered psychological treatment for anxiety disorders. Australian Psychologist, 50(4), 259-264.[22]

Varker, T., Brand, R. M., Ward, J., Terhaag, S., & Phelps, A. (2018). Efficacy of synchronous telepsychology interventions for people with anxiety, depression, posttraumatic stress disorder, and adjustment disorder: A rapid evidence assessment. Psychological Services.[23]

Whiteside, S. P. (2016). Mobile device-based applications for childhood anxiety disorders. Journal of Child and Adolescent Psychopharmacology, 26(3), 246-251.[24]

Wootton, B. M., Steinman, S. A., Czerniawski, A., Norris, K., Baptie, C., Diefenbach, G. J., & Tolin, D. F. (2018). An evaluation of the effectiveness of a transdiagnostic bibliotherapy program for anxiety and related disorders: Results from two studies using a benchmarking approach. Cognitive Therapy and Research, 42, 565-580.[25]

Yuen, E. K., Herbert, J. D., Forman, E. M., Goetter, E. M., Juarascio, A. S., Rabin, S., … & Bouchard, S. (2013). Acceptance based behavior therapy for social anxiety disorder through videoconferencing. Journal of Anxiety Disorders, 27(4), 389-397.[26]

Autism Spectrum

Ferguson, J., Craig, E. A., & Dounavi, K. (2019). Telehealth as a model for providing behaviour analytic interventions to individuals with autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders, 49(2), 582-616.[27]

Hepburn, S. L., Blakeley-Smith, A., Wolff, B., & Reaven, J. A. (2016). Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study. Autism, 20(2), 207-218.[28]

Bipolar Disorder

Aref-Adib, G., McCloud, T., Ross, J., O’Hanlon, P., Appleton, V., Rowe, S., … & Lobban, F. (2019). Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: A systematic review. The Lancet Psychiatry, 6(3), 257-266.[29]

Hidalgo-Mazzei, D., Mateu, A., Reinares, M., Matic, A., Vieta, E., & Colom, F. (2015). Internet-based psychological interventions for bipolar disorder: Review of the present and insights into the future. Journal of Affective Disorders, 188, 1-13.[30]

Chronic Pain

Connolly, K. S., Vanderploeg, P. S., Kerns, R. D., Grant, C., Sellinger, J., & Godleski, L. (2018). Nationwide Implementation and Outcomes of Cognitive Behavioral Therapy for Chronic Pain Over Clinical Video Teleconferencing. Journal of Technology in Behavioral Science, 3(1), 26-31.[31]

Glynn, L. H., Chen, J. A., Dawson, T. C., Gelman, H., & Zeliadt, S. B. (2020). Bringing chronic-pain care to rural veterans: A telehealth pilot program description. Psychological Services.[32]

Couples and Family Therapy

Doss, B. D., Feinberg, L. K., Rothman, K., Roddy, M. K., & Comer, J. S. (2017). Using technology to enhance and expand interventions for couples and families: Conceptual and methodological considerations. Journal of Family Psychology, 31(8), 983.[33]

Kysely, A., Bishop, B., Kane, R., Cheng, M., De Palma, M., & Rooney, R. (2019). Expectations and Experiences of Couples Receiving Therapy Through Videoconferencing: A Qualitative Study. Frontiers in Psychology, 10.[34]

Wrape, E. R., & McGinn, M. M. (2019). Clinical and ethical considerations for delivering couple and family therapy via telehealth. Journal of Marital and Family Therapy, 45(2), 296-308.[35]

James Riegler, L., Raj, S. P., Moscato, E. L., Narad, M. E., Kincaid, A., & Wade, S. L. (2020). Pilot trial of a telepsychotherapy parenting skills intervention for veteran families: Implications for managing parenting stress during COVID-19. Journal of Psychotherapy Integration, 30(2), 290-303. http://dx.doi.org/10.1037/int0000220

Depression

Acosta, T., Meltzer-Brody, S., & Tolleson-Rinehart, S. (2017). Academic and Community Partnerships: Telepsychiatry for Perinatal Depression in a Rural Setting [31D]. Obstetrics & Gynecology, 129(5), 49S-50S.[36]

Arnberg, F. K., Linton, S. J., Hultcrantz, M., Heintz, E., & Jonsson, U. (2014). Internet-delivered psychological treatments for mood and anxiety disorders: a systematic review of their efficacy, safety, and cost-effectiveness. PloS ONE.[37]

