The Mental Health Professional and the New Technologies: A Handbook for Practice Today

The Mental Health Professional and the New Technologies: A Handbook for Practice Today

The Mental Health Professional and the New Technologies: A Handbook for Practice Today

The Mental Health Professional and the New Technologies: A Handbook for Practice Today


In the last two decades, new communication technologies have dramatically changed the world in which mental health professionals and their patients live. Developments such as e-mail, online chat groups, Web pages, search engines, and electronic databases are directly or indirectly affecting most people's routines and expectations. Other developments are poised to do so in the near future. Already, for example, patients are acquiring both good and bad advice and information on the Web; many expect to be able to reach their therapists by e-mail. And already there is pressure from third party payers for providers to submit claims electronically. These technological breakthroughs have the potential to make mental health care more widely available and accessible, affordable, acceptable to patients, and adaptable to special needs. But many mental health professionals, as well as those who train them, are skeptical about integrating the new capabilities into their services and question the ethical and legal appropriateness of doing so. Those unfamiliar with the technologies tend to be particularly doubtful. How much e-mail contact with patients should I encourage or permit, and for what purposes? Why should I set up a Web site and how do I do so and what should I put on it? Should I refer patients to chat groups or Web-based discussion forums? Could video-conferencing be a helpful tool in some cases and what is involved? How do I avoid trouble if I dare to experiment with innovations? And last but not least, will the results of my experimentation be cost-effective? In this wide-ranging and practical handbook, five experts, each with a different vantage point and training, systematically guide readers through the new practice arenas already made possible by current information technologies--ranging from Internet-wired offices to wearable computers--and point to those on the horizon. Throughout, the authors clearly define terminology for the beginner and illuminate their points with rich, clinical vignettes and first-person accounts of the experience of pioneering practitioners. The book includes: *an extensive overview of legal and regulatory issues, such as those raised by the Health Insurance Portability and Accountability Act (HIPAA); *concrete technical, ethical, and managerial suggestions summarized in a seven-step Online Consultation Risk Management model; and *"how to" resource lists and sample documents of use to beginners and experienced professionals alike. For better or worse, no mental health professional today can avoid confronting the issues presented by the new technologies. The Mental Health Professional and the New Technologies: A Handbook for Practice Today will enormously simplify the job of thinking through the issues and making clinically, ethically, and legally prudent decisions.


Alice G. went to her second appointment with Dale Giolas, M. D., a psychiatrist who uses his computer desktop as a point of care. In her initial office visit with Dr. Giolas, Alice was given a dual diagnosis of a chemical abuse disorder and another psychiatric disorder; she also received medication prescriptions and a printed description of possible side effects and interactions with other medications.

Dr. Giolas subscribes to InfoScriber, one of several Internet companies that update drug interaction information daily. Dr. Giolas explained, “I use it with every patient every day. It helps me know that I am not hurting them with the medications I am prescribing. I also use InfoScriber as a partial electronic medical record because it tracks a patient's diagnosis, medications, and which diagnosis each medication is targeting. I print this out, handwrite my case notes at the bottom of the page, and put the document in the patient's file.

“If I want to fax a copy to anyone else caring for the same patient, such as a psychotherapist or primary care physician, I get a release from the patient along with the other practitioner's fax number, and I then use a program called WriteFax. If the colleague does not have a secured fax machine, I can give a copy of the InfoScriber printout with my notes to the patient to take to the other practitioner. This is great for building up my referral system, because other practitioners greatly appreciate knowing my diagnosis and any medication changes, and reading my comments on the bottom of the page. It also helps us all if our charts get audited, because there is a complete paper trail of the treatment”.

After her first visit, Alice was particularly appreciative of the leaflets Dr. Giolas gave her for the two medications prescribed. She was comforted knowing that her psychiatrist was taking the time to provide her with information tailored to her specific situation. At home, she could read the leaflets at her leisure and come up with questions to ask during her second appointment.

Dr. Giolas said, “There's plenty of reliable information written by other reputable people on the Internet. I don't keep patient information leaflets in my office any more. I print them all off the Internet for each patient”.

Within a minute of greeting Alice and both of them getting settled into their respective chairs, Dr. Giolas realized he didn't have her file on his desk. He unobtrusively signaled “Chart” to his office manager through the instant messaging system on his computer. She soon appeared with Alice's chart. Dr. Giolas explained, “I am in immediate contact with any one of several different offices in my facility, so I can send or receive any type of information that I might need during a session with a patient. We have code systems. We all know, for example, that if I type ‘chart, ’ my office manager knows I am missing . . .

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