Expanding our Reach: Telehealth and Licensure Implications for Psychologists

Webb, Carol; Orwig, Janet

doi:10.1007/s10880-015-9440-9

Cited by 13 publications

(10 citation statements)

References 6 publications

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“…CBT-I is a multicomponent intervention that addresses the maladaptive sleep behaviors and beliefs maintaining insomnia disorder, incorporating sleep restriction (limiting time in bed to reflect sleep duration), stimulus control (avoidance of nonsleep activities in bed), sleep hygiene (implementing positive sleep behaviors and improving social/environmental factors), cognitive therapy (reframing negative thoughts surrounding sleep and its daytime impact), and relaxation exercises . Because there are few CBT-I–trained clinicians and state licensure regulations often prohibit cross-border practice, treatment availability is a challenge . Internet-delivered CBT-I programs (eg, Sleep Healthy Using the Internet [SHUTi]) can increase access.…”

Section: Introductionmentioning

confidence: 99%

“…23 Because there are few CBT-I-trained clinicians and state licensure regulations often prohibit cross-border practice, treatment availability is a challenge. 24,25 Internet-delivered CBT-I programs (eg, Sleep Healthy Using the Internet [SHUTi]) can increase access. The SHUTi program is an automated intervention that has been studied across multiple patient populations around the world, with consistent data demonstrating its effectiveness.…”

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confidence: 99%

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Effect of Culturally Tailored, Internet-Delivered Cognitive Behavioral Therapy for Insomnia in Black Women

et al. 2022

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IMPORTANCE Black women are at risk for insomnia disorder. Despite interest in addressing sleep health disparities, there is limited research investigating the efficacy of criterion-standard treatment (cognitive behavioral therapy for insomnia [CBT-I]) among this racial minority population. OBJECTIVE To compare the efficacy of a standard version of an internet-delivered CBT-I program, a culturally tailored version, and a sleep education control at improving insomnia symptoms. DESIGN, SETTING, AND PARTICIPANTS In this single-blind, 3-arm randomized clinical trial, participants in a national, longitudinal cohort (Black Women's Health Study [BWHS]) were recruited between October 2019 and June 2020. BWHS participants with elevated insomnia symptoms were enrolled and randomized in the current study. INTERVENTIONS Participants were randomized to receive (1) an automated internet-delivered treatment called Sleep Healthy Using the Internet (SHUTi); (2) a stakeholder-informed, tailored version of SHUTi for Black women (SHUTi-BWHS); or (3) patient education (PE) about sleep. MAIN OUTCOMES AND MEASURESThe primary outcome was insomnia severity (Insomnia Severity Index [ISI]). Index score ranged from 0 to 28 points, with those scoring less than 8 points considered to not have clinically significant insomnia symptoms and a score of 15 points or higher suggesting insomnia disorder. An ISI score reduction of more than 7 points was considered a clinically significant improvement in insomnia symptoms. The SHUTi-BWHS program was hypothesized to be more effective at significantly decreasing insomnia severity compared with the SHUTi program and PE.RESULTS A total of 333 Black women were included in this trial, and their mean (SD) age was 59.5 (8.0) years. Those randomized to receive either SHUTi or SHUTi-BWHS reported significantly greater reductions in ISI score at 6-month follow-up (SHUTi: −10.0 points; 95% CI, −11.2 to −8.7; SHUTi-BWHS: −9.3 points; 95% CI, −10.4 to −8.2) than those randomized to receive PE (−3.6 points; 95% CI, −4.5 to −2.1) (P < .001). Significantly more participants randomized to SHUTi-BWHS completed the intervention compared with those randomized to SHUTi (86 of 110 [78.2%] vs 70 of 108 [64.8%]; P = .008). Participants who completed either intervention showed greater reductions in insomnia severity compared with noncompleters (−10.4 points [95% CI, −11.4 to −9.4] vs −6.2 points [95% CI, −8.6 to −3.7]). CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, both the SHUTi and SHUTi-BWHS programs decreased insomnia severity and improved sleep outcomes more than PE. The