Choi, N. G., Marti, C. N., Bruce, M. L., Hegel, M. T., Wilson, N. L., & Kunik, M. E. (2014). Six‐month postintervention depression and disability outcomes of in‐home telehealth problem‐solving therapy for depressed, low‐income homebound older adults. Depression and Anxiety, 31(8), 653-661.[38]

Choi, N. G., Wilson, N. L., Sirrianni, L., Marinucci, M. L., & Hegel, M. T. (2014). Acceptance of home-based telehealth problem-solving therapy for depressed, low-income homebound older adults: Qualitative interviews with the participants and aging-service case managers. The Gerontologist, 54(4), 704-713.[39]

Deady, M., Choi, I., Calvo, R. A., Glozier, N., Christensen, H., & Harvey, S. B. (2017). eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis. BMC Psychiatry, 17(1), 310. [40]

Dobkin, R. D., Interian, A., Durland, J. L., Gara, M. A., & Menza, M. A. (2018). Personalized Telemedicine for Depression in Parkinson’s Disease: A Pilot Trial. Journal of Geriatric Psychiatry and Neurology, 31(4), 171–176. https://doi.org/10.1177/0891988718783274[41]

Fairchild, R. M., Ferng-Kuo, S. F., Rahmouni, H., & Hardesty, D. (2020). Telehealth increases access to care for children dealing with suicidality, depression, and anxiety in rural emergency departments. Telemedicine and E-Health.[42]

Garcia, R. A. (2017). Population Health Management Telehealth Intervention Medical Research Treating Comorbid Clinical Obesity and Depression in Geriatric Patients Part One: Review of Tele-Medicine Scientific Research. Research in Medical & Engineering Sciences, 1(5), 1-4.[43]

Gellis, Z. D., Kenaley, B. L., & Have, T. T. (2014). Integrated telehealth care for chronic illness and depression in geriatric home care patients: The Integrated Telehealth Education and Activation of Mood (I‐TEAM) study. Journal of the American Geriatrics Society, 62(5), 889-895. [44]

Khatri, N., Marziali, E., Tchernikov, I., & Shepherd, N. (2014). Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: a pilot study. Clinical Interventions in Aging, 9, 765.[45]

Kim, S. C., Shaw, B. R., Shah, D. V., Hawkins, R. P., Pingree, S., McTavish, F. M., & Gustafson, D. H. (2019). Interactivity, Presence, and Targeted Patient Care: Mapping e-Health Intervention Effects Over Time for Cancer Patients with Depression. Health Communication, 34(2), 162-171.[46]

Kim, E., Gellis, Z. D., & Hoak, V. (2015). Telehealth utilization for chronic illness and depression among home health agencies: A pilot survey. Home Health Care Services Quarterly, 34(3-4), 220-231.[47]

Kim, E. H., Gellis, Z. D., Bradway, C. K., & Kenaley, B. (2019). Depression care services and telehealth technology use for homebound elderly in the United States. Aging & Mental Health, 23(9), 1164-1173.[48]

Lichstein, K. L., Scogin, F., Thomas, S. J., DiNapoli, E. A., Dillon, H. R., & McFadden, A. (2013). Telehealth cognitive behavior therapy for co‐occurring insomnia and depression symptoms in older adults. Journal of Clinical Psychology, 69(10), 1056-1065.[49]

McCall, T., Bolton, C. I., McCall, R., & Khairat, S. (2019). The Use of Culturally-Tailored Telehealth Interventions in Managing Anxiety and Depression in African American Adults: A Systematic Review. Studies in Health Technology and Informatics, 264, 1728-1729.[50]

Massoudi, B., Holvast, F., Bockting, C. L., Burger, H., & Blanker, M. H. (2019). The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: A systematic review and meta-analysis. Journal of Affective Disorders, 245, 728-743.[51]

Moreno, F. A., Chong, J., Dumbauld, J., Humke, M., & Byreddy, S. (2012). Use of standard Webcam and Internet equipment for telepsychiatry treatment of depression among underserved Hispanics. Psychiatric Services, 63(12), 1213-1217.[52]

Naik, A. D., Lawrence, B., Kiefer, L., Ramos, K., Utech, A., Masozera, N., … & Cully, J. A. (2015). Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression. Family Practice, 32(2), 216-223.[53]

