Journal for
Technology in Behavioral Science - Upcoming Articles

 

Members of the CTiBS Competencies Task Force have published several articles about telebehavioral health (TBH) competencies and are in process of submitting and published others. CTiBS members have free access to those that have been published in the Journal for Technology in Behavioral Science by going to the Members section on the CTiBS website at https://ctibs.org/. The following is information about those that have been published:

Maheu, M., Drude, K., Hertlein, K., Hilty, D. (2018). A Framework of Interprofessional Telebehavioral Health Competencies: Implementation and Challenges Moving Forward. Academic Psychiatry, 42(6), 824-833. https://doi.org/10.1007/s40596-018-0988-1

Technology is rapidly becoming a key player in care delivery, lifelong learning, and education/training. The American Psychiatric Association Practice-Based Learning and Improvement Core Competencies include the use information technology and lifelong learning [1]. Current competency-based education (CBE) focuses on skills rather than on what is taught [23]. Competency may be defined as a measurable human capability required for effective performance [4]. The Institute of Medicine (IOM) [5] suggested three key elements for patient-centered care: skills-focused education, interdisciplinary team-based care, and a technology/informatics-oriented administrative approach.

A key premise of telepsychiatric competencies published in 2015 [6] is that faculty clinicians and educators have to first improve their care via clinical and technological competence, in order to then oversee trainees’ use of technologies in clinical care. Fundamental steps to this work are the alignment of clinical outcomes with teaching/supervisory methods, evaluation, and feedback [67]. Professional association standards and guidelines typically do not focus on competencies, are complex, and are frequently incomplete (e.g., diverse populations and settings) [678], and comparisons across professions are rare [7].

Telebehavioral health (TBH) is a broad term inclusive across behavioral health professions and technically includes both mental health and substance use care; in this paper, it will also include TP. Each BH discipline and field has its own nomenclature for telehealth (e.g., telepsychiatry, telepsychology, distance counseling) [9], though competencies related to technological standards were suggested years ago [1011]. A TBH competency set arrived in [12] and a specific one for use of social media arrived in 2018 [13]. Care delivered by TBH may require additional skills—or adjusted behaviors—compared to in-person care [67111213].

shadow-ornament

Drude, K., Maheu, M. (2018). Telemental/telebehavioral health competencies, evaluation and outcomes. Journal for Technology in Behavioral Science, 3(2), 77-79

Telemental/telebehavioral health (TMH/TBH) is a mature, valid, reliable, and clinically effective way to practice healthcare (Hilty et al. 2013; American Telemedicine Association Practice Guidelines 20092013). TMH is practiced by a wide range of MH fields—most commonly videoconferencing by stand-alone or Internet-based platforms. A review of TMH/TBH best practices was recently published (Luxton et al. 2016). Each profession has its own nomenclature for telehealth (e.g., telepsychiatry, telepsychology, distance counseling).

Behavioral health professional organizations have begun to conceptualize and define competencies for practice, and in some cases, these include telehealth competencies. Professions doing telepractice need to strive not only for a knowledge base but also a competency or skill base for practice. A consensus process is needed to facilitate the education, training, practice of individual and interdisciplinary TMH/TBH services. Although a number of professional organizations have adopted TMH standards and guidelines, little has been done to identify the TMH competencies assumed necessary to practice in conformance with these standards or guidelines, either within specific professions or interprofessionally.

shadow-ornament

Maheu, M., Drude, K., Hertlein, K., Wall, K., Long, R., Luoma, T., Hilty, D. (2018). Correction to:An interprofessional framework for telebehavioral competencies. Journal for Technology in Behavioral Science, 3(2), 108-140.

In 2001, the Institute of Medicine (IOM) released a report that highlighted the inadequacies of health care professional training and assessment of ongoing proficiency to enhance patient care and safety (IOM 2001). The IOM’s subsequent Health Professions Education Summit (HPES) then identified objectives for educational reform for the following health professionals in the United States: nurses, pharmacists, physician assistants, physicians, and allied health professionals, including, for example, psychologists, counselors, and social workers (IOM HPES 2003b). The IOM thereby identified a set of simple, core competencies that all health clinicians should possess, regardless of their discipline, to meet the needs of the twenty-first-century health care system (p. 45). These included the ability to:

Provide patient-centered care
Work in interdisciplinary teams
Employ evidence-based practice
Apply quality improvement
Use information technology (IOM 2003a, p. 45)

Since then, educational reform related to competencies has made significant advances. In fact, the above-mentioned competencies are now often considered a foundation for workforce development. They provide indicators that are necessary to develop effective curriculum for worker training, orientation and continued staff development. They also provide indicators to inform workers and their supervisors of job performance requirements. For example, the utilization of competencies in the training of Direct Service Workers (DSW) reinforces shared values of direct service workers’ skills and growth (Hoge et al. 2008; Center for Medicare and Medicaid Services’ (CMS) 2013, p. 13).

shadow-ornament

Hilty, D., Maheu, M., Drude, K., Hertlein, K., Wall, K., Long, R., Luoma, T. (2017). Telebehavioral health, telemental health, e-therapy and e-health competencies: The need for an interdisciplinary framework. Journal for Technology in Behavioral Science, 2(3–4), 171–189.

Telebehavioral health (TBH) in the form of synchronous video is effective, well received and a standard way to practice. Current guidelines and policies discuss the importance of good clinical, technical, and administrative components to care. A review of the TBH evidence-based literature across psychiatry/medicine, psychology, social work, counseling, marriage/family, behavioral analysis, and other behavioral sciences found no common TBH competencies across disciplines. The scope of professional guidelines and standards about technology are broad (e.g., practice of telepsychology; Internet and social media use in social work practice), to mid-range (e.g., American Telemedicine (ATA), American Counseling Association (ACA)), to narrow (e.g., preliminary “guidelines” for asynchronous communication such as e-mail and texts). There is only one set of competencies for telepsychiatry, which discusses skills, training and evaluation. These competencies suggested (1) novice/advanced beginner, competent/proficient, and expert levels; (2) domains of patient care, communications, system-based practice, professionalism, practice-based improvement, knowledge and technological know-how; and (3) pedagogical methods to teach and evaluate skills. Revisions to this framework and technology-specific competencies with additional domains may be needed. A challenge to competencies across disciplines may be finding consensus, due to varying scopes of practice, training differences and faculty development priorities. Disciplines and organizations involved with TBH need to consider certification/accreditation and ensure quality care.

Please register here for news, alerts, and publications

Use the following form to register for our quarterly email newsletter. After subscribing, you will be returned to this page.

privacy We value your privacy and would never spam you