American)Telemedicine)Association)/)American)Psychological)Association)Guidelines)(2013)Comparison))

Derived'from'APA'&'ATA'Guidelines,'2013'by'Marlene'M.'Maheu,'Ph.D.'&Massimo'Agnoletti,'Ph.D.''

*CAUTION: This draft document has been designed for discussion & training purposes only. Omissions or mis-interpretations may have occurred. Use at your own risk, proceed with caution and defer to your own clinical judgment. Verify original documents referenced & consult with your attorney, state boards and other authorities before implementing any changes to your standard practices.

Copyright © 2013 Marlene M. Maheu, Ph.D. & Massimo Agnoletti, Ph.D.

This'best'practices'and'documentation'checklist'is'derived'from'a'Telebehavioral+Health+Institute+review'of'2013'American'Psychological'Association'and'American'Telemedicine'Association’s'Guidelines.*''''

)

2013)APA)&)ATA)Guideline)Similarities))

'

Both'documents'do'not'purport'to'establish'binding'legal'standards'and'defer'to'clinical'judgment'in'any'specific'circumstance.''

'Both'documents'recommend:''•' Adherence'to'local,'state'(licensing'laws,'interjurisdictional'practice,'mandatory'reporting),'federal'laws'(e.g.'HIPAA'

and'HITECH),'&'ethical'codes'of'profession''•' Competency'of'practitioner'(adequate'professional'and'technical'knowledge'and'skills,'etc.)'•' Competency'of'client/patient'(e.g.,'appropriateness'for'telepractice'services,'technical'competencies,'cooperation)'•' Informed'consent'•' Careful'and'ongoing'assessment'•' Emergency'planning'•' Privacy,'security'and'confidentiality'and'risk'management''•' Documentation'''''

)

2013)APA)&)ATA)Guideline)Differences))

'

APA'Written'for'Psychologists''

'

ATA'Written'for'All+Telebehavioral+Health+Providers'

Global'perspective' Specific'perspective''Scope'is'email,'telephone,'social'networking'and'video'teleconferencing'(requires'broad'principles)'

Scope'is'realTtime,'videoconferencing'via'personal'computers'and'mobile'devices'allows'for'specificity'(e.g.,'connectivity,'device'security,'camera'angle,'PIP)'

Theoretical,'describes'ethical'concepts'more'than'“how'to”'

Practical,'clinical,'administrative'and'technical'“how'to”'

Focused'largely'on'consumerTprotection' Focused'on'both'consumer'and'professionalTprotection'(e.g.,'availability'of'emergency'contact'info'at'each'session,'working'with'uncooperative'patients)'

Makes'strong'statement'regarding'the'need'to'not'only'know,'but'keep'updated'with'the'evidenceTbased'literature'

References'a'number'of'studies'but'does'not'explicitly'direct'the'provider'to'adhere'to'the'evidenceTbase'or'keep'updated'

Specific'use'of'psychological'test'instruments'and'other'procedures'when'conducting'assessments'

Broader'use'of'term'Assessment'

Language'is'aspirational'(e.g.,'“might,”'“could,”'etc.)' Language'is'mixed'(e.g.,'“should,”'“shall,”'“may”)'

'' '

American)Telemedicine)Association)/)American)Psychological)Association)Guidelines)(2013)Comparison))

Derived'from'APA'&'ATA'Guidelines,'2013'by'Marlene'M.'Maheu,'Ph.D.'&Massimo'Agnoletti,'Ph.D.''

*CAUTION: This draft document has been designed for discussion & training purposes only. Omissions or mis-interpretations may have occurred. Use at your own risk, proceed with caution and defer to your own clinical judgment. Verify original documents referenced & consult with your attorney, state boards and other authorities before implementing any changes to your standard practices.

Copyright © 2013 Marlene M. Maheu, Ph.D. & Massimo Agnoletti, Ph.D.

Telebehavioral)Health)Institute)Checklist)

TOPICS) APA) ATA) Done?)1.'**'Document'considerations'and'choices'regarding'the'use'of'telecommunications'technologies'' X' ' '

2.'**'Document'risks'and'benefits'of'telepsychology'service'(e.g.,'cost'savings'for'client/patient,'travel,'time'off'work,'parking,'baby'sitting),'improved'access'to'care'&'specialty'care'(e.g.,'emergency'or'elderly,'disabled,'reduced'stigma'and'embarrassment)'

X' ' '

3.'**'In'testing'and'assessment'documentation,'specify'that'a'particular'test'or'assessment'procedure'has'been'administered'via'telepsychology,'and'describe'any'accommodations'or'modifications'that'have'been'made'

X' ' '