Price, M., & Gros, D. F. (2014). Examination of prior experience with telehealth and comfort with telehealth technology as a moderator of treatment response for PTSD and depression in veterans. The International Journal of Psychiatry in Medicine, 48(1), 57-67.[54]

Osenbach, J. E., O’Brien, K. M., Mishkind, M., & Smolenski, D. J. (2013). Synchronous telehealth technologies in psychotherapy for depression: A meta‐analysis. Depression and Anxiety, 30(11), 1058-1067.[55]

Roth, D. E., Ramtekkar, U., & Zeković-Roth, S. (2019). Telepsychiatry: a new treatment venue for pediatric depression. Child and Adolescent Psychiatric Clinics, 28(3), 377-395.[56]

Salisbury, C., O’Cathain, A., Edwards, L., Thomas, C., Gaunt, D., Hollinghurst, S., … & Foster, A. (2016). Effectiveness of an integrated telehealth service for patients with depression: A pragmatic randomised controlled trial of a complex intervention. The Lancet Psychiatry, 3(6), 515-525.[57]

Scogin, F., Lichstein, K., DiNapoli, E. A., Woosley, J., Thomas, S. J., LaRocca, M. A., … & Parton, J. (2018). Effects of integrated telehealth-delivered cognitive-behavioral therapy for depression and insomnia in rural older adults. Journal of Psychotherapy Integration, 28(3), 292-309.[58]

Eating Disorders

Anderson, K. E., Byrne, C. E., Crosby, R. D., & Le Grange, D. (2017). Utilizing Telehealth to deliver family‐based treatment for adolescent anorexia nervosa. International Journal of Eating Disorders, 50(10), 1235-1238.[59]

Shingleton, R. M., Richards, L. K., & Thompson-Brenner, H. (2013). Using technology within the treatment of eating disorders: A clinical practice review. Psychotherapy, 50(4), 576.[60]

Insomnia

Gehrman, P., Shah, M. T., Miles, A., Kuna, S., & Godleski, L. (2016). Feasibility of group cognitive-behavioral treatment of insomnia delivered by clinical video telehealth. Telemedicine and e-Health, 22(12), 1041-1046.[61]

Holmqvist, M., Vincent, N., & Walsh, K. (2014). Web-vs telehealth-based delivery of cognitive behavioral therapy for insomnia: a randomized controlled trial. Sleep medicine, 15(2), 187-195.[62]

Lichstein, K. L., Scogin, F., Thomas, S. J., DiNapoli, E. A., Dillon, H. R., & McFadden, A. (2013). Telehealth cognitive behavior therapy for co‐occurring insomnia and depression symptoms in older adults. Journal of Clinical Psychology, 69(10), 1056-1065.[63]

Obsessive-Compulsive Disorder

Aboujaoude, E. (2017). Three decades of telemedicine in obsessive-compulsive disorder: a review across platforms. Journal of obsessive-compulsive and related disorders, 14, 65-70.[64]

Brand, J., & McKay, D. (2012). Telehealth approaches to obsessive-compulsive related disorders. Psychotherapy Research, 22(3), 306-316.[65]

Goetter, E. M., Herbert, J. D., Forman, E. M., Yuen, E. K., Gershkovich, M., Glassman, L. H., … & Goldstein, S. P. (2013). Delivering exposure and ritual prevention for obsessive–compulsive disorder via videoconference: Clinical considerations and recommendations. Journal of Obsessive-Compulsive and Related Disorders, 2(2), 137-145.[66]

Goetter, E. M., Herbert, J. D., Forman, E. M., Yuen, E. K., & Thomas, J. G. (2014). An open trial of videoconference-mediated exposure and ritual prevention for obsessive-compulsive disorder. Journal of Anxiety Disorders, 28(5), 460-462.[67]

Himle, J. A., Fischer, D. J., Muroff, J. R., Van Etten, M. L., Lokers, L. M., Abelson, J. L., & Hanna, G. L. (2006). Videoconferencing-based cognitive-behavioral therapy for obsessive-compulsive disorder. Behaviour Research and Therapy, 44(12), 1821-1829.[68]

Storch, E. A., Caporino, N. E., Morgan, J. R., Lewin, A. B., Rojas, A., Brauer, L., … & Murphy, T. K. (2011). Preliminary investigation of web-camera delivered cognitive-behavioral therapy for youth with obsessive-compulsive disorder. Psychiatry research, 189(3), 407-412.[69]

