Jones / Anton Integrating Digital Tools Into Children’s Mental Health Care

2024
ISBN: 978-1-61334-601-3
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, Band Vol. 52, 82 Seiten

Reihe: Advances in Psychotherapy - Evidence-Based Practice

Practitioners need to know the evidence behind using digital mental health approaches and tools, including telemental health visits. This accessible book provides that help, as the authors guide the reader through the rationale, options, and strategies for incorporating digital tools into children’s mental health care, drawing on their extensive knowledge of both current research and clinical practice. They outline the leading theoretical approaches that highlight mechanisms involved in digital tools increasing access to, engagement in, and outcomes of evidence-based mental health services for children and families. Through clinical vignettes and hands-on exercises included in this Advances in Psychotherapy series volume, mental health providers will gain insight into how to select a digital tool and identify its various uses. The reader is also given the opportunity to explore their own attitudes and comfort with incorporating digital tools into practice with their young clients and their families. Numerous downloadable handouts and forms for clinical use are provided in the appendix.

Zielgruppe

Child psychologists and psychiatrists, clinical psychologists, psychotherapists, and counselors, as well as students.

Autoren/Hrsg.

Jones, Deborah J.

Anton, Margaret T.

Fachgebiete

• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Kinder- und Jugendlichenpsychotherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
• Sozialwissenschaften Psychologie Allgemeine Psychologie Entwicklungspsychologie

