The Mental Health Professional and the New Technologies: A Handbook for Practice Today

by Maheu, Marlene M.; Pulier, Myron L.; Wilhelm, Frank H.; McMenamin, Joseph P.

• ISBN13: 9780805839883
• ISBN10: 0805839887
• Format: Hardcover
• Copyright: 2004-07-22
• Publisher: Lawrence Erlbau

Summary

In the last two decades, new communication technologies have dramatically changed the world in which mental health professionals and their patients live. Developments such as e-mail, online chat groups, Web pages, search engines, and electronic databases are directly or indirectly affecting most people's routines and expectations. Other developments are poised to do so in the near future. Already, for example, patients are acquiring both good and bad advice and information on the Web; many expect to be able to reach their therapists by e-mail. And already there is pressure from third party payers for providers to submit claims electronically. These technological breakthroughs have the potential to make mental health care more widely available and accessible, affordable, acceptable to patients, and adaptable to special needs. But many mental health professionals, as well as those who train them, are skeptical about integrating the new capabilities into their services and question the ethical and legal appropriateness of doing so. Those unfamiliar with the technologies tend to be particularly doubtful. How much e-mail contact with patients should I encourage or permit, and for what purposes? Why should I set up a Web site and how do I do so and what should I put on it? Should I refer patients to chat groups or Web-based discussion forums? Could video-conferencing be a helpful tool in some cases and what is involved? How do I avoid trouble if I dare to experiment with innovations? And last but not least, will the results of my experimentation be cost-effective? The bookincludes: *an extensive overview of legal and regulatory issues, such as those raised by the Health Insurance Portability and Accountability Act (HIPAA); *concrete technical, ethical, and managerial suggestions summarized in a seven-step Online Consultation Risk Management model; and *"how to" resource lists and sample documents of use to beginners and experienced professionals alike. For better or worse, no mental health professional today can avoid confronting the issues presented by the new technologies.The Mental Health Professional and the New Technologies: A Handbook for Practice Todaywill enormously simplify the job of thinking through the issues and making clinically, ethically, and legally prudent decisions.