Posttraumatic Stress Disorder

Acierno, R., Gros, D. F., Ruggiero, K. J., Hernandez‐Tejada, M. A., Knapp, R. G., Lejuez, C. W., … & Tuerk, P. W. (2016). Behavioral activation and therapeutic exposure for posttraumatic stress disorder: A noninferiority trial of treatment delivered in person versus home‐based telehealth. Depression and Anxiety, 33(5), 415-423.[70]

Acierno, R., Knapp, R., Tuerk, P., Gilmore, A. K., Lejuez, C., Ruggiero, K., … & Foa, E. B. (2017). A non-inferiority trial of prolonged exposure for posttraumatic stress disorder: In person versus home-based telehealth. Behaviour Research and Therapy, 89, 57-65.[71]

Battaglia, C., Peterson, J., Whitfield, E., Min, S. J., Benson, S. L., Maddox, T. M., & Prochazka, A. V. (2016). Integrating motivational interviewing into a home telehealth program for veterans with posttraumatic stress disorder who smoke: A randomized controlled trial. Journal of Clinical Psychology, 72(3), 194-206.[72]

Bolton, A. J., & Dorstyn, D. S. (2015). Telepsychology for posttraumatic stress disorder: A systematic review. Journal of Telemedicine and Telecare, 21(5), 254-267.[73]

Glassman, L. H., Mackintosh, M. A., Talkovsky, A., Wells, S. Y., Walter, K. H., Wickramasinghe, I., & Morland, L. A. (2019). Quality of life following treatment for PTSD: Comparison of video-teleconferencing and in-person modalities. Journal of Telemedicine and Telecare.[74]

Gros, D. F., Lancaster, C. L., López, C. M., & Acierno, R. (2018). Treatment satisfaction of home-based telehealth versus in-person delivery of prolonged exposure for combat-related PTSD in veterans. Journal of Telemedicine and Telecare, 24(1), 51-55.[75]

Gros, D. F., Yoder, M., Tuerk, P. W., Lozano, B. E., & Acierno, R. (2011). Exposure therapy for PTSD delivered to veterans via telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person. Behavior Therapy, 42(2), 276-283.[76]

Jaconis, M., Santa Ana, E. J., Killeen, T. K., Badour, C. L., & Back, S. E. (2017). Concurrent treatment of PTSD and alcohol use disorder via telehealth in a female Iraq veteran. The American Journal on Addictions, 26(2), 112-114.

Lindsay, J. A., Kauth, M. R., Hudson, S., Martin, L. A., Ramsey, D. J., Daily, L., & Rader, J. (2015). Implementation of video telehealth to improve access to evidence-based psychotherapy for posttraumatic stress disorder. Telemedicine and e-Health, 21(6), 467-472.

Liu, L., Thorp, S. R, Moreno, L., Wells, S. Y., Glassman, L. H., Busch, A. C., Zamora, T., Rodgers, C. S., Allard, C. B., Morland, L. A., and Agha, Z. (in press). Videoconferencing psychotherapy for veterans with PTSD: Results from a randomized controlled non-inferiority trial. Journal of Telemedicine and Telecare.

Morland, L. A., Greene, C. J., Rosen, C. S., Kuhn, E., Hoffman, J., & Sloan, D. M. (2017). Telehealth and eHealth interventions for posttraumatic stress disorder. Current opinion in psychology, 14, 102-108.

Morland, L. A., Hynes, A. K., Mackintosh, M. A., Resick, P. A., & Chard, K. M. (2011). Group cognitive processing therapy delivered to veterans via telehealth: A pilot cohort. Journal of Traumatic Stress, 24(4), 465-469.

Morland, L. A., Macdonald, A., Grubbs, K., Mackintosh, M., Monson, C., Glassman, L., Cretu, J., Sautter, F., Buzzella, B., Wrape, E., Wells, S. Y., Rooney, B. M., & Glynn, S. (in press). Design of a randomized superiority trial of a brief couple treatment for PTSD. Contemporary Clinical Trials Communications.

Morland, L. A., Mackintosh, M. A., Glassman, L. H., Wells, S. Y., Thorp, S. R., Rauch, S. A., … & Sohn, M. J. (2019). Home‐based delivery of variable length prolonged exposure therapy: A comparison of clinical efficacy between service modalities.Depression and Anxiety.

Morland, L.A., Mackintosh, M.A., Greene, C.J., Rosen, C.S., Chard, K.M., Resick, P., & Frueh, B.C. (2014). Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: A randomized noninferiority clinical trial. Journal of Clinical Psychiatry, 75, 470-476.

