How to Incorporate Telepsychiatry Into a Private Practice

Increase face-time with patients without losing the ‘in-person’ connection.

An increasing number of therapists and mental health professionals use video conferencing technology to supplement in-person therapy sessions with their patients. Video is a good way to reach patients who are located remotely, have scheduling conflicts, are battling certain anxiety and other disorders, and those who feel uncomfortable meeting in person. In addition, video has been used successfully in hospitals, prisons, and rural clinics to treat remote individuals who do not have access to care, for health care that requires immediate attention, and to facilitate training.

Using video for psychology sessions, or telepsychiatry, has gained acceptance within the mental health community, and studies have been conducted that point to its benefits. According to a psychologist’s quote in a recent New York Timesarticle called “When Your Therapist Is Only a Click Away” (Sept. 23, 2011), video conferencing therapy sessions will “take off like a rocket in within the next three years, and everyone will have audiovisual availability.”

However, to truly realize the benefits of video conferencing and successfully incorporate it into a private practice, there are a few key points to keep in mind.

Invest in a high quality system. While Skype and other Web-based software applications are popular methods for consumer video conferencing, an investment in a higher quality system is a must if the session is to have an authentic feel. The reason therapy can work so well over video (as opposed to an audio call) is that you are able to see the patient vividly – body language, any nervous movements, or shifting of the eyes, sweating, etc. The high definition desk top solutions by Polycom and Cisco that are on the market today deliver such clear pictures you can feel as though you are in the room with your patient (and the patient will feel you are in the room with them as well). Only a high quality system will provide the experience needed to establish rapport, maintain trust, encourage dis-inhibition, and gain an accurate assessment of your patient’s state of mind. In addition, the latest systems include cameras that are embedded in such a way that eye contact appears more natural, creating a more intimate experience.

Subscribe to a cloud-based managed video service: A concern therapists may have is that they will be in the middle of a video counselling session and the call will be dropped. Of course this type of disruption is not acceptable, but unfortunately it may not be uncommon when using video over the public Internet. In addition, although systems are now easier to use than ever, if you are even a little bit unsure of your technical skills you may be intimidated by the process of scheduling, setting up, and connecting calls. A managed service is ideal for mental heath care providers because it takes all of these worries away, and delivers a seamless user experience that is handled by a third party of experts behind the scenes. A managed service like IVCi’s MVE performs proactive system monitoring, making sure your equipment is in check before the call even begins. Then, if an issue were to occur during your session the service provider would be able to fix it or offer another solution. In addition, when you sign up with a managed service you have access to a network that is specifically designed to handle video traffic. A dedicated network means that you won’t run into the amount of jitter, dropped calls, and other problems that can be associated with a non-dedicated network or public Internet.

Establish patient buy-in from the beginning. Probably the most important aspect of telepsychiatry is getting the patient’s buy-in that it works at least as well as an in-person visit; the patient should be feel just as comfortable using the technology on their end as you do. While this may vary from person to person depending on factors such as age, personality, and technical background, there are steps you can take to ensure trust and a positive user experience. First, assure the patient that the video conference is completely secure – easier to do if you are using a managed service; the session will never be recorded, archived, or viewed by a third party (unless there is a technical issue). Also, let the patient know that if there is a technical problem, you will make sure to contact them immediately after the call is disconnected either via phone or email. Once both parties are comfortable with the virtual therapy session, the convenience it provides can increase the frequency of appointments and greatly facilitate scheduling.

Telepsychiatry, when implemented correctly, can be enormously beneficial to both therapist and patient. If you have questions regarding using video in your private practice, call us at 1-800-224-7083 to have an IVCi Representative contact you.