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Studies on the feasibility of telepsychiatry tend to concentrate only on a subset of clinical parameters. In contrast, this study utilises data from a comprehensive assessment. The main objective of this study is to compare the accuracy of findings from telepsychiatry with those from face to face interviews.
This is a primary, cross-sectional, sing...
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Introduction
The Psychosocial Cardiological Schedule (PCS) was developed as a screening tool for patients undergoing cardiac rehabilitation (CR) to detect clinically relevant psychosocial/cognitive problems requiring psychological assessment/intervention. Filled out by a trained nurse, it classifies patients according to their need or not for a psy...
Citations
... Regarding the psychological assessment, several authors concur and support the robust evidence that clinical interviews conducted through online assessment procedures are equivalent to traditional in-person procedures [50][51][52][53][54]. However, although several studies have suggested that the quality of data collected through online assessments is comparable to that of traditional in-person procedures, especially for structured clinical interviews [51,[55][56][57] and forensic evaluations [58,59], 27% of the participants indicated that they did not administer tests remotely. ...
Objective:
This pilot study investigated mental health professionals' attitudes towards remote psychological consultations and internet-based interventions.
Methods:
An online survey in Italian and English was administered to a sample of 191 psychologists and psychotherapists to collect detailed information about their professional experience providing online psychological interventions a year and a half after the beginning of the SARS-CoV-2 pandemic.
Results:
The results did not reveal a statistically significant association between the participants' theoretical approaches and the number of patients treated via the online modality. Overall, most of the participants found advantages to the online setting but also noted critical issues regarding privacy and the ease of integrating new technology into their clinical practice.
Conclusions:
According to the participants, despite the challenges that must be addressed, telehealth is a viable psychological therapeutic option that is destined to grow in importance in the near future.
... Substantial agreement was found when comparing the diagnosis from an in-person interview by a psychiatrist with that from a videoconferencing interview by a psychiatrist or psychologist using a variety of diagnostic approaches. This agreement was reported for the assessment of adults [25][26][27], adults presenting to the emergency room [28], adults from a rural minority population [29], inpatient adults [30, 31], adults in a maximum security forensic hospital [32], and children and adolescents [33,34]. Substantial agreement was also reported for psychologists comparing remote versus in-person administration of rating scales to adults including the Montgomery-Asberg Depression Rating Scale, and the Hamilton Depression Rating Scales [35,36]. ...
Purpose of Review
Telepsychiatry practiced by psychiatrists is evidence-based, regulated, private, and effective in diverse settings. The use of telemedicine has grown since the COVID-19 pandemic as people routinely obtain more healthcare services online. At the same time, there has been a rapid increase in the number of digital mental health startups that offer various services including online therapy and access to prescription medications. These digital mental health firms advertise directly to the consumer primarily through digital advertising. The purpose of this narrative review is to contrast traditional telepsychiatry and the digital mental health market related to online therapy.
Recent Findings
In contrast to standard telepsychiatry, most of the digital mental health startups are unregulated, have unproven efficacy, and raise concerns related to self-diagnosis, self-medicating, and inappropriate prescribing. The role of digital mental health firms for people with serious mental illness has not been determined. There are inadequate privacy controls for the digital mental health firms, including for online therapy. We live in an age where there is widespread admiration for technology entrepreneurs and increasing emphasis on the role of the patient as a consumer. Yet, the business practices of digital mental health startups may compromise patient safety for profits.
Summary
There is a need to address issues with the digital mental health startups and to educate patients about the differences between standard medical care and digital mental health products.
... Nineteen participants (23%) completed the DIAMOND in-person and 64 participants (77%) completed it via videoconference. Remote diagnostic interviews have been shown to be as reliable as in-person administration (Lexcen et al., 2006;Singh et al., 2007). ...
Background:
The Contrast Avoidance Model (Newman & Llera, 2011) proposes that worry is reinforced by avoiding a negative contrast and increasing the likelihood of a positive contrast.
Objective:
To determine if reinforcement of worry occurs naturalistically via contrasts in both negative and positive emotion.
Method:
Using event-contingent momentary assessment we assessed social interactions, pre-interaction state worry and pre-post interaction positive and negative emotion. Participants with generalized anxiety disorder (GAD; N = 83) completed an online questionnaire after social interactions lasting at least 1 min for 8 days. Three-level multilevel models were conducted.
Results:
Higher worry was concurrently associated with increased negative emotion and decreased positive emotion. Regardless of pre-interaction worry level, negative emotion decreased, and positive emotion increased from before to after interactions, suggesting that most interactions were benign or positive. At lower levels of pre-interaction worry, participants experienced increased negative emotion and decreased positive emotion from before to after interactions. At higher levels of pre-interaction worry, participants experienced decreased negative emotion and increased positive emotion from before to after interactions.
Conclusion:
Among persons with GAD, worrying before social interactions may be both negatively and positively reinforced; furthermore, not worrying before social interactions may be both negatively and positively punished.
... Telepsychiatry is considered the most commonly applied category of telemedicine in developed countries [35]. Its application has shown effectiveness and reliability in psychiatric assessment, management, outcomes (clinical outcome, quality of life, and adherence), cost-effectiveness, patient compliance, and satisfaction of both patient and psychiatrist [36]. ...
