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

Abstract

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.