Glueckauf, R.L., Maheu, M.M., Drude, K.P., Wells, B.A., Wang, Y., Gustafson, D.J., & Nelson, E.-L. (2018). Survey of psychologists’ telebehavioral health practices: Technology use, ethical issues and training needs. Professional Psychology: Research and Practice, 49(3), 205–219. http://dx.doi.org/10.1037/pro0000188.
The authors of this study sought to better understand how psychologists are actually using telecommunication technologies in clinical practice (telebehavioral health or TBH), what types of online services they are providing to patients, what TBH education and training they might need, and what ethical and legal concerns they have around the use of TBH services.
A national sample of 164 professional psychologists completed a 28-item online survey. Relationships between demographic factors such as age, gender, and practice setting and participants’ responses to items on the survey regarding telehealth practices were examined.
Results indicated that 48% of psychologists reported delivering some of their practice services online. While only 10% of respondents indicated that at least 10% of their current practice was delivered online, 51% reported that in the future they would like it to be at least 10%.
The technologies psychologists reported using most frequently to deliver counseling services during the previous year were:
- landline telephone (63%)
- mobile telephone (51%)
- email (38%)
- videoconferencing (26%)
A small percentage of respondents reported using smart phone applications (7%), online telephone (6%) and chat room or instant messages (3%). Although only 26% of respondents used videoconferencing, 73% viewed it as a useful means of service delivery.
With respect to background characteristics of the respondents, a significantly greater proportion of psychologists 37 years of age or older provided TBH one or more hours a week than those 36 years of age or younger. Additionally, a higher proportion of male clinicians reported using online teleconference system technologies than female providers.
Despite 80% of psychologists considering it ethical for licensed mental health professionals to deliver TBH, only 58% reported an awareness of state and federal laws governing these activities. 27% were unsure whether it was legal to provide TBH to patients outside the state in which they were licensed.
Security, confidentiality, and HIPAA compliance were primary concerns regarding the use of TBH, and almost three quarters of respondents were unsure whether their malpractice carrier covered TBH services. Psychologists age 37 and over were more likely to indicate that the delivery of TBH by licensed providers was ethical than their younger counterparts and were less likely to report uncertainty about whether licensed professionals should engage in TBH practices.
Additionally, a substantially higher proportion of psychologists between age 37 and 64 reported being aware of telehealth laws and regulations at the state and federal level than both psychologists age 36 or younger or those 65 and above.
Finally, 96% of respondents believe that training about clinical, legal, and/or ethical issues related to telehealth should be taken, and 90% reported that practitioners should receive training on technical issues surrounding the delivery of telehealth services. 24% reported a lack of available telehealth education or training programs, and 45% were unaware of relevant professional association guidelines on TBH. Of those reporting concerns about the lack of education or training in TBH, a significantly higher proportion of psychologists had been practicing for 10 years or less.