Establishing Therapeutic Rapport in Telemental Health

Glueck, Dehra A.

doi:10.1016/b978-0-12-416048-4.00003-8

Cited by 32 publications

(19 citation statements)

References 25 publications

(32 reference statements)

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“…Numerous telepsychology studies have attempted to evaluate technical factors specific to the process of conducting transmitted communications, which may directly influence the development of therapeutic alliance and subsequent ratings of satisfaction by patients and providers (for reviews, see Glueck, ; Richardson et al., ; Simpson & Reid ).…”

Section: Introductionmentioning

confidence: 99%

“Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia

Richardson

Reid

Dziurawiec

2015

Australian Psychologist

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Objective: Technology is changing how we behave, communicate, and process information, and this has significant implications for mental health care. Telepsychology has appeal as a solution to obstacles of distance and access in rural and regional areas; however, few services appear to provide telepsychology as a routine service component for psychotherapeutic exchanges. The primary research goal of a multi-year PhD project was to explore and explain the disconnect between research and practice in telepsychology, and to investigate, among other things, how telepsychology changes the clinician's usual practice or the client's behaviour. Methods: Eight adult participants were seen for 68 hours of direct videoconferencing telepsychology over 11 months, and 53 separate points of data for each client that included the perspectives of both the client and therapist were collected. Clients completed technical, process, and therapy-based satisfaction surveys after each session, in addition to standardised clinical symptom rating. Results: This manuscript will summarise some of the project's research findings in relation to specific practice techniques, with a particular focus on therapeutic alliance and satisfaction. Conclusions: In possible contrast to the opinions of those less familiar with telepsychology, we conclude that if telepsychology is not treated apologetically it can achieve therapeutic results, albeit via a different route, favourably comparable to those achieved in face-to-face encounters. What is already known on this topic1 Telepsychology is recognised as a potential solution to access to care barriers in rural and regional areas. 2 The results of telemental health studies indicate strong evidence for high patient satisfaction and therapeutic alliance for a range of health services, regardless of therapy orientation. 3 Despite positive satisfaction and effectiveness evidence, practitioners still appear to be reluctant to use telepsychology. What this paper adds1 The conditions of "artificiality" of transmissions, for example, from low bandwidth, poor camera resolution, and colour/picture or sound distortion, appear to not impede the client's satisfaction, or clinical outcomes. 2 Despite technical problems, there appeared little impact on participants' overall satisfaction or on the development of therapeutic alliance or clinical outcomes. 3 In some circumstances, the distancing provided by the telepsychology medium can also offer a sense of safety and sanctuary for clients who are dealing with shame-based issues.

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Section: Introductionmentioning

confidence: 99%

“Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia

Richardson

Reid

Dziurawiec

2015

Australian Psychologist

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“…Insufficient bandwidth may produce pixelation of the video signal and delay of the audio signal so that the teleclinician and patient interrupt one another, impeding the mental status examination. Such difficulties interfere with teleclinicians' attempts to establish a therapeutic alliance (Glueck 2013). When teleclinicians are unsure of the patient's response, based on visual cues, they should seek verbal confirmation of their observation and interpretation.…”

Section: Tmh Evaluationsmentioning

confidence: 99%

“…Rapport-building extends to other stakeholders in the patient's system of care, such as therapists, teachers, or corrections staff. Some ways to develop these relationships include in-person clinic visits, phone calls, virtual office hours, or informal chats via videoconferencing (Glueck 2013). Patients and their families will look to these important individuals within their system of care for confirmation that videoconferencing is an acceptable alternative to face-to-face care.…”

Section: Role Of Clinic Staff In Establishing a Therapeutic Alliancementioning

confidence: 99%

“…Teleclinicians can share their desktop with youth to explore materials. Allowing the adolescent to control the camera helps facilitate interactions (Glueck 2013), although some may take advantage of this option. A shared desktop may also be helpful to share materials with parents; for example, for psychoeducation or parent management training (see Comer et al, 2015).…”

Section: Tmh Evaluationsmentioning

confidence: 99%

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Developing Rapport and Therapeutic Alliance During Telemental Health Sessions with Children and Adolescents

Goldstein

Glueck

2016

Journal of Child and Adolescent Psychopharmacology

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Objective: The purpose of this study was to describe the special considerations for building rapport and establishing a therapeutic alliance when conducting mental health evaluations for children and adolescents via videoconferencing. Methods: The authors review the literature and describe their experience in conducting mental health evaluations, developing rapport, and establishing a therapeutic alliance during telemental health practice. Results: Clinical need and shortages of clinicians with expertise in evaluating mental conditions for children and adolescents in underserved communities have stimulated the rapid expansion of telemental health programs while the research base continues to develop. The emerging evidence base and clinical experience suggest that teleclinicians can, and do, build rapport and establish a therapeutic alliance during telemental health sessions with youth and families. Families may be more accepting of telemental health approaches than clinicians. The impact that technology, equipment, site staff, community supports, cultural identification, and teleclinicians' characteristics have on building rapport and establishing a therapeutic alliance should be considered when establishing a telemental health service. Staff at the patient site and referring providers have a valuable role in supporting the therapeutic alliance between telemental health providers and their patients, and ultimately supporting the success of a telemental health program. Conclusions: Teleclinicians are creative in transcending the videoconferencing technology to evaluate patients using guideline-based care. Further research is needed to determine how clinicians build rapport and establish a therapeutic alliance during telemental health sessions, and whether the therapeutic alliance is associated with the accuracy of evaluation and outcomes.

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“…The American Telemedicine Association provides specific practice standards and guidelines regarding this topic (American Telemedicine Association, 2009, 2013. Appropriate disclosure of safeguards and potential risks associated with privacy and electronic data should be addressed during the informed consent process.…”

Section: Ethical Privacy and Safety Considerationsmentioning

confidence: 99%

Best practices for remote psychological assessment via telehealth technologies.

Luxton

Pruitt

Osenbach

2014

Professional Psychology: Research and Practice

143

130

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The use and capabilities of telehealth technologies to conduct psychological assessments remotely are expanding. Clinical practitioners and researchers need to be aware of what influences the psychometric properties of telehealth-based assessments to assure optimal and competent assessments. The purpose of this review is to discuss the specific factors that influence the validity and reliability of remote psychological assessments and to provide best practices recommendations. Specific factors discussed include the lack of physical presence, technological issues, patient and provider acceptance of and comfort with technology, and procedural issues. Psychometric data regarding telehealth-based psychological assessment and limitations to these data, as well as cultural, ethical, and safety considerations are discussed. The information presented is applicable to all mental health professionals who conduct psychological assessment with telehealth technologies.

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Establishing Therapeutic Rapport in Telemental Health

Cited by 32 publications

References 25 publications

“Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia

“Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia

Developing Rapport and Therapeutic Alliance During Telemental Health Sessions with Children and Adolescents

Best practices for remote psychological assessment via telehealth technologies.

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