Dr. Karen Cohen on the Psychology Practice Fact Sheet & Tele-Health
On the fact sheet you wrote, Psychological Practice and the Coronavirus, you mention growing evidence that psychological services can be delivered effectively through tele-health. What is that evidence?
I would encourage folks who want to learn more about the delivery of psychological services through electronic media to read some of the work that’s being done now by psychologist members – Dr. Heather Hadjistavropoulous, Dr. Stephane Bouchard, Dr. Peter Cornish. There really is mounting evidence that internet-delivered CBT is effective in the treatment of depression and anxiety.
I think there are things you need to know if you’re going to adapt your service to deliver it virtually. We have some excellent materials on the COVID page of our website and resources for folks who want to inform themselves, and some of the things they need to know when delivering services in that way.
Assuming you’re a practitioner who has a private and secure platform to do tele-psychology, what are a few of the things they need to know?
Obviously, you need to talk to your clients about their comfort using that technology, you need to be sure that whatever mechanism you choose is safe and secure. You need to know you’re always talking to your client, you need to use passwords to confirm their identity when that’s necessary.
BMS, who’s the broker of our professional liability insurance program, and our preferred legal provider Gowlings, have a series of fact sheets, also on our COVID website, that talk about things you need to be aware of when you deliver tele-psychology. You want to be aware whether your client’s insurance is going to pay for a session delivered by tele-psychology. Or you can have your client find that out before you begin, don’t assume it will necessarily be the case.
It’s always a good idea to put on a receipt the type of service that was delivered and in what format. Inform yourself on the things that impact the delivery of psychological service differently when you’re delivering it virtually.
I saw a few health insurers come out and say they’ll be covering tele-psychology in what appears to be a blanket way. Sun Life I think was one. If you saw your health insurance provider come out and say that, can you assume that you’re covered and you’re good to go with virtual therapy sessions?
Not necessarily. I think the issue is that although the insurer may decide that given COVID or for any other reason they’re going to cover tele-psychology, it’s important to understand that everyone’s plan isn’t necessarily the same. If two people had different policies, which they would if they had two different employers, they would still need to confirm that that particular policy will cover it.
You’ve said there are skills and competencies unique to tele-psychology. What are some of those?
It’s probably best for our membership to consult those who are more expert than I. Dr. Christine Korol, for example, has some resources on her website that would be very useful. In broad strokes, it’s about your comfort with technology, that you go seek out training from folks who have made a practice of delivering psychological services virtually so you know what those are and are aware of any differences that method of service delivery can present.
You’ll want to know how to prepare your clients for working in this way, make sure they’re comfortable with it and you understand their comfort with it. The important thing to keep in mind is that all other professional standards still apply. Everything you would need to do in terms of competencies and skills and informed consent and continuity of care when you’re delivering care face to face would still apply when you’re delivering care virtually.
I’ve been talking to Dr. Korol, and she suggested getting a white noise machine to put outside your home office so as not to be interrupted and ensure privacy.
Those are things that would apply in any setting, of course. In a busy clinic you might need a white noise machine outside any room to ensure privacy as well. So some of the things are very transferrable, and some are more particular to that kind of service delivery.
I think it’s worth underscoring that there are some populations for whom telepsychology might work even better. If you’re in a rural or remote location, or up north in a province where there aren’t a lot of psychologists in that area, being able to talk to one virtually could be wonderful. If you have any kind of mobility issues, or you’re a senior, it may be easier for you to talk to someone from your own home rather than travelling a physical distance to meet them.
One of the things we’ve been talking about as health professional organizations, and we’ve been meeting regularly and sharing resources around COVID, is “will COVID change the way we deliver health care?” Psychology is one of those professions that lends itself a little more easily to tele-health than other professions. You know dentists, for example, would have a lot of trouble doing their work virtually.
Maybe we’re ramping up a little quicker now with COVID, and those practitioners who maybe weren’t using tele-psychology much are now doing more so now. But are these changes that are going to be permanent in the fabric of health care and tele-health care?
It may be a learning curve right now in terms of delivering and receiving these services, but in the future it might become a whole new business model – do you think that’s likely?
I think so! I think once people become familiar, and see how these services can be best delivered within the context of their scope of practice, I do think we’ll see it more and more. I know that as an association we’ve been working very hard with a practice management platform to bring an offering to our members. Hopefully we’re just on the verge of being able to announce that. It’s one that really has the psychologist-practitioner at the centre, and features a whole suite of services to help you manage your practice.
I think that one of the things individual practitioners run up against is that when you’re a salaried practitioner at a hospital or a school you have an institution to rely on who does some of that diligence around providing a secure and private platform. But when you’re in private practice and you don’t have that institutional resource, there’s more pressure on you to make the best choice. That it’s a practice management offering that meets your needs, that’s secure, that’s private.
So, as an association we hope to be able to do some of that diligence for our members and we hope to be able to announce this offering very shortly.
Alright, now I want to talk about remote dentistry.