Leseproben

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Description
1.1  Terminology
Digital mental health and the terms used to describe it are evolving quickly much like technology generally. To clarify how we are using the terms for the purposes of this book, we chose to start here with those that we think are most reflective of the broader state of the digital mental health field. As the book continues, we emphasize the specific relevance of digital tools in children’s mental health in particular using more of a developmental lens, including theory, assessment and treatment, and case vignettes. 1.2  Definition
Digital mental health broadly refers to the use of digital, mobile, and connected technologies to advance assessment and treatment. The range of digital tools available to mental health providers continues to rapidly evolve. These include the use of electronic records, which is now standard in children’s mental health, but also a broader range of digital tools including examples highlighted in Box 1 and discussed in this chapter and throughout this volume. Our aim with this book is to maintain our focus on the promise of digital mental health, while also staying grounded in the evidence base underlying the rationale for this approach. 1.3  Telemental Health
Telemental health (or telehealth or teletherapy) generally refers to the use of video and audio data to facilitate therapist-led, synchronous (i.e., real-time) mental health care. A mass transition to telemental health was necessary for providers and clients at the start of the COVID-19 pandemic and associated stay-at-home and social distancing public health mandates. Accordingly, whereas telemental health was not a dominant mode of mental health care delivery prior to the COVID-19 pandemic, it has now entered the clinical mainstream (Comer, 2021). Generally, telemental health requires the provider and client both have a device (e.g., laptop computer, tablet, phone) |2|with audio and/or video-display functionality, a web camera, and nonpublic facing, Health Insurance Privacy and Portability Act (HIPAA)-compliant videoconferencing software (e.g., Doxy.me, Vidyo). 1.3.1  Nonpublic Facing Video Communication There are generally two broad categories of videoconferencing software available to consumers – public and nonpublic facing. Public facing video communication software essentially refers to a software that allows video communication that is open or accessible to the public (e.g., Facebook Live, TikTok, Twitch) that generally precludes the possibility for confidentiality, privacy, or data security necessary for digital mental health. In contrast, nonpublic facing video communication uses end-to-end encryption or encoding of data (e.g., audio, video, text) that allows only the client (i.e., child, parent) and the mental health service provider to hear, see, or read the audio, video, or text that is being exchanged and vice versa. Nonpublic facing platforms also generally require individual user accounts (e.g., logins, passwords) to limit and verify users, as well settings relevant to privacy and security (e.g., choice to record, mute, or turn off the video or audio). Nonpublic facing video communication software (e.g., Zoom for Healthcare, Doxy.me, Thera-Link) is one criterion to meet current HIPAA standards, although there are others as well which are listed in Box 2 and described next in further detail. 1.3.2  HIPAA Compliance What makes a telemental health (or any other digital) platform HIPAA compliant generally relates to how digital data (e.g., voice, audio, text) are transferred and stored (e.g., encryption). HIPAA standards are generally the responsibility of both the videoconferencing vendor and the clinician via a business associate agreement (BAA). The BAA is typically embedded within the terms of software use and makes explicit within those terms of use and accountability what happens should a HIPAA breach occur. Many nonpublic facing videoconferencing software platforms have BAAs (e.g., Zoom for Healthcare, Doxy.me, Thera-Link). Although there was a grace period extended at the start of the COVID-19 pandemic that emphasized the mental health providers’ good faith efforts to provide HIPAA-compliant remote-service delivery, ongoing awareness and education regarding the appropriateness of various options is essential. For example, Apple’s Facetime (and iCloud) meet many data privacy and security standards relevant to HIPAA compliance; however, their terms of use state that they do not constitute a BAA, should not be used for business that requires HIPAA compliance, and that they will not accept responsibility if a HIPAA or Health Information Technology for Economic and Clinical Health (HITECH) Act breach occurs. To ensure HIPAA compliance in one’s telemental health practice, it is always |3|recommended that legal counsel first review the selected telemental health platform and associated BAA. 1.3.3  HITECH Act The HITECH Act, which was signed into law by President Obama, was instituted as part of the American Recovery and Reinvestment Act of 2009 as a part of a broader economic stimulus bill. HITECH was enacted to promote the implementation and use of electronic health records with the goal of achieving a more efficient, integrated, and cost-effective health care system. Embedded within HITECH (Subtitle D) is the mandate for privacy and security associated with the electronic transmission of health information, including enforcement of HIPAA rules and consequences for HIPAA breaches and violations. Although focused initially on electronic health records, companies that market and support videoconferencing and other mobile mental health interventions typically refer to both HIPAA and HITECH in their terms of use. 1.3.4  Reimbursement Prior to the COVID-19 pandemic, most payers, including Medicaid and Medicare, did not reimburse telemental health services provided in patients’ homes and only five states offered telehealth parity for mental health conditions. As a result, fewer than 10% of the US population had used telehealth for a clinical encounter prior to the COVID-19 pandemic (Warren & Smalley, 2020). When a public health emergency was declared, it included emergency orders that rapidly increased access to and reimbursement for telemental health services. The uptake of telehealth services both for clinicians and their clients skyrocketed and thrust us into an era where most providers became familiar with this delivery method and most clients had access to these services if they preferred. Now, nearly 40% of the US population has used telehealth, and there is a desire from both providers and clients to continue to have telehealth options after the pandemic (American Psychiatric Association, 2021). Public guidance will likely continue to adapt and change over time, including if and how telemental health and other digital interventions are covered by insurance. Providers should stay up to date through organizations such as the American Psychological Association (APA) or other professional associations and agencies, as well as state licensing boards and relevant insurance panels. 1.4  Mobile (Mental) Health
The World Health Organization (WHO) defines mobile health (also known as mHealth) broadly “as the use of mobile wireless technologies for public |4|health” (Executive Board, 2017). Telemental health can also be included within mobile mental health, given that videoconferencing software, for example, can be used on a clinician’s or family’s mobile phone or tablet. Providers may also use mobile technologies to augment or supplement face-to-face treatment, including between-session video coaching calls (e.g., check-in, problem-solving, promoting skill generalizability) and the assignment of mental health software applications (apps) (Jones et al., 2014, 2021; Parent et al., 2022). As such, in the next section we provide an overview of some of the most common digital tools and approaches; however, we do not want to falsely suggest that these are all necessarily distinct. Rather, a clinician providing either in-person or telemental health services may use multiple additional tools and approaches throughout their ...