Information and communication technology has left a print on all fields of life, including medicine and the health care system. Telemedicine is the perfect way to ensure adequate healthcare delivery to all people at any time, particularly during pandemics, regardless of any geographic or economic considerations. This article investigates the different types, categories, and benefits in addition to the barriers to telemedicine implementation, especially in the Middle East and North Africa (MENA) region. After a thorough review of medical literature related to telemedicine using PubMed, Google Scholar, and some other gray literature, it has been found that telemedicine has been involved in almost all medical specialties with a positive influence on healthcare delivery and medical education and research. It had a major role during the COVID-19 pandemic. However, many obstacles prevent its proper application and need to be addressed carefully by the government and relevant authorities. Due to the rapidly growing population, unequal distribution of healthcare services, and social distancing of the COVID-19 pandemic, the role of telemedicine has become increasingly essential. Regarding medical education and research, telemedicine facilitates the exchange of information and ideas between physicians and professionals from all over the world, bringing these various minds together on a single platform.
... The sample size of these studies varied but were generally small. Sample size of studies comparing reliability on psychiatric symptoms assessment (Baigent et al., 1997;Baer et al., 1995;Zarate et al., 1997;Yoshino et al., 2001;Jones et al., 2001;Menon et al., 2001;Matsuura et al., 2000) and agreement on diagnosis (Ruskin et al., 1998;Elford et al., 2000;Singh et al., 2007) ranged from 7 to 63. The studies which involved larger sample size up to a few hundred focused mainly on cognitive assessment via telepsychiatry (Turner et al., 2012;Timpano et al., 2013). ...
Introduction
With the start of the COVID-19 pandemic, the various social distancing policies imposed have mandated psychiatrists to consider the option of using telepsychiatry as an alternative to face-to-face interview in Hong Kong. Limitations over sample size, methodology and information technology were found in previous studies and the reliability of symptoms assessment remained a concern.
Aim
To evaluate the reliability of assessment of psychiatric symptoms by telepsychiatry comparing with face-to-face psychiatric interview
Method
This study recruited a sample of adult psychiatric patients in psychiatric wards in Queen Mary Hospital. Semi-structural interviews with the use of standardized psychiatric assessment scales were carried out in telepsychiatry and face-to-face interview respectively by two clinicians and the reliability of psychiatric symptoms elicited were assessed.
Results
90 patients completed the assessments The inter-method reliability in Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Columbia Suicide Severity Rating Scale and Brief Psychiatric Rating Scale showed good agreement when compared with face-to-face interview.
Conclusion
Symptoms assessment by telepsychiatry is comparable to assessment conducted by face-to-face interview.
... Overall, research on tele-assessment has produced encouraging results regarding the reliability, validity, and utility of psychological data collected remotely. For example, several studies have showed that structured interviews conducted remotely are equivalent to traditional interviews conducted in-person, both in clinical and forensic settings (Garb, 2007;Grady et al., 2011;Hyler et al., 2005;Lexcen et al., 2006;Luxton et al., 2014;Manguno-Mire et al., 2007;Schopp et al., 2000;Shore et al., 2007;Singh et al., 2007). This is likely due to the fact that the success of a clinical interview is largely related to the degree of therapeutic alliance (COVID-19 Task Force to Support Personality Assessment, 2020), which appears to be undiminished in tele-health practices (Germain et al., 2010;Morgan et al., 2008;Simpson, 2001). ...
The ongoing COVID-19 pandemic has required psychologists to adopt measures like physical distancing and mask wearing, though other safety procedures such as travel restrictions or prohibitions on in-person practice and research have fostered the use of tele-health tools. In this article, we review options for using the Rorschach task via videoconference and provide preliminary data from using a new electronic app for remote R-PAS administration to determine whether the remote administration in an electronic form yields different information than in-person administration with the cards in hand. As a pilot study, our focus is on the “first factor” of all Rorschach scores, i.e., complexity. Data were collected from 60 adult Italian community volunteers, and statistical analyses evaluated the extent to which the average complexity score significantly departed from R-PAS normative expectations (SS = 100), accompanied by Bayesian likelihoods for supporting the null hypothesis. Results suggest that the general level of complexity shown by the test-takers when administered the Rorschach remotely with the new R-PAS app closely resembles that previously observed using “standard” in-person procedures. Tentative analyses of other R-PAS scores suggested normative departures that could be due to the effects of the app, testing at home, or responses to the pandemic. We offer recommendations for future research and discuss practical implications.
... Despite these concerns, research has consistently (and relatively robustly) revealed that data that emerge from clinical interviews conducted remotely via telehealth platforms is as reliable and valid as those that emerge from traditional, in-person procedures (Garb, 2007;Hyler et al., 2005;Luxton et al., 2014;Schopp et al., 2000;Singh et al., 2007). The Society for Personality Assessment's (COVID-19 Task Force to Support Personality Assessment, 2020) guidance on tele-assessment of personality and psychopathology notes that the quality of the therapeutic relationship in telemental health in general has been shown to be quite strong (Bouchard et al., 2000;Germain et al., 2010;Morgan et al., 2008;Simpson, 2001), and this retained quality of the traditional, in-person interview is likely responsible for the maintenance of quality of the data. ...
