Abstract
Telepsychiatry (TP) is an effective, well-received, and a standard way to practice mental health care provision on distance. Both residents and young practitioners have significant interest and there is a growing demand for telepsychiatrists. Many are making strides towards addressing some of these needs and gaps in services for patients and trainees around the world. Traditionally, too, there was emphasis placed on knowledge acquisition, and more focus is needed on TP skill competencies for clinicians to practice effectively and achieve good clinical outcomes with their patients. TP competencies have been published and structured at novice or advanced beginner, competent/proficient, and expert levels. Curricula include seminar, rotations, and supervision, with accompanying feedback. Continuing education/medical education events may also help clinicians, programs, agencies, and other institutions. Both residents and young practitioners have significant interest, and there is a growing demand for telepsychiatrist. Many are making strides towards addressing some of these needs and gaps in services for patients around the world, but fewer are focused on competencies related to TP. This chapter will attempt to move forward the emphasis on skills (e.g., interviewing, assessment), attitudes that ensure quality care and knowledge (e.g., appropriate model, legal standards, privacy) by reviewing the history and scope of practice related to TP and other e-mental health (eMH) technologies. Readers will be encouraged to reflect, self-assess, and evaluate strengths and weaknesses, then consider clinical and curricular methods for improving. TP will also be explored on a spectrum of other eMH technologies used for clinical care, for which additional competencies may also be indicated.
Similar content being viewed by others
References
Accreditation Council on Graduate Medical Education (2013) Common program requirements. https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf. Accessed 1 Sept 2017
American Association of Medical Colleges, Core Medical Student Competencies (2015) https://www.aamc.org. Accessed 1 Sept 2017
Andersson G, Carlbring P, Holmstrom A, Sparthan E, Furmark T, Nilsson-Ihrfelt E, Ekselius L (2006) Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial. J Consult Clin Psychol 74(4):677–686
Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Coventry P (2012) Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev 10:CD006525. https://doi.org/10.1002/14651858.CD006525.pub2
Armstrong EG, Mackey M, Spear SJ (2004) Medical education as a process management problem. Acad Med 79:721–728. PMID: 15277126
Balon R, Beresin EV, Coverdale JH, Louie AK, Roberts LW (2015) Strengthening telepsychiatry’s role in clinical care and education. Acad Psychiatry 39:6–9
Capobianco DJ, Schultz HJ (2007) The program director – a competency-based job description. ACGME Bulletin, 28–30 Aug. http://www.acgme.org/acWebsite/bulletin/bulletin08_07.pdf. Accessed 1 Sept 2017
Celio AA, Winzelberg AJ, Wilfley DE, Eppstein-Herald D, Springer EA, Dev P, Taylor CB (2000) Reducing risk factors for eating disorders: comparison of an Internet- and a classroom-delivered psychoeducational program. J Consult Clin Psychol 68(4):650–657. PMID: 10965640
Chipps J, Ramlall S, Mars M (2012) Practice guidelines for videoconference-based TP in South Africa. Afr J Psychiatry (Johannesburg) 15:271–282
Christensen H, Griffiths K, Groves C, Korten A (2006) Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program. Aust N Z J Psychiatry 40(1):9–62. PMID: 16403040
Clarke G, Eubanks D, Reid E, Kelleher C, O’Connor E, DeBar LL, Lynch F, Gullion C (2005) Overcoming depression on the Internet (ODIN) (2): a randomized trial of a self-help depression skills program with reminders. J Med Internet Res 7(2):e16. PMID: 15998607
Cowley D, Dunaway K, Forstein M, Frosch E, Han J, Joseph R, Unutzer J (2014) Teaching psychiatry residents to work at the interface of mental health and primary care. Acad Psychiatry 38(4):398–404. https://doi.org/10.1007/s40596-014-0081-3