4.'**'Document'how'secure'the'communicated'information'is'with'each'technology'used,'and'any'technologyTrelated'vulnerability'to'confidentiality'and'security'by'creating'and'storing'electronic'client/patient'data'and'information'

X' ' '

5.'Consider'client/patient'preferences'regarding'technology,'treatment,'arrangements' X' ' '6.'**'Document'emergency'resources'(e.g.,'telephone'numbers,'hospital'admissions,'local'clinical'resources,'local'champion'or'proctor,'friend/family'member(s)' X' ' '

7.'**'Provide'and'discuss'clear'emergency'plan'with'written'instructions'(e.g.,'suicide,'homicide,'abuse,'other)' X' X' '

8.'**'Document'plan'for'addressing'emergencies'and'other'relevant'factors're:'efficacy'and'safety'of'treatment' X' X' '

9.'Consider'potential'benefits:'cost/time'savings'(e.g.,'saved'babyTsitting'fees,'parking'fees,'time'away'from'work,'travel'costs)' X' X' '

10.'Consider'other'“disadvantages”'of'using'telepsychology' X' X' '11.'Adhere'to'current'evidence'base,'outcomes'research,'best'practices' X' X' '12.'Manage'factors'that'can'impact'on'the'efficacy'of'intervention'(e.g.,'“intrusions”'caused'by'people'or'events)' X' X' '

13.'Consider'multicultural,'diversity,'socioeconomic'&'linguistic'issues'(e.g.,'is'it'advisable'to'test'language'skills?)' X' X' '

14.'Consider'other'individual'characteristics'(e.g.,'medical'status,'psychiatric'stability,'physical/cognitive'disability,'personal'preferences)' X' X' '

15.'Consider'accessibility'of'technology'&'client’s/patient’s'and'practitioner’s'technical'competence' X' X' '

16.'**'Document'verbal'informed'consent'prior'to'treatment'(risks/benefits'of'chosen'technologyc'limits'to'confidentialityc'access,'disclosure'&'storage'of'datac'boundariesc'procedures'for'responding'to'eTcommunications)'

X' X' '

17.'**'Document'the'method'&'procedures'for'data'&'information'storage,'which'info'will'be'stored,'how'info'will'be'stored'transmission,'disposal'of'malware,'cookies,'etc.' X' X' '

18.'Adhere'to'legal/regulatory'mandates'for'all'jurisdictions'involved'(clinician’s'&'client’s/patient’s'location'at'time'of'contact)' X' X' '

19.'**'Document'and'verify'client/patient'location' ' X' '�20.'**'Documentation'to'include'date,'duration'and'type'of'service'(med'management,'therapy,'assessment,'etc.)'

' X' '

21.'**'Document'the'treatment'plan'based'upon'an'assessment'of'the'patient’s'needs.'The'plan'should'meet'the'professional’s'discipline'standards'and'guidelines'and'include'a'description'of'services'to'be'provided'and'the'goals'for'services'

' X' '

22.'**'Document'all'communications'with'the'patient'(e.g.,'written,'audiovisual,'or'verbal)' ' X' '+

**+Starred+topics+suggest+need+for+documentation.+ +

American)Telemedicine)Association)/)American)Psychological)Association)Guidelines)(2013)Comparison))

Derived'from'APA'&'ATA'Guidelines,'2013'by'Marlene'M.'Maheu,'Ph.D.'&Massimo'Agnoletti,'Ph.D.''

*CAUTION: This draft document has been designed for discussion & training purposes only. Omissions or mis-interpretations may have occurred. Use at your own risk, proceed with caution and defer to your own clinical judgment. Verify original documents referenced & consult with your attorney, state boards and other authorities before implementing any changes to your standard practices.

Copyright © 2013 Marlene M. Maheu, Ph.D. & Massimo Agnoletti, Ph.D.

References''American'Psychological'Association.'(2013).'Guidelines'For'The'Practice'Of'Telepsychology.'Retrieved'from'

http://www.apapracticecentral.org/ce/guidelines/telepsychologyTguidelines.pdf''

American'Telemedicine'Association.'(2013).'Practice'Guidelines'for'VideoTbased'Online'Mental'Health'Services.'Retrieved'from'http://www.americantelemed.org/practice/standards/ataTstandardsT'guidelines/practiceTguidelinesTforTvideoTbasedTonlineTmentalThealthTservices''

American'Telemedicine'Association.'(2007).'Core'Standards'for'Telemedicine'Operations.'Retrieved'from'http://www.americantelemed.org/docs/defaultTsource/standards/coreTstandardsTforTtelemedicineT'operations.pdf?sfvrsn=4'