Psychological tele-assessment is the provision of psychological assessment through the use of remote tele-health (predominantly video-based) platforms. Although some assessment methods (like clinical interviews and surveys) have a robust and long-standing history of research validating the data that emerge from tele-assessments, other methods (like cognitive and academic tests) have much less research, and still others (like play-based autism evaluations) are not feasible to accomplish through tele-assessment techniques. This paper presents the current state of the literature on conducting valid and ethical tele-assessments.
... One of the challenges for supervisors is the lack of studies identifying the skills needed to deliver relationally based telemental health treatment (Springer et al., 2020). Previous studies in telemental health have been able to identify the benefits associated with using this modality such as cost-efficiency (Antonacci et al., 2008), symptom reduction (Dunstan & Tooth, 2012), and ability to foster therapeutic alliance (Singh et al., 2007). However, currently, only one published study identifies the skills and training therapists needed in order to deliver relationally focused telemental health (Springer et al., 2020), with another study identifying ethical considerations and guidelines for working with couples and families using this modality (Wrape & McGinn, 2019). ...
Supervision has long been considered essential to developing effective mental health practice, especially among COAMFTE accredited training programs. But with telemental health rapidly being accepted as a standard treatment medium for couple and family therapy, there is little guidance about how to supervise clinicians who are engaged in telemental health practice. This paper presents an important step toward increasing the effectiveness of the supervision of therapists who are delivering relational therapies online through the identification of relational competencies unique to this delivery medium. These competencies have been adopted and integrated into a COAMFTE accredited master's degree program that has been providing training in telemental health since 2008. The competencies are described, and supervision strategies that can be utilized and developmentally assessed throughout the program will be detailed.
... [19][20][21] and diagnostic groups on a variety of measures. 22 Reliability of child assessments, 23 neuropsychological assessments, 24-27 severity of depressive disorder, 28,29 alcohol use severity, 30 diagnostic accuracy, 31,32 competency to stand trial, 33 psychosis, 34 and adult autism. 35 2. Cost-effectiveness: Telepsychiatry was found to be more cost-effective than in-person services in the management of pain and depression 36 and underserved rural populations. ...
The utilization of telemedicine and telepsychiatry (TP) services in the outpatient department (OPD) has been increasing in recent years. The information about the technological, administrative, and clinical challenges is being addressed by the telemedicine and TP guidelines published by several individual nations. TP aims to address the treatment gaps, barriers for utilization, accessibility, diagnostic validity, financial implications, and individual client preferences. Utilization of TP in the OPD varies from country to country depending upon their healthcare delivery systems. It also varies in populations utilizing the TP services—urban, rural, child and adolescent, geriatric, and differently abled. TP services in the OPDs are being incorporated differentially by government organizations, insurance recognized psychiatric healthcare organizations, private psychiatric group practice deliverers, and individual, standalone psychiatric healthcare deliverers. TP may not replace the traditional in-person consultations completely. Covid-19 pandemic has hastened its utilization across several healthcare delivery systems. Healthcare organizations, clinicians, other healthcare deliverers, and end users are in the process of adapting to the new scenario. Incorporation of the big data, machine learning, artificial intelligence, virtual reality, and other technological advances in the psychiatric healthcare delivery systems into TP services in the OPDs would significantly contribute to the overall quality and efficacy of the psychiatric healthcare delivery systems in the future.
... This study is important because it identifies the experience of learning how to deliver relationally based telemental health services via videoconferencing. While previous studies have explored other aspects of telemental health, such as its cost efficiency (Antonacci et al., 2008), effectiveness with symptom reduction in comparison to face-to-face therapy (Dunstan & Tooth, 2012), and ability to foster the therapeutic alliance (Foster & Whitworth, 2005;Singh, Arya, & Peters, 2007), no other published study has looked at the experience of relational therapists who are new to this modality. The results of this study provide insight into the issues, challenges, barriers, and strategies for learning to use technology to deliver relationally based mental health care, and what clinicians and faculty of family therapy training programs should consider when developing and delivering systemic-based training. ...
There is mounting evidence that telemental health is an effective delivery method for treating a variety of mental, emotional, behavioral, and relational health problems. While many of the therapeutic skills leading to the effectiveness of face‐to‐face treatments are transferable, the effectiveness of telemental health requires unique skills. The purpose of this phenomenological study was to determine the experience of learning how to use videoconferencing to deliver relationally focused mental health care. Participants included 10 graduates of a COAMFTE‐accredited master's degree program emphasizing training in telemental health. Each student had practicum placements that required videoconferencing to deliver relationally based psychotherapy. Analysis of interview data revealed (a) personal reservations about distance delivery; (b) the importance of scaffolding student learning through curriculum, supervision, and mental health‐care delivery protocols; (c) the technological barriers associated with this delivery method; and (d) overcoming technological barriers through intentionality.