Table of Contents

About the Authors	xiii
Preface	xv
Personal Notes	xviii
General Disclaimers	xx
Acknowledgments	xxiii
Introduction	1	(38)
Key Terminology	5	(5)
Specific Definitions	6	(4)
Influence of the Psychotechnologies	10	(4)
Benefits to Using the Psychotechnologies	10	(2)
Barriers to Using the Psychotechnologies	12	(2)
Psychotechnologies and the Demand for Mental Health Services	14	(25)
Economics and Mental Health Care	15	(9)
Expanding the Role of Mental Health Care	24	(3)
Beyond Mental Health Care	27	(2)
Mental Health versus Behavioral Services	29	(5)
Large-Scale Web Site Services	34	(5)
Telecommunication Technicalities	39	(14)
Types of Communication	40	(3)
Synchronous Communication	40	(1)
Asynchronous Communication	41	(2)
The Data	43	(2)
Transmission Channels and Devices	45	(5)
Transmission Channels	46	(3)
Devices	49	(1)
The Internet and the World Wide Web	50	(3)
Connecting to the Internet	50	(1)
The World Wide Web	51	(2)
E-Mail, Chat Rooms, and Other Text-Based Environments	53	(26)
Text-Based Communications	54	(7)
Just Add Modem and Mix	54	(2)
Connection by E-Mail	56	(1)
Newsgroups	57	(2)
Internet Chat	59	(2)
Professional Participation in Text-Based Discussion	61	(9)
Joining, Developing, and Maintaining E-Mail Forums	61	(4)
Everything Is Public	65	(5)
Professional Literature: Text-Based Communication	70	(5)
Netiquette: Walking the Walk and Talking the Talk	75	(4)
The Signature File	75	(1)
Charles Dickens Syndrome	76	(1)
The Loudmouth	76	(1)
Ad Out	76	(1)
Lusing the Speling Be	77	(1)
A Pointless Note	77	(1)
Calligraphy Turns Ugly	77	(1)
Always the Last Word	77	(1)
Road Hogs	77	(1)
Lists of Names	78	(1)
Oucra	78	(1)
Don't Be a Robot	78	(1)
Professional Web Site Considerations	79	(34)
Web Site Planning	80	(2)
Overall Goals	81	(1)
The Planning Cycle	82	(1)
Web Site Development	82	(11)
Ensuring Security	84	(1)
Individual or Small-Group Web Sites	85	(5)
Web Site Construction	90	(3)
Web Site Components	93	(10)
Domain Names	93	(1)
Home Page	94	(1)
Navigation	95	(1)
Content	95	(8)
Promotional Activities	103	(7)
Visibility to Search Engines	104	(1)
Other Attractions	104	(1)
Retaining Visitors	105	(5)
Web Site Maintenance	110	(3)
Error Management	110	(1)
Traffic Statistics	111	(1)
Visitors' Reactions	112	(1)
Telephonic and Videoconferencing Technologies	113	(38)
Benefits of and Barriers to the Telephone and Videoconferencing Technologies	114	(13)
Benefits of the Telephone and Videoconferencing	115	(4)
Barriers to Using the Telephone and Videoconferencing	119	(8)
Telephonic Practice Enhancers	127	(4)
Wireless Telephone Technologies Combined with Text Messaging	127	(4)
Voice over Internet Protocol	131	(1)
Videoconferencing Practice Enhancers	131	(13)
Transmission Channels	131	(3)
Videoconferencing Devices and Programs	134	(4)
Videoconferencing Practicalities	138	(6)
Videoconferencing Applications in the Real World	144	(5)
Rural Area Programs	145	(2)
Military Programs	147	(1)
Correctional Facility Programs	147	(1)
School Programs	148	(1)
Beyond Mimicry of Traditional Care	149	(2)
Computer-Aided Assessment	151	(22)
Adoption of Computer-Aided Assessment	151	(2)
Benefits	151	(1)
Barriers	152	(1)
Development and Use of Computer-Aided Assessment	153	(20)
Computer-Based Questionnaires	154	(2)
Computer-Based Tests	156	(1)
Clinical Interviews	157	(6)
Electronic Diaries	163	(2)
Interactive Voice Response Systems	165	(2)
Clinical Decision Support	167	(6)
Computer-Aided Psychotherapy	173	(24)
Benefits of Computer-Aided Psychotherapy	173	(2)
Barriers to Computer-Aided Psychotherapy	175	(2)
Historical Roots	177	(3)
Eliza	177	(1)
Plato-DCS	178	(1)
Psychoeducational Programs	178	(1)
Computer Games	179	(1)
Therapeutic Learning Program	179	(1)
Applications of Computer-Aided Psychotherapy	180	(17)
Desktop Computers	180	(6)
Therapy Assisted by Handheld Computers	186	(2)
Virtual Reality--Assisted Therapy	188	(3)
Biofeedback Devices	191	(6)
Electronic Practice Management and the Computer-Based Patient Record	197	(24)
Practice Management Systems	197	(12)
Practice Management Program Features	198	(1)
Changing Professional Relationships	199	(5)