CPA (2013) Clinical guidelines and position papers: TP [webpage on the Internet]. Canadian Psychiatric Association, Ottawa. Available from http://ww1.cpa-apc.org:8080/publications/position_papers/TP.asp
Dreyfus SE, Dreyfus HL (1980) A five-stage model of the mental activities involved in directed skill acquisition. University of California, Operations Research Center, Berkeley. http://www.dtic.mil/dtic/tr/fulltext/u2/a084551.pdf. Accessed 1 Sept 2017
Dwyer TF (1973) TP: psychiatric consultation by interactive television. Am J Psychiatry 130(8):865–869
Fairchild DG, Benjamin EM, Gifford DR, Huot SJ (2004) Physician leadership: enhancing the career development of academic physician administrators and leaders. Acad Med 79:214–218. PMID: 14985193
Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198. PMID: 1202204
Fortney JC, Pyne JM, Mouden SB, Mittal D, Hudson TJ, Schroeder GW, Rost KM (2013) Practice-based versus telemedicine-based collaborative care for depression in rural federally qualified health centers: a pragmatic randomized comparative effectiveness trial. Am J Psychiatry 170(4):414–425. https://doi.org/10.1176/appi.ajp.2012.12050696
Fortney JC, Pyne JM, Kimbrell TA, Hudson TJ, Robinson DE, Schneider R, Schnurr PP (2015) Telemedicine-based collaborative care for posttraumatic stress disorder: a randomized clinical trial. J Am Med Assoc Psychiatry 72(1):58–67. https://doi.org/10.1001/jamapsychiatry.2014.1575
Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ (2006) Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Internal Med 166(21):2314–2321. https://doi.org/10.1001/archinte.166.21.2314
Glover JA, Williams E, Hazlett LJ, Campbell N (2013) Connecting to the future: TP in postgraduate medical education. Telemed J E Health 19(6):1–6. https://doi.org/10.1089/tmj.2012.0182
Harden RM, Crosby JR, Davis MH (1999) AMEE guide no. 14: outcome-based education: part 1 – an introduction to outcome-based education. Med Teach 21:7–14
Hatem CJ, Lown BA, Newman LR (2006) The academic health center coming of age: helping faculty become better teachers and agents of educational change. Acad Med 81:941–944. PMID: 17065851
Hilty DM, Marks SL, Doug U, Yellowlees PM, Nesbitt TS (2004) Clinical and educational TP applications: a review. Can J Psychiatry 49(1):12–23
Hilty DM, Yellowlees PM, Cobb HC, Bourgeois JA, Neufeld JD, Nesbitt TS (2006) Models of TP consultation-liaison service to rural primary care. Psychosomatics 47(2):152–157. PMID: 16508028
Hilty DM, Marks S, Wegeland JE, Callahan EJ, Nesbitt TS (2007) A randomized controlled trial of disease management modules, including TP care, for depression in rural primary care. Psychiatry 4(2):58–65
Hilty DM, Ferrer DC, Parish MB, Johnston B, Callahan EJ, Yellowlees PM (2013) The effectiveness of telemental health: a 2013 review. Telemed J E Health 19(6):444–454. https://doi.org/10.1089/tmj.2013.0075
Hilty DM, Yellowlees PM, Nasatir SEH, Shoemaker EZ, Pato MT (2014) Program evaluation and practical: supporting pragmatic data-driven clinical videoconferencing CV services. In: Tuerk JP, Shore P (eds) Behavioral telehealth series volume 1- clinical video conferencing: program development and practice. Springer Publishing, New York, pp 105–134
Hilty DM, Chan S, Torous J, Mahautmr J, Mucic DM (2015a) New frontiers in healthcare and technology: Internet- and web-based mental options emerge to complement in-person and TP care options. J Health Med Inform 6(4):1–14
Hilty DM, Crawford A, Teshima J, Chan S, Sunderji N, Yellowlees PM, Kramer G, O’Neill P, Fore C, Luo JS, Li ST (2015b) A framework for telepsychiatric training and e-health: competency-based education, evaluation and implications. Int Rev Psychiatry 27(6):569–592
Hilty DM, Green J, Nasatir-Hilty SE, Johnston B, Bourgeois JA (2015c) Mental healthcare to rural and other underserved primary care settings: benefits of TP, integrated care, stepped care and interdisciplinary team models. J Nurs Care 4:2. https://doi.org/10.4172/2167-1168.1000237
