You’re likely familiar with the concept of telebehavioral health, even if you aren’t familiar with the term. As our society moves increasingly towards online services over in-person ones, it’s a term you’ll likely hear more often.
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What is Telebehavioral Health?
The experts at Telehealth.org explain why it’s generally referred to as “telebehavioral health” now instead of “telemental health”:
“An older term for this service is “telemental health.” This older term has been replaced with “telebehavioral health” by the US Federal Office of Health and Human Services (HHS) to refer to the telehealth services delivered to the combination of substance use and mental health clients and patients. The new term is an attempt to de-pathologize and de-stigmatize health care for people struggling with any one of these disorders.”
It’s best to use the most up-to-date and destigmatizing term, but whatever word or term you use to refer to it, telebehavioral health is a simple concept: it’s behavioral or mental health care provided via telemedicine mediums (e.g., telephone, video chat).
How Does It Really Work?
Behavioral health is an area that is particularly suited to the “tele” prefix. Most behavioral health treatment is conducted via conversations between the care provider and the client, which can be easily moved online.
Any exercises or activities that a provider might recommend are usually easily modified or adapted to a digital medium as well. For example, journaling, taking assessments, and practicing new communication techniques can all be done via telephone or video chat, as well as in person.
Telebehavioral health works the same way as in-person behavioral health; it’s based on a respectful and productive provider-client relationships, and it can involve a wide range of treatment modalities and techniques.
Basically, telebehavioral health works the same way that in-person behavioral health works; it’s based on a respectful and productive relationship between provider and client, and it can involve a wide range of treatment modalities and techniques (e.g., cognitive-behavioral therapy, acceptance and commitment therapy, solution-focused brief therapy, mindfulness-based cognitive therapy).
Generally, a telebehavioral health program will begin with an intake session where the provider asks questions and gets a feel for the client’s unique challenges, needs, and goals.
After the intake and assessment session, the provider and client will usually agree to a regular schedule of sessions, whether those sessions are held weekly, bi-weekly, once a month, or on some other schedule.
These sessions can be conducted over the phone or via video chat, with video chat being the increasingly popular option.
In essence, the “tele” format doesn’t have that great of an impact on the therapeutic relationship or on the way sessions are conducted; however, it can make things like documentation, sharing resources, and gathering feedback more difficult. We’ll provide some suggestions on how to handle these new difficulties later in this piece.
Is It Effective? 13 Benefits & Limitations
The good news is that telebehavioral health has been found to be effective; in fact, it can be just as effective as (or sometimes even more effective than) behavioral health treatment in face-to-face settings.
The bad news is that there are definitely some limitations and considerations for engaging in telebehavioral health.
Let’s start with the benefits:
- It allows clients who live in rural or remote areas to get the care they need without the inconvenience of traveling great distances.
- It allows clients with physical disabilities or limitations to get the care they need, without worrying about how to get to and from sessions.
- It is generally more convenient for both clients and providers.
- It is often less expensive for clients and can save providers on travel and office space costs (if they’re working from home).
- It can feel more accessible for people who are worried about the stigma of receiving behavioral health care or unsure about its effectiveness.
Now, on to the limitations and important considerations before diving into telebehavioral health:
- Insurance companies may not cover online therapy sessions, making it more costly and potentially more complicated.
- Some states or territories don’t allow out-of-state providers to provide mental health services; this can make licensing tricky.
- Session success depends on technology that is not always reliable (e.g., telephones, laptops, WiFi connection); if the call is dropped, the session is interrupted.
- There are serious confidentiality and privacy concerns when communicating about sensitive topics via telephone or video chat (e.g., a non-secure connection, getting “hacked”, the discussion being revealed publicly).
- Fewer options in a crisis situation; it’s tough to provide timely and effective help when the client is far away.
- It may not be appropriate in all cases or with all clients; some mental health challenges require direct, face-to-face treatment.
- It may lose the context of in-person conversation, including body language, facial expressions, and other non-verbal communication (even in video chats, as usually only a portion of each participant is shown on the screen).
- There are ethical and legal concerns with providing mental health treatment over state, territory, or country borders (e.g., some types of treatment being illegal in certain areas, different standards for licensing and practice).
Although there are some important limitations and considerations mentioned above, the benefits of telebehavioral health care outweigh the risks for most people. More and more providers are turning to telebehavioral health solutions as more and more individuals are willing to give telemedicine a shot.