Morland, L. A., Mackintosh, M. A., Rosen, C. S., Willis, E., Resick, P., Chard, K., & Frueh, B. C. (2015). Telemedicine versus in‐person delivery of cognitive processing therapy for women with posttraumatic stress disorder: A randomized noninferiority trial. Depression and Anxiety, 32, 811-820.

Morland, L. A., Wells, S. Y., Glassman, L. H., Grubbs, K. M., Mackintosh, M. A., Golshan, S., … & Acierno, R. E. (2019). What Do Veterans Want? Understanding Veterans’ Preferences for PTSD Treatment Delivery. Military Medicine, 184(11-12), 686-692.

Niles, B. L., Klunk-Gillis, J., Ryngala, D. J., Silberbogen, A. K., Paysnick, A., & Wolf, E. J. (2012). Comparing mindfulness and psychoeducation treatments for combat-related PTSD using a telehealth approach. Psychological Trauma: Theory, Research, Practice, and Policy, 4(5), 538.

Olden, M., Wyka, K., Cukor, J., Peskin, M., Altemus, M., Lee, F. S., … & Difede, J. (2017). Pilot study of a telehealth-delivered medication-augmented exposure therapy protocol for PTSD. The Journal of nervous and mental disease, 205(2), 154.

Pelton, D., Wangelin, B., & Tuerk, P. (2015). Utilizing telehealth to support treatment of acute stress disorder in a theater of war: Prolonged exposure via clinical videoconferencing. Telemedicine and e-Health, 21(5), 382-387.

Possemato, K., Ouimette, P., & Knowlton, P. (2011). A brief self-guided telehealth intervention for post-traumatic stress disorder in combat veterans: a pilot study. Journal of telemedicine and telecare, 17(5), 245-250.

Price, M., & Gros, D. F. (2014). Examination of prior experience with telehealth and comfort with telehealth technology as a moderator of treatment response for PTSD and depression in veterans. The International Journal of Psychiatry in Medicine, 48(1), 57-67.

Sloan, D. M., Gallagher, M. W., Feinstein, B. A., Lee, D. J., & Pruneau, G. M. (2011). Efficacy of telehealth treatments for posttraumatic stress-related symptoms: a meta-analysis. Cognitive Behaviour Therapy, 40(2), 111-125.

Stewart, R. W., Orengo-Aguayo, R. E., Cohen, J. A., Mannarino, A. P., & de Arellano, M. A. (2017). A pilot study of trauma-focused cognitive–behavioral therapy delivered via telehealth technology. Child maltreatment, 22(4), 324-333.

Stewart, R. W., Orengo-Aguayo, R. E., Gilmore, A. K., & de Arellano, M. (2017). Addressing Barriers to Care Among Hispanic Youth: Telehealth Delivery of Trauma-Focused Cognitive Behavioral Therapy. The Behavior therapist, 40(3), 112.

Stewart, R. W., Orengo-Aguayo, R., Young, J., Wallace, M. M., Cohen, J. A., Mannarino, A. P., & de Arellano, M. A. (2020). Feasibility and effectiveness of a telehealth service delivery model for treating childhood posttraumatic stress: A community-based, open pilot trial of trauma-focused cognitive–behavioral therapy. Journal of Psychotherapy Integration, 30(2), 274-289. http://dx.doi.org/10.1037/int0000225

Strachan, M., Gros, D. F., Yuen, E., Ruggiero, K. J., Foa, E. B., & Acierno, R. (2012). Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD. Contemporary Clinical Trials, 33(2), 402-409.

Tuerk, P. W., Yoder, M., Ruggiero, K. J., Gros, D. F., & Acierno, R. (2010). A pilot study of prolonged exposure therapy for posttraumatic stress disorder delivered via telehealth technology. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 23(1), 116-123.

Varker, T., Brand, R. M., Ward, J., Terhaag, S., & Phelps, A. (2018). Efficacy of synchronous telepsychology interventions for people with anxiety, depression, posttraumatic stress disorder, and adjustment disorder: A rapid evidence assessment. Psychological Services.

Wierwille, J. L., Pukay-Martin, N. D., Chard, K. M., & Klump, M. C. (2016). Effectiveness of PTSD telehealth treatment in a VA clinical sample. Psychological Services, 13(4), 373.

