Clinicians Should Set Realistic Expectations for Telehealth Treatment

Onboarding patients to telepsychiatry includes setting realistic expectations for both the patient and provider and ensuring the patient is comfortable with the platform, said Psych Congress Steering Committee member Edward Kaftarian, MD, during a live Q&A session at the recent Psych Congress Elevate virtual meeting. Steven Chan, MD, MBA, moderated the “Ask the Experts” discussion with Dr Kaftarian addressing topics related to technology in mental healthcare.

To ensure patients have the proper resources before beginning the onboarding process, Dr Chan, also a member of the Psych Congress Steering Committee, prefers to “ask simple questions like ‘do you have a phone or computer?’ ‘do you watch videos on it?’ ‘do you talk with anybody on videos or webcams?’ to start to get a feel for whether they have had that experience in the past, and that can help gauge how much onboarding they need.”

In addition to gauging the patient’s comfort level with the medium, Dr Kaftarian suggests proper preparation in advance is critical in ensuring the patient has a good experience and continues using telehealth as an option. Patients should be made aware of the privacy and confidentiality of telehealth as part of that preparation to give the patient the best impression possible.

Internet-Delivered Cognitive Behavioral Therapy Effective for Social Anxiety in Youth

Some issues may arise that can impact the success of the treatment despite telehealth being a viable treatment option, especially during the COVID-19 pandemic. Background noise, family members or coworkers being in the room, poor audio or video quality, patient’s lack of understanding of their own expectations, and the inability for the physician to see fine motor movements can negatively affect the treatment, Dr Kaftarian suggests.

Clinicians should set realistic expectations for telehealth visits and not expect the “perfection” that comes with in-office treatment, says Dr Chan.

“Even when folks come to offices and clinics … they may not have the most appropriate behavior and that's also a data point … but certainly if it crosses any sort of dangerous boundaries or it gets into sort of danger to self, danger to others, then those are concrete boundaries,” Dr Chan told virtual attendees.

While there are the aforementioned downsides of telehealth not taking place in a controlled, clinical environment “one of the advantages of doing telepsych to a patient’s home is because you can see their circumstances and their behavior when they're comfortable,” Dr Kaftarian concluded.

—Meagan Thistle

Reference

Kaftarian E, Chan S. Ask the experts: technology and mental health. Presented at: Psych Congress Elevate; June 11–13, 2021; Virtual.