According to Business and Professions Code 2290.5, telehealth is the practice of health care using “interactive” communications. The two forms are synchronous and asynchronous. The former is live, real time, interactive audiovisual communication, e.g. telephone, Skype, face time, etc. The latter is not real time, and may include email exchanges about clinical issues. I exclusively use synchronous media for telehealth, and though I use email and texts, I do so for logistical purposes only.
My license allows me to practice only in CA. It is considered unlawful and unprofessional conduct for me to render services to a client living outside state lines. In 1996, California was one of the first states to enact the ‘Telemedicine Development Act’. It was originally created to serve populations who could not access health care, due to disabilities, language barriers, geographic distance, economic hardships, etc. Initially, I was skeptical of the utility of ‘long-distance’ therapy, holding fast to my notion that ‘in-person’ sessions are best. But my notion was theoretic, not based on actual practice. Years ago, at the request of several clients, I began doing phone, FaceTime, and Skype-with or without video-sessions. I was quickly schooled (and humbled!) in my mistaken notion. Clients love it, not only for the convenience, but for the nuances in tone, timbre, pitch, cadence, resonance of emotion within voice. When I have only voice presence (without visual cues), I listen to the spaces within the silence. As information, it’s as useful, and though different, my attunement/engagement with clients is as effective.
I’m thrilled to offer this technology format to my clients. Today, my having insisted on ‘in-office’ sessions seems rigid, outdated, limited, and quaint! Telehealth is a boon in helping me connect with clients who otherwise could not seek or maintain continuity with therapy. With people traveling for business, working late hours . . . having the option to do a Skype with or without video, phone call, or FaceTime session, keeps intact the momentum of our therapeutic progress.
To date, there are no studies indicating telehealth is less effective than conventional in-office therapy. As of 2014, written consent from the client for receiving telehealth is not mandated. The law is now amended that clinicians should get verbal consent for the first session, with implied consent for subsequent appointments.