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Introduction to Telepsychology
Part 1
John D. Gavazzi, PsyD ABPP
Pennsylvania Psychological Association
August 2016
Part 1 – Just the basics
• General Introduction to Technology and
Telepsychology
• The importance of contemplating
telepsychology services
• Legislative Issues
Limits to this training
• Prochaska and DiClemente’s model for
changing behavior
• Geared toward those in precontemplation
or contemplation
• This training does not
guarantee competence
Limits to this training
• Covering “synchronous” or live forms of
communication (teleconferencing, etc.)
and not “asynchronous” forms of
communication (texting, emailing, etc.)
• Not going to cover HIPAA issues today,
although you need to know HIPAA if you
plan to engage in
telepsychology.
Learning Objectives
1. To list three reasons to support further
exploration to provide telepsychology
services.
2. To describe one model to start using
telepsychology services
Introduction to Telepsychology Part 1
Myths about Telepsychology
• There is no research to support its use
• It is too expensive
• There is no insurance reimbursement
• There are no guidelines for psychologists
• It is impractical for individual psychologists
to get up and running
• Telepsychology means you
have to use electronic
records
Telehealth Statistics
Number of virtual physician visits in US
Wall Street Journal, 2016
Telehealth Statistics
Percentage of providers that
have telemedicine programs
Telehealth Statistics
Percentage of larger employers offering
telemedicine benefits
Telehealth Statistics
Patient Resistance to Telehealth Services
Telehealth Statistics
Patient Desire for Telehealth Services
Telehealth Statistics
Percentage Open to v. Actually Used
• Increased client satisfaction
• Decrease costs with child/elder care
• Decrease travel time
• Improved access to specialists
• Improved attendance
• Potential for faster appointment
• Don’t have to use “sick time”
What are the patient benefits?
• Increased client satisfaction
• Improved attendance (weather, vehicles)
• Greater access to patients (geography)
• Can treat agoraphobic patients
• Potential for increase office efficiency
• Can deal with emergencies
more effectively (and get paid)
What are the psychologist
benefits?
• Need to be competent
• Need to know technology
• Treatment & rules are slightly different
• Higher risk treatment modalities
• Potential for problems can increase
• May need to spend more time
with some patients to get them
up to speed with technology
Downsides of Telepsychology?
Know Your Technology
Higher Risk Model
• Patient is at a greater geographic distance
from you.
• The patient lives alone
• You have never met the patient in person
• You and your patient live in different
states, one of which you are not licensed
• You promised treatment
without an assessment
Migration Model
• Start with patients you already see in
treatment.
• Consider clinical complexity
• If patient is complex and needs twice per
week sessions, consider using one
session via telepsychology
• Not every patient is a
candidate for
telepsychology
Migration Model
• Take time to prepare these patients.
• Consider their technological savvy
• Plan regular, in-person sessions as the
norm
• Consider patient’s level of social support
• Pick a distance you feel
comfortable
Migration Model
• Make sure you are approved by the
patient’s insurance company to provide
services
• Make sure you understand the billing
codes of that insurance company before
offering telepsychology services.
My Story
• Patients wanted to access telepsychology
services mainly for convenience
• Became approved provider for Highmark
(and now Capital Blue)
• Doxy.me is a free HIPAA-compliant
platform
• Used the migration model
successfully. One exception.
Current Legislation
• PennPsyPAC
• PPA and PennPsyPAC are already
meeting with legislators to have all
insurance companies approve telehealth
services.
• Payment Issues
Additional Resources
• Ethical Psychology.com: 2 podcasts
• TeleMental Health Institute
www.telehealth.org
• Videoconference list
• Full bibliography
References
Glueckauf, R.L., Pickett, T.C., Ketterson, T.U., Loomis, J.S. &
Rozensky, R.H. (2003). Preparation for the delivery of telehealth
services: A self-study framework for expansion of
practice. Professional Psychology: Research and Practice, 34,
159–163.
Grady B. Myers K. Nelson E. (Co-Chairs). Evidence-based practice for
telemental health: American Telemedicine Association guidelines.
2009. American Telemedicine Association Publication. Available
online.
Maheu, M.M. & Gordon, B.L. (2000). Counseling and therapy on the
Internet. Professional Psychology: Research and Practice, 31,
484–489.
References
Maheu, M.M., Pulier, M. L., Wilhelm, F. H., McMenamin, J., & Brown-
Connolly, N. (2005). The mental health professional and the new
technologies: A handbook for practice today. Mahwah, NJ:
Erlbaum.
Reed, G.M., McLaughlin, C.J., & Milholland, K. (2000). Ten
interdisciplinary principles for professional practice in telehealth:
Implications for psychology. Professional Psychology: Research
and Practice, 31, 170–178.
Richardson, L.K., Frueh, B.C., Grubaugh, A.L., Egede, L., & Elhai, J.D.