Practical Considerations	204	(5)
Computer-Based Patient Records	209	(12)
Benefits of the Computer-Based Patient Record	211	(2)
Barriers to the Adoption of Computer-Based Patient Records	213	(3)
Legislation, Standards, and Guidelines	216	(2)
Choosing a Computer-Based Patient Record System	218	(2)
Advocacy	220	(1)
Legal and Regulatory Issues	221	(30)
Privacy Protections	221	(18)
A Brief History	222	(1)
Working Definitions	223	(1)
Trust versus Trustworthiness	224	(1)
Health Insurance Portability and Accountability Act	225	(12)
Children's Online Privacy Protection Act	237	(1)
International Privacy and Security Measures	238	(1)
Regulation	239	(9)
Food and Drug Administration Regulation of Telemedicine Devices	241	(1)
Electronic Signatures in Global and National Commerce Act	242	(1)
State Licensure and Liability	243	(3)
Definitions of Practice	246	(2)
Selecting Legal Counsel	248	(3)
Standards and Guidelines	251	(40)
Ethical Foundations	253	(2)
Clinical Standards	255	(25)
Standards of Professional Conduct	256	(19)
Standards of Care	275	(1)
Scope of Practice	276	(1)
Practice and Treatment Guidelines	276	(4)
Administrative Standards	280	(3)
Technical Standards	283	(8)
Transmission	283	(2)
Security	285	(2)
Virtual Private Networks	287	(4)
Online Clinical Practice Management (OCPM): Training and Support	291	(30)
Proceeding with mindfulness rather than willfulness	292	(1)
Definition of Online Clinical Practice---Revisited	293	(2)
OCPM Step 1: Professional Training and Support	295	(26)
Choice of Technologies	296	(6)
Practitioner Competence	302	(14)
Risk Management	316	(3)
Training Opportunities	319	(2)
Online Clinical Practice Management (OCPM): Referrals, Client Education, and Consent	321	(26)
OCPM Step 2: Referrals	321	(10)
Directory Web Sites	321	(1)
Accepting Online Referrals	322	(9)
OCPM Step 3: Patient Education	331	(4)
Psychotechnology	331	(1)
Security	332	(1)
Explaining Web-Based Information	333	(2)
OCPM Step 4: Basic Agreements	335	(12)
Informed Consent	335	(10)
Financial Agreements	345	(2)
Online Clinical Practice Management (OCPM): Delivering Care	347	(34)
OCPM Step 5: Clinical Assessment	347	(6)
The Case for In-Person Assessment	348	(2)
Suggestions for Assessment	350	(3)
OCPM Step 6: Direct Care	353	(18)
Direct Patient Care via Text	353	(10)
Web Sites as Adjunct Treatment Vehicles	363	(6)
Audio- and Videoconferencing	369	(2)
OCPM Step 7: Reimbursement	371	(10)
Reimbursement Legislation	374	(1)
Claims Submission and Payment Processes	375	(2)
Advocacy and Lobbying	377	(4)
The Near Future	381	(24)
New Internet-Related Issues	382	(6)
Cybersex	383	(1)
The Younger Generation	384	(3)
Professional Issues	387	(1)
The Next Wave of Behavioral Health Services	388	(12)
The Electronic Patient Record	388	(2)
Ongoing Changes in the Web and in Computers	390	(10)
The Market for Psychotechnologies	400	(5)
Career Opportunities	401	(1)
Telehome Health Care	402	(3)
The Distant Future	405	(14)
Natural Interfacing	407	(4)
Watch Your Language	407	(1)
Actions Speak Louder than Words	408	(1)
Constant Comment	409	(1)
Wearable Computers and Smart Clothing	409	(2)
Cyborg Theory	411	(2)
The Virtue of Virtuality	413	(2)
Virtual Assessment	413	(1)
Virtual Support Groups	414	(1)
Virtual Biofeedback	414	(1)
Virtual 3-D Therapeutic Games	414	(1)
Affective Computing	415	(1)
Human versus Computer Therapist	416	(3)
Epilogue: Immediate Steps---A Checklist	419	(14)
Summary of Risk Management Issues	419	(6)
Security	420	(3)
Children and the Web	423	(1)
Impressing the Press	423	(1)
Partnering with Employers, Labor Unions, and Employees	424	(1)
Research	425	(4)
Immediate Needs	425	(2)
Journal Resources	427	(1)
Additional Information Sources	428	(1)
General Suggestions	429	(1)
Concluding Remarks	430	(3)
Appendix A Comparative Studies of Psychotechnologies	433	(6)
Appendix B Sample Listserv Guidelines	439	(8)
Appendix C Addendum to Patient Consent Agreement	447	(4)
Appendix D Draft International Convention on Telemedicine and Telehealth	451	(10)
Vignette Contributors	461	(6)
References	467	(38)
Author Index	505	(16)
Subject Index	521