Hilty DM, Rabinowitz T, Yellowlees PM (2015d) Telepsychiatry’s evidence base shows effectiveness: new models (asynchronous), more psychotherapy, and innovations with special populations (child, gero, other), symposium, American Psychiatric Association, Toronto
Hilty DM, Snowdy CE, Shoemaker EZ, Gutierrez YSM, Carli V (2015e) Social media and clinical practice: why it is popular, tips/guidelines on how to work with patients, and dealing with pathological Internet use. Med Res Arch 3(7). http://www.journals.ke-i.org/index.php/mra/article/view/292
Hoffman P, Kane JM (2015) Telepsychiatry education and curriculum development in residency training. Acad Psychiatry 39(1):108–109
Hoge MA, Morris JA, Laraia M, Pomerantz A, Farley T (2014) Core competencies for integrated behavioral health and primary care. SAMHSA-HRSA Center for Integrated Health Solutions, Washington, DC. http://www.integration.samhsa.gov/workforce/Integration_Competencies_Final.pdf. Accessed 1 Sept 2017
Holmboe ES, Sherbin J, Donlin ML, Swing SR, Franks JR (2010) The role of assessment in competency-based medical education. Med Teach 32:676–682. https://doi.org/10.3109/0142159X.2010.500704
Jones RM, Leonard S, Birmingham L (2006) Setting up a TP service. Psychiatr Bull 30:464–467
Kates N, Mazowita G, Lemire F, Jayabarathan A, Bland R, Selby P, Audet A (2011) The evolution of collaborative mental health care in Canada: a shared vision for the future. Can J Psychiatry 56(5):1–10
Katon W, Von Korff M, Lin E, Walker E, Simon GE, Bush T, … Russo J (1995) Collaborative management to achieve treatment guidelines impact on depression in primary care. J Am Med Assoc 273(13):1026–1031
Kirkpatrick J, Kirkpatrick W (2009) The Kirkpatrick Four Levels: a fresh look after 50 years, 1959–2009. http://www.kirkpatrickpartners.com/Portals/0/Resources/Kirkpatrick%20Four%20Levels%20white%20paper.pdf. Accessed 1 Sept 2017
Litzelman DK, Stratos GA, Marriott DJ, Skeff KM (1998) Factorial validation of a widely disseminated educational framework for evaluating clinical teachers. Acad Med 73:688–695
Ljotsson B, Lundin C, Mitsell K, Carlbring P, Ramklint M, Ghaderi A (2007) Remote treatment of bulimia nervosa and binge eating disorder: a randomized trial of Internet-assisted cognitive behavioural therapy. Behav Res Ther 45(4):649–661. PMID: 16899213
Luo JS, Hilty DM, Worley LLM, Yager J (2006) Considerations in change management related to technology. Acad Psychiatry 30(6):465–469. PMID: 17139017
McLean M, Cilliers F, Van Wyk JM (2008) Faculty development: yesterday, today and tomorrow. Med Teach 30:555–584. https://doi.org/10.1080/01421590802109834
Mucic D (2009) International TP in cross-cultural mental healthcare. Telemed J E Health 15(s1):27–79
Mucic D (2010) Transcultural TP and its impact on patient satisfaction. J Telemed Telecare 16:237–242
Mucic D, Hilty DM (eds) (2016) e-Mental health. Springer, Cham
Mucic D, Hilty DM, Yellowlees PM (2016a) e-Mental health toward cross-cultural populations worldwide. In: Mucic D, Hilty DM (eds) e-Mental health. Springer, Cham
Mucic D, Hilty DM, Parrish MB, Yellowlees PM (2016b) Web- and Internet-based services: education, support, self-care and formal treatment approaches. In: Mucic D, Hilty DM (eds) e-Mental health. Springer, Cham
Myers KM, Turvey C (eds) (2013) Telemental health: clinical, technical, and administrative foundations for evidence-based practice. Elsevier, London
Myers K, Cain S, Work Group on Quality Issues, American Academy of Child and Adolescent Psychiatry Staff (2008) Practice parameter for TP with children and adolescents. J Am Acad Child Adolesc Psychiatry 47:1468–1483
Nadler G, Hibino S, Farrell J (1999) Creative solution finding: the triumph of breakthrough thinking over conventional problem solving. Prima Publications, Rocklin