American'Psychological'Association.'(1997).'APA'Statement'on'Services'by'Telephone,'Teleconferencing,'and'Internet:'A'statement'by'the'Ethics'Committee'of'the'American'Psychological'Association.'Retrieved'from'http://www.apa.org/ethics/education/telephoneTstatement.aspx'

Australian'Psychological'Society.'(2011).'Guidelines'for'providing'psychological'services'and'products'using'the'internet'and'telecommunications'technologies.'Retrieved'from'http://aaswsocialmedia.wikispaces.com/file/view/EGTInternet.pdf''

Bouchard,'S.,'Paquin,'B.,'Payeur,'R.,'Allard,'M.,'Rivard,'V.,'Fournier,'T.,'et'al.'(2004).'Delivering'cognitiveT'behavior'therapy'for'panic'disorder'with'agoraphobia'in'videoconference.'Telemedicine'Journal'and'ET'Health,'10'(1),'13T25''

Day,'S.X.,'&'Schneider,'P.L.,'(2002).'Psychotherapy'using'distance'technology:'A'comparison'of'faceTtoT'face,'video,'and'audio'treatment.'Journal'of'Counseling'Psychology,'49'(4),'499T503.''

Dongier,'M.,'Tempier,'R.,'LalinecTMichaud,'M.,'&'Meunier,'D.'(1986).'Telepsychiatry:'psychiatric'consultation'through'twoTway'television.'A'controlled'study.'Canadian'Journal'of'Psychiatry,'31'(1),'32T'34.''

Grady,'B.,'Myers,'K.M.,'Nelson,'E.L.,'Belz,'N.,'Bennett,'L.,'Carnahan,'L.,'et'al.'(2011).'EvidenceTbased'practice'for'telemental'health.'Telemedicine'Journal'and'ETHealth,'17'(2),'131T148.''

Hyler,'S.E.,'&'Gangure,'D.P.'(2004).'Legal'and'ethical'challenges'in'telepsychiatry.'Journal'of'Psychiatric'Practice,'10'(4),'272T276.''

Luxton,'D.D.,'O'Brien,'K.,'McCann,'R.A.,'&'Mishkind,'M.C.'(2012).'HomeTbased'telemental'healthcare'safety'planning:'what'you'need'to'know.'Telemedicine'Journal'and'ETHealth,'18'(8),'629T633.''

Luxton,'D.D.,'Sirotin,'A.P.,'&'Mishkind,'M.C.'(2010).'Safety'of'telemental'healthcare'delivered'to'clinically'unsupervised'settings:'a'systematic'review.'Telemedicine'Journal'and'ETHealth,'16'(6),'705T711.''

Ohio'Psychological'Association.'(2010).'Telepsychology'Guidelines.'Retrieved'from'http://www.ohpsych.org/psychologists/files/2011/06/OPATelepsychologyGuidelines41710.pdf'

O'Reilly,'R.,'Bishop,'J.,'Maddox,'K.,'Hutchinson.'L.,'Fisman,'M.,'&'Takhar,'J.'(2007).'Is'telepsychiatry'equivalent'to'faceTtoTface'psychiatry?'Results'from'a'randomized'controlled'equivalence'trial.'Psychiatry'Services,'58'(6),'836T843.�'

National'Association'of'Social'Workers.'(2005).'Standards'for'Technology'and'Social'Work'Practice.'Retrieved'from'http://www.socialworkers.org/practice/standards/naswtechnologystandards.pdf''

Ruskin,'P.E.,'SilverTAylaian,'M.,'Kling,'M.A.,'Reed,'S.A.,'Bradham,'D.D.,'Hebel,'J.R.,'et'al.'(2004).'Treatment'outcomes'in'depression:'comparison'of'remote'treatment'through'telepsychiatry'to'inTperson'treatment.'The'American'Journal'of'Psychiatry,'161'(8),'1471T1476.�'

Sharp,'I.R.,'Kobak,'K.A.,'&'Osman,'D.A.'(2011).'The'use'of'videoconferencing'with'patients'with'psychosis:'a'review'of'the'literature.'Annals'of'General'Psychiatry,'10'(1),'14.�'

Yellowlees,'P.,'Shore,'J.,'&'Roberts,'L.,'(2010).'Practice'guidelines'for'videoconferencingTbased'telemental'health'T'October'2009.Telemedicine'Journal'and'ETHealth,'16'(10),'1074T1089.�'

VA'Northwest'Health'Network'Office.'(2011).'HomeTBased'Telemental'Health'(HBTMH)'Standard'Operating'Procedures'Manual.'Vancouver,'WA:'Shore,'P.''