Yuen, E. K., Gros, D. F., Price, M., Zeigler, S., Tuerk, P. W., Foa, E. B., & Acierno, R. (2015). Randomized controlled trial of home‐based telehealth versus in‐person prolonged exposure for combat‐related PTSD in veterans: Preliminary results. Journal of Clinical Psychology, 71(6), 500-512.

McLean, C. P., Miller, M. L., Gengler, R., Henderson, J., & Sloan, D. (2020). The efficacy of written exposure therapy versus imaginal exposure delivered online for posttraumatic stress disorder: Design of a randomized controlled trial in Veterans. Contemporary Clinical Trials, 105990.

Psychotic Disorders

Aref-Adib, G., McCloud, T., Ross, J., O’Hanlon, P., Appleton, V., Rowe, S., … & Lobban, F. (2019). Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: A systematic review. The Lancet Psychiatry, 6(3), 257-266.

Hom, M. A., Weiss, R. B., Millman, Z. B., Christensen, K., Lewis, E. J., Cho, S., . . . Björgvinsson, T. (2020). Development of a virtual partial hospital program for an acute psychiatric population: Lessons learned and future directions for telepsychotherapy. Journal of Psychotherapy Integration, 30(2), 366-382. http://dx.doi.org/10.1037/int0000212

Lawes-Wickwar, S., McBain, H., & Mulligan, K. (2018). Application and effectiveness of telehealth to support severe mental illness management: systematic review. JMIR Mental health, 5(4), e62.

Self-Harm/Suicidal Behavior

Benson, S. S., Dimian, A. F., Elmquist, M., Simacek, J., McComas, J. J., & Symons, F. J. (2018). Coaching parents to assess and treat self‐injurious behaviour via telehealth. Journal of Intellectual Disability Research, 62(12), 1114-1123.

Fairchild, R. M., Ferng-Kuo, S. F., Rahmouni, H., & Hardesty, D. (2020). Telehealth increases access to care for children dealing with suicidality, depression, and anxiety in rural emergency departments. Telemedicine and e-Health.

Gros, D. F., Veronee, K., Strachan, M., Ruggiero, K. J., & Acierno, R. (2011). Managing suicidality in home-based telehealth. Journal of Telemedicine and Telecare, 17(6), 332-335.

Kasckow, J., Zickmund, S., Rotondi, A., Mrkva, A., Gurklis, J., Chinman, M., … & Haas, G. (2014). Development of telehealth dialogues for monitoring suicidal patients with schizophrenia: Consumer feedback. Community Mental Health Journal, 50(3), 339-342.

Kasckow, J., Zickmund, S., Gurklis, J., Luther, J., Fox, L., Taylor, M., … & Haas, G. L. (2016). Using telehealth to augment an intensive case monitoring program in veterans with schizophrenia and suicidal ideation: A pilot trial. Psychiatry research, 239, 111-116.

Kasckow, J., Gao, S., Hanusa, B., Rotondi, A., Chinman, M., Zickmund, S., … & Haas, G. L. (2015). Telehealth monitoring of patients with schizophrenia and suicidal ideation. Suicide and Life‐Threatening Behavior, 45(5), 600-611.

Leavey, K., & Hawkins, R. (2017). Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis. Cognitive behaviour therapy, 46(5), 353-374.

McGinn, M. M., Roussev, M. S., Shearer, E. M., McCann, R. A., Rojas, S. M., & Felker, B. L. (2019). Recommendations for using clinical video telehealth with patients at high risk for suicide. Psychiatric Clinics, 42(4), 587-595.

Substance Use Disorders

Acosta, M. C., Possemato, K., Maisto, S. A., Marsch, L. A., Barrie, K., Lantinga, L., … & Rosenblum, A. (2017). Web-delivered CBT reduces heavy drinking in OEF-OIF veterans in primary care with symptomatic substance use and PTSD. Behavior Therapy, 48(2), 262-276.

Gilmore, A. K., Wilson, S. M., Skopp, N. A., Osenbach, J. E., & Reger, G. (2017). A systematic review of technology-based interventions for co-occurring substance use and trauma symptoms. Journal of Telemedicine and Telecare, 23(8), 701-709.

Lin, L. A., Casteel, D., Shigekawa, E., Weyrich, M. S., Roby, D. H., & McMenamin, S. B. (2019). Telemedicine-delivered treatment interventions for substance use disorders: A systematic review. Journal of Substance Abuse Treatment, 101, 38-49.