Odor A, Yellowlees P, Hilty D, Parish MB, Nafiz N, Iosif AM (2011) PsychVACS: a system for asynchronous TP. Telemed J E Health 17:299–303
RANZCP (2013) TP: professional practice standards and guides for TP [webpage on the Internet]. The Royal Australian and New Zealand College of Psychiatrists, Melbourne. http://www.ranzcp.org/Files/Resources/RANZCP-Professional-Practice-Standards-and-Guides.aspx. Accessed 1 Sept 2017
Ratzliff A, Norfleet K, Chan YF, Raney L, Unützer J (2015) Perceived educational needs of the integrated care psychiatric consultant. Acad Psychiatry 39(4):448–456. https://doi.org/10.1007/s40596-015-0360-7
Ritterband LM, Thorndike F (2006) Internet interventions or patient education web sites? J Med Internet Res 8(3):e18. PMID: 17032634
Rouse DN (2011) Employing Kirkpatrick’s evaluation framework to determine the effectiveness of health information management courses and programs. Perspect Health Inf Manag 8(Spring):1c. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070232/. Accessed 1 Sept 2017
Royal College of Physicians and Surgeons of Canada, CanMEDS Framework (2005) http://www.royalcollege.ca/portal/page/portal/rc/canmeds/framework. Accessed 1 Sept 2017
Sargeant JK, Tanis A, McGregor F, Pearce P, Quinn D, Milev R, Renaud S, Skakum K, Dada N (2010) Psychiatric human resources planning in Canada. Position paper of the Canadian Psychiatric Association. Can J Psychiatry 55(9):1–20
Shore JH (2013) TP: videoconferencing in the delivery of psychiatric care. Am J Psychiatry 170(3):256–262. https://doi.org/10.1176/appi.ajp.2012.12081064
Shore JH, Mishkind MC, Bernard J, Doarn CR, Bell I Jr, Bhatla R, Vo A (2013) A lexicon of assessment and outcome measures for telemental health. Telemed E Health 3:282–292. https://doi.org/10.1089/tmj.2013.0357
Skeff KM, Stratos GA, Mount JFS (2007) Faculty development in medicine: a field in evolution. Teach Teach Educ 23:280–285
Srinivasan M, Li ST, Meyers FJ, Pratt DD, Collins JB, Braddock C, Hilty DM (2011) Teaching as a competency for medical educators: competencies for medical educators. Acad Med 86(10):1211–1220. https://doi.org/10.1097/ACM.0b013e31822c5b9a
Sunderji N, Crawford C, Jovanovic M (2015) TP in graduate medical education: a narrative review. Acad Psychiatry 39:55–62
Tekian A, Hodges BD, Roberts TE, Schuwirth L, Norcini J (2015) Assessing competencies using milestones along the way. Med Teach 37(4):399–402. http://www.ncbi.nlm.nih.gov/pubmed/25523010
Volpe T, Boydell KM, Pignatiello A (2013) Attracting child psychiatrists to a televideo consultation service: the TeleLink experience. Int J Telemed Appl 146858. https://doi.org/10.1155/2013/146858
Woltmann E, Grogan-Kaylor A, Perron B, Georges H, Kilbourne AM, Bauer MS (2012) Comparative effectiveness of collaborative chronic care models for mental health conditions across primary, specialty, and behavioral health care settings: systematic review and meta-analysis. Am J Psychiatry 169(8):790–804. https://doi.org/10.1176/appi.ajp.2012.11111616
Yellowlees P, Shore J, Roberts L, American Telemedicine Association (2010) Practice guidelines for videoconferencing-based telemental health – October 2009. Telemed J E Health 16(10):1074–1089
Yellowlees PM, Odor A, Iosif A, Parish MB, Nafiz N, Patrice K, … Hilty D (2013) Transcultural psychiatry made simple: asynchronous TP as an approach to providing culturally relevant care. Telemed J E Health 19(4):1–6. https://doi.org/10.1089/tmj.2012.0077
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Singapore Pte Ltd.
About this entry
Cite this entry
Mucic, D., Hilty, D.M. (2018). Training in Telepsychiatry. In: Hermans, M., Hoon, T., Pi, E. (eds) Education about Mental Health and Illness. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-0866-5_26-1
Download citation
DOI: https://doi.org/10.1007/978-981-10-0866-5_26-1
Received:
Accepted:
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-0866-5
Online ISBN: 978-981-10-0866-5
eBook Packages: Springer Reference Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences