Telepsychiatry Is it something that I should trust?

Hi. It’s Jenny at AnxietyBoss.com. Our question today is from Danny in Kansas City. Recently, there have been some doctors on sites pushing telepsychiatry. Is it something that I should trust? What should I know about it?

Telepsychiatry or teletherapy involves using Skype or similar technology to conduct evaluations, therapy or medication reviews. This is a legitimate, convenient and cost effective way to deliver services. It’s a practice in its infancy, but it is growing. There are some complexities that don’t arise when seeing a psychiatrist or therapist face to face.

One consideration is are you in the same state, province, country as your therapist? This is important because a therapist must be licensed in the jurisdiction in which they practice. For example, if I’m a therapist in Florida in the US and I’m seeing a patient by teletherapy in Arizona in the US, I need to be licensed for practice in both states. The provider’s malpractice insurance may not cover them doing telepsychiatry or telecounseling or conversely the patient’s health insurance may not cover the service and you’ll have to pay out of pocket.

What if there’s a crisis and the patient becomes suicidal? Is there a crisis plan in place? Is the patient’s privacy being preserved or are they Skyping from a coffee shop where people nearby can hear or see the session? These are just some of the issues.

Ethical guidelines for telepsychiatry are under development in many places. Some recommendations for best practice include the first session is face to face. A session a few weeks or months out is face to face. Terminating treatment is done face to face, and there’s a crisis plan in place just in case of an emergency. The provider is licensed and experienced and/or properly supervised, and the therapist and patient are in relatively close geographic proximity.