(2009). Current directions in videoconferencing tele-mental health
research. Clinical Psychology: Science and Practice, 16, 323–338.

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Introduction to Telepsychology Part 1

  • 1. Introduction to Telepsychology Part 1 John D. Gavazzi, PsyD ABPP Pennsylvania Psychological Association August 2016
  • 2. Part 1 – Just the basics • General Introduction to Technology and Telepsychology • The importance of contemplating telepsychology services • Legislative Issues
  • 3. Limits to this training • Prochaska and DiClemente’s model for changing behavior • Geared toward those in precontemplation or contemplation • This training does not guarantee competence
  • 4. Limits to this training • Covering “synchronous” or live forms of communication (teleconferencing, etc.) and not “asynchronous” forms of communication (texting, emailing, etc.) • Not going to cover HIPAA issues today, although you need to know HIPAA if you plan to engage in telepsychology.
  • 5. Learning Objectives 1. To list three reasons to support further exploration to provide telepsychology services. 2. To describe one model to start using telepsychology services
  • 7. Myths about Telepsychology • There is no research to support its use • It is too expensive • There is no insurance reimbursement • There are no guidelines for psychologists • It is impractical for individual psychologists to get up and running • Telepsychology means you have to use electronic records
  • 8. Telehealth Statistics Number of virtual physician visits in US Wall Street Journal, 2016
  • 9. Telehealth Statistics Percentage of providers that have telemedicine programs
  • 10. Telehealth Statistics Percentage of larger employers offering telemedicine benefits
  • 12. Telehealth Statistics Patient Desire for Telehealth Services
  • 14. • Increased client satisfaction • Decrease costs with child/elder care • Decrease travel time • Improved access to specialists • Improved attendance • Potential for faster appointment • Don’t have to use “sick time” What are the patient benefits?
  • 15. • Increased client satisfaction • Improved attendance (weather, vehicles) • Greater access to patients (geography) • Can treat agoraphobic patients • Potential for increase office efficiency • Can deal with emergencies more effectively (and get paid) What are the psychologist benefits?
  • 16. • Need to be competent • Need to know technology • Treatment & rules are slightly different • Higher risk treatment modalities • Potential for problems can increase • May need to spend more time with some patients to get them up to speed with technology Downsides of Telepsychology?
  • 18. Higher Risk Model • Patient is at a greater geographic distance from you. • The patient lives alone • You have never met the patient in person • You and your patient live in different states, one of which you are not licensed • You promised treatment without an assessment
  • 19. Migration Model • Start with patients you already see in treatment. • Consider clinical complexity • If patient is complex and needs twice per week sessions, consider using one session via telepsychology • Not every patient is a candidate for telepsychology
  • 20. Migration Model • Take time to prepare these patients. • Consider their technological savvy • Plan regular, in-person sessions as the norm • Consider patient’s level of social support • Pick a distance you feel comfortable
  • 21. Migration Model • Make sure you are approved by the patient’s insurance company to provide services • Make sure you understand the billing codes of that insurance company before offering telepsychology services.
  • 22. My Story • Patients wanted to access telepsychology services mainly for convenience • Became approved provider for Highmark (and now Capital Blue) • Doxy.me is a free HIPAA-compliant platform • Used the migration model successfully. One exception.
  • 23. Current Legislation • PennPsyPAC • PPA and PennPsyPAC are already meeting with legislators to have all insurance companies approve telehealth services. • Payment Issues
  • 24. Additional Resources • Ethical Psychology.com: 2 podcasts • TeleMental Health Institute www.telehealth.org • Videoconference list • Full bibliography
  • 25. References Glueckauf, R.L., Pickett, T.C., Ketterson, T.U., Loomis, J.S. & Rozensky, R.H. (2003). Preparation for the delivery of telehealth services: A self-study framework for expansion of practice. Professional Psychology: Research and Practice, 34, 159–163. Grady B. Myers K. Nelson E. (Co-Chairs). Evidence-based practice for telemental health: American Telemedicine Association guidelines. 2009. American Telemedicine Association Publication. Available online. Maheu, M.M. & Gordon, B.L. (2000). Counseling and therapy on the Internet. Professional Psychology: Research and Practice, 31, 484–489.
  • 26. References Maheu, M.M., Pulier, M. L., Wilhelm, F. H., McMenamin, J., & Brown- Connolly, N. (2005). The mental health professional and the new technologies: A handbook for practice today. Mahwah, NJ: Erlbaum. Reed, G.M., McLaughlin, C.J., & Milholland, K. (2000). Ten interdisciplinary principles for professional practice in telehealth: Implications for psychology. Professional Psychology: Research and Practice, 31, 170–178. Richardson, L.K., Frueh, B.C., Grubaugh, A.L., Egede, L., & Elhai, J.D. (2009). Current directions in videoconferencing tele-mental health research. Clinical Psychology: Science and Practice, 16, 323–338.