Telemental Health

The Internet and advances in technology are substantially increasing our ability to communicate. Those remote audio and video communications technologies offer mental healthcare professionals with the opportunity to clinically engage with patients outside of the traditional office setting. However, with those opportunities come new challenges. Clinicians interested in utilizing remote communications technology to treat patients, telemental health, should carefully consider new legal exposures inherent in treating patients outside the office before incorporating telemental health into their practices. Telemental health raises new issues for mental healthcare professionals in the context of malpractice claims, personal jurisdiction, informed consent, licensing, and compliance with the Health Insurance Portability and Accountability Act (HIPAA). This chapter identifies the new and sometimes subtle problematic issues associated with telemental health, exploring the nature of the risks to the telemental health clinician and discussing a practical approach to minimizing the exposures.

Psychologist, over 1 year’s experience, UK

This chapter details a Psychologist’s first experience of working with patients with “Dissociative Seizures” as a junior assistant Psychologist with very little therapeutic experience. In the Psychologist’s experience, labeling these events as “non-epileptic attacks” tended to inspire confusion, frustration, and a sense of hopelessness on the part of patients. Indeed, these patients expressed that this label helped them understand what they did not have but provided them with little information about what they did have, and what this meant for them. Working with these patients, the Psychologist experienced with frequency the difficult thoughts and feelings that come along with the role of being a mental health clinician. The Psychologist often felt moved by patients’ stories, which frequently demonstrated resilience and strength in the face of adversity or trauma. The chapter then outlines one case study that had a lasting impact on the Psychologist to illustrate some of the clinical challenges of working with patients who experience Dissociative Seizures.

When I Need Clinical or Risk Management Advice I Should Ask for It on a Listserv

Every mental health clinician will at times need clinical or risk management advice to assist in responding to challenges and to provide the best possible care to clients. How and where to best obtain this advice may seem unclear and be quite challenging for some. This chapter explains the reasons for seeking input and advice from colleagues, options for accessing or obtaining needed guidance when faced with challenges and dilemmas, and risks of which to be aware. Although listservs may be valuable for obtaining general information and for maintaining a community of supportive colleagues, when obtaining clinical consultations that include confidential information, a number of risks are present. This chapter explains these risks, to include confidentiality issues and an inability to share enough information on a listserv to obtain meaningful consultations. How best to obtain needed consultations and how to do so ethically and legally is explained.