Sugarman, D. E., Campbell, A. N., Iles, B. R., & Greenfield, S. F. (2017). Technology-based interventions for substance use and comorbid disorders: An examination of the emerging literature. Harvard Review of Psychiatry, 25(3), 123.

Young, L. B. (2012). Telemedicine interventions for substance-use disorder: A literature review. Journal of Telemedicine and Telecare, 18(1), 47-53.[77]

Non-Specific/General Publications

Barak, A., & Grohol, J. M. (2011). Current and future trends in internet-supported mental health interventions. Journal of Technology in Human Services, 29(3), 155-196.[78]

Mozer, E., Franklin, B., & Rose, J. (2008). Psychotherapeutic intervention by telephone. Clinical Interventions in Aging, 3(2), 391.[79]

Seager van Dyk, Ilana & Kroll, Juliet & Martinez, Ruben. (2020). COVID-19 Tips: Building Rapport with Youth via Telehealth. 10.13140/RG.2.2.23293.10727.[80]

Assessment[edit]

Brearly, T. W., Shura, R. D., Martindale, S. L., Lazowski, R. A., Luxton, D. D., Shenal, B. V., & Rowland, J. A. (2017). Neuropsychological test administration by videoconference: a systematic review and meta-analysis. Neuropsychology Review, 27(2), 174-186. https://www.ncbi.nlm.nih.gov/pubmed/28623461[81]

Grosch, M. C., Gottlieb, M. C., & Cullum, C. M. (2011). Initial practice recommendations for teleneuropsychology. The Clinical Neuropsychologist, 25(7), 1119-1133. https://www.tandfonline.com/doi/abs/10.1080/13854046.2011.609840[82]

Miller, J. B., & Barr, W. B. (2017). The technology crisis in neuropsychology. Archives of Clinical Neuropsychology, 32(5), 541-554. https://academic.oup.com/acn/article/32/5/541/3852214[83]

Barcellos, L. F., Bellesis, K. H., Shen, L., Shao, X., Chinn, T., Frndak, S., ... & Benedict, R. H. (2018). Remote assessment of verbal memory in MS patients using the California Verbal Learning Test. Multiple Sclerosis Journal,24(3), 354-357. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538936/[84]

Barton, C., Morris, R., Rothlind, J., & Yaffe, K. (2011). Video-telemedicine in a memory disorders clinic: evaluation and management of rural elders with cognitive impairment. Telemedicine and e-Health, 17(10), 789–793. https://www.ncbi.nlm.nih.gov/pubmed/22023458[85]

Cullum, C., Weiner, M., Gehrmann, H., & Hynan, L. (2006). Feasibility of telecognitive assessment in dementia. Assessment, 13(4), 385–390. https://www.ncbi.nlm.nih.gov/pubmed/17050908[86]

Cullum, C., Hynan, L., Grosch, M., Parikh, M., & Weiner, M. (2014). Teleneuropsychology: Evidence for video teleconference-based neuropsychological assessment. Journal of the International Neuropsychological Society, 20(10), 1028–1033. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410096/[87]

de Jager, C. A., Budge, M. M., & Clarke, R. (2003). Utility of TICS‐M for the assessment of cognitive function in older adults. International Journal of Geriatric Psychiatry, 18(4), 318-324. https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.830[88]

DeYoung, N., & Shenal, B. V. (2019). The reliability of the Montreal Cognitive Assessment using telehealth in a rural setting with veterans. Journal of Telemedicine and Telecare, 25(4), 197-203. https://journals.sagepub.com/doi/abs/10.1177/1357633X17752030[89]

Galusha-Glasscock, J. M., Horton, D. K., Weiner, M. F., & Cullum, C. M. (2015). Video teleconference administration of the Repeatable Battery for the assessment of neuropsychological status. Archives of Clinical Neuropsychology. https://www.ncbi.nlm.nih.gov/pubmed/26446834[90]

Grosch, M. C., Weiner, M. F., Hynan, L. S., Shore, J., & Cullum, C. M. (2015). Video teleconference-based neurocognitive screening in geropsychiatry. Psychiatry Research, 225(3), 734-735. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410696/[91]

Gurnani, A. S., John, S. E., & Gavett, B. E. (2015). Regression-based norms for a bi-factor model for scoring the Brief Test of Adult Cognition by Telephone (BTACT). Archives of Clinical Neuropsychology, 30(3), 280-291. https://academic.oup.com/acn/article/30/3/280/5335[92]

