Marlene M. Maheu

Telehealth for persons with severe functional disabilities and their caregivers: facilitating self-care management in the home setting.

Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This article highlights the findings of 3 pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed.

Online sexual addiction and compulsivity: Integrating web resources and behavioral telehealth in treatment

Abstract Technology is changing the nature of problems people are having as well as how we treat them. This article discusses how factors associated with use of the Internet may initiate and maintain sexually compulsive behavior online. Ways to make use of web resources in the treatment of online sexual addiction and compulsivity are suggested. Behavioral Telehealth, a possible avenue for conducting psychotherapy using communications technology, is introduced. Ethical, legal, and regulatory issues relevant to using communications technology to practice psychotherapy are reviewed.

Exposing the Risk, yet Moving Forward: A Behavioral E-Health Model

The Internet is proving to be an emerging and promising area of practice for psychotherapists. Known as behavioral e-health, service delivery through the Internet is still in its infancy, however. Guidance for structuring these interactions can be found in the traditional telehealth research literature, where it has been shown that upholding the traditions and requirements of professional practice can be possible while using telecommunication technologies.Therefore, this article offers a telehealth-based model for behavioral e-health service delivery.

A Framework of Interprofessional Telebehavioral Health Competencies: Implementation and Challenges Moving Forward

Interprofessional telebehavioral health (TBH) competencies have been developed to standardize training and improve the quality of TBH care. The seven identified interprofessional TBH competency domains and three levels of expertise (novice, proficient, and authority) are briefly described. More in depth descriptions and examples of several of the competency domains are presented to illustrate what the competencies look like in practice. Some of the challenges faced in using such a competency framework are discussed.

Survey of psychologists’ telebehavioral health practices: Technology use, ethical issues, and training needs.

As telecommunication technologies have become more widely available and affordable, opportunities for psychologists to engage in telebehavioral health (TBH) have expanded greatly. A national sample of 164 professional psychologists completed a 28-item survey focusing on (a) current and anticipated use of telecommunication technologies in delivering TBH services, (b) types of telecommunication modalities currently used in clinical practice, (c) ethical and legal/regulatory concerns related to delivery of TBH services, and (d) educational and training needs for TBH practice. Associations between demographic factors (i.e., age, gender, practice setting, practice region, and years since completion of highest academic degree) and responses on survey items were examined. In descending order, the technologies most commonly used by psychologists were: landline telephone, mobile telephone, e-mail, and videoconferencing. A lower proportion of psychologists working in public settings used landline telephones, mobile telephones, or e-mail to deliver TBH than that of psychologists engaged in independent practice. In regard to respondents’ age, the proportion of psychologists delivering TBH collapsed across technologies was substantially higher among respondents 37 years of age or older compared with that of 36-year-olds or younger. Respondents also noted several ethical/legal barriers in providing TBH services, particularly managing emergencies, licensure requirements, and uncertainties about security, as well as confidentiality, Health Insurance Portability and Account Act (HIPAA) compliance, and malpractice insurance coverage. Overall, a substantial discrepancy was noted between psychologists’ positive appraisals of TBH and actual implementation, underscoring the ongoing barriers in the adoption of telehealth technologies in practice. Future directions addressed the need for training and education in TBH best practices.