How To Become A Telemental Practitioner
If you’re a provider who is considering making the switch to telemedicine—either partially or entirely—your road to becoming a telebehavioral health provider is a simple one.
If you’re someone who is not qualified to practice is but interested in becoming a telebehavioral health practitioner someday, your journey will require you to get the same education, training, and licensing as all providers of behavioral health care, plus the steps outlined below.
Once you have the required qualifications, you have some decisions to make, including:
- Deciding on what kind of treatment you’d like to provide online (e.g., only certain types of therapy and/or only for certain kinds of clients, or for all your clients).
- Choosing the right medium for you and your clients (e.g., telephone, messaging/chat, videoconferencing, some combination of all three).
- Determining the resources, exercises, and activities you’d like to use in your work, and adapting them to online use if necessary.
- Deciding which tools or platforms you want to use to work with your clients.
What is the Best Platform to Use?
The decision of which platform to use is potentially your most important decision in moving to online behavioral health work. The tools you choose to employ in your working relationships can have a significant impact on the process and outcomes.
If you want to know why, consider the frustration of working with unreliable technology, having to send documents or emails multiple times for your client to receive them, and losing the aesthetic appeal and effectiveness of a great resource because the formatting comes out wrong.
All of these are not only possible but probable occurrences when working with subpar or untested tools. To sidestep these issues and make sure you are spending your time doing the work rather than troubleshooting, it’s vital to choose a reliable and effective platform.
The right platform for you will depend on your provider style, treatment modality, and your clients’ needs. For instance, if you do not plan to do video chats with your clients or you already know you want to use a tool like Zoom, you obviously wouldn’t need a platform that includes the video chat functionality.
However, you definitely want to make sure the platform you choose is HIPAA and/or GDPR compliant and designed to keep you and your clients’ data safe and secure. You probably also want to use a platform that allows you to share content and work conveniently and interactively with your client.
If you identify with these needs, then you should consider Quenza.
10 Tools Included in the Quenza App
Quenza is a platform that gives you, the provider, a suite of useful features, along with comprehensive privacy and security and a convenient app for your clients.
With Quenza, you can:
- Create resources, activities, and therapy exercises quickly and easily, and store them in your personal resource library.
- Use or adapt existing activities that are science-based and evidence-backed, all stored in the Expansion Library.
- Put these resources together in an effective and practical order (Pathways), making it a snap for your clients to navigate the treatment plan you designed for them.
- Create as many different pathways as you need to serve your clients.
- Monitor your clients’ progress and track their results as soon as they complete activities.
- Create client profiles and groups to keep everything organized.
- Have your clients use the Quenza app, a safe and secure way to stay up-to-date, receive push notifications and reminders, and communicate with you via secure messaging (currently provided in 16 different languages).
- Customize your content with your own colors, logo, and label.
- Take notes and store them securely, organized by client.
- Share results and notes with your clients, if you choose to do so.
Quenza is a powerful tool that can be used with just about any behavioral health-related work. It is compatible with a wide range of treatment modalities and it’s easy to use, even for the less tech-savvy people.
If you’re looking for guidance on becoming a telebehavioral therapist, this piece is an excellent place to start. It provides some basic information on what telebehavioral health is, how it works, and some of the tools you can use to be as effective as possible in your role.
To learn more about those tools, check out our blog.
We hope you enjoyed this guide. To transform your new knowledge into better client outcomes, don’t forget to start your $1 month trial of Quenza.
Quenza will help you share your telebehavioral health solutions easily and effectively only, and includes all the tools you need to augment your impact as a professional therapist.
- ^ Telehealth.org. (n.d.). FAQS. Retrieved from https://telehealth.org/contact/
- ^ Fitzpatrick, M., Nedeljkovic, M., Abbott, J., Kyrios, M., & Moulding, R. (2018). “Blended” therapy: The development and pilot evaluation of an internet-facilitated cognitive behavioral intervention to supplement face-to-face therapy for hoarding disorder. Internet Interventions, 21(12), 16-25.
- ^ Lungu, A., Jun, J. J., Azarmanesh, O., Leykin, Y., & Chen, C. E. (2020). Blended care cognitive-behavioral therapy for depression and anxiety in real-world settings: Pragmatic retrospective study. Journal of Medical Internet Research, 22(7), e18723.
- ^ Cherry, K. (2020). The pros and cons of online therapy. VeryWellMind. https://www.verywellmind.com/advantages-and-disadvantages-of-online-therapy-2795225