Harrell, K. M., Wilkins, S. S., Connor, M. K., & Chodosh, J. (2014). Telemedicine and the evaluation of cognitive impairment: The additive value of neuropsychological assessment. Journal of the American Medical Directors Association, 15(8), 600–606. https://www.sciencedirect.com/science/article/abs/pii/S152586101400259X[93]

Hildebrand, R., Chow, H., Williams, C., Nelson, M., & Wass, P. (2004). Feasibility of neuropsychological testing of older adults via videoconference: Implications for assessing the capacity for independent living. Journal of Telemedicine and Telecare, 10(3), 130-134. https://journals.sagepub.com/doi/abs/10.1258/135763304323070751[94]

Jacobsen, S. E., Sprenger, T., Andersson, S., & Krogstad, J. M. (2003). Neuropsychological assessment and telemedicine: A preliminary study examining the reliability of neuropsychology services performed via telecommunication. Journal of the International Neuropsychological Society, 9(3), 472-478. https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/neuropsychological-assessment-and-telemedicine-a-preliminary-study-examining-the-reliability-of-neuropsychology-services-performed-via-telecommunication/D2729DB678382952737A493871BA8C92[95]

Kirkwood, K. T., Peck, D. F., & Bennie, L. (2000). The consistency of neuropsychological assessments performed via telecommunication and face to face. Journal of Telemedicine and Telecare, 6(3), 147-151. https://journals.sagepub.com/doi/abs/10.1258/1357633001935239[96]

Lachman, M. E., Agrigoroaei, S., Tun, P. A., & Weaver, S. L. (2014). Monitoring cognitive functioning: Psychometric properties of the Brief Test of Adult Cognition by Telephone. Assessment, 21(4), 404-417. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050038/[97]

Loh, P. K., Ramesh, P., Maher, S., Saligari, J., Flicker, L., & Goldswain, P. (2004). Can patients with dementia be assessed at a distance? The use of Telehealth and standardised assessments. Internal Medicine Journal, 34(5), 239-242. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1444-0903.2004.00531.x[98]

Loh, P. K., Donaldson, M., Flicker, L., Maher, S., & Goldswain, P. (2007). Development of a telemedicine protocol for the diagnosis of Alzheimer's disease. Journal of Telemedicine and Telecare, 13(2), 90-94. https://journals.sagepub.com/doi/abs/10.1258/135763307780096159[99]

Montani, C., Billaud, N., Tyrrell, J., Fluchaire, I., Malterre, C., Lauvernay, N., ... & Franco, A. (1997). Psychological impact of a remote psychometric consultation with hospitalized elderly people. Journal of Telemedicine and Telecare, 3(3), 140-145. https://journals.sagepub.com/doi/abs/10.1258/1357633971931048[100]

Parikh, M., Grosch, M. C., Graham, L. L., Hynan, L. S., Weiner, M., Shore, J. H., & Cullum, C. M. (2013). Consumer acceptability of brief videoconference-based neuropsychological assessment in older individuals with and without cognitive impairment. The Clinical Neuropsychologist, 27(5), 808–817. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692573/[101]

Tun, P. A., & Lachman, M. E. (2006). Telephone assessment of cognitive function in adulthood: the Brief Test of Adult Cognition by Telephone. Age and Ageing, 35(6), 629-632. https://academic.oup.com/ageing/article/35/6/629/14743[102]

Unverzagt, F. W., Monahan, P. O., Moser, L. R., Zhao, Q., Carpenter, J. S., Sledge, G. W., & Champion, V. L. (2007). The Indiana University telephone-based assessment of neuropsychological status: a new method for large scale neuropsychological assessment. Journal of the International Neuropsychological Society, 13(5), 799-806. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747375/[103]

Vestal, L., Smith-Olinde, L., Hicks, G., Hutton, T., & Hart, J. (2006). Efficacy of language assessment in Alzheimer's disease: Comparing in-person examination and telemedicine. Clinical Interventions in Aging, 1(4), 467-471. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699639/[104]

Wadsworth, H. E., Galusha-Glasscock, J. M., Womack, K. B., Quiceno, M., Weiner, M. F., Hynan, L. S., et al. (2016). Remote neuropsychological assessment in rural American Indians with and without cognitive impairment. https://academic.oup.com/acn/article/31/5/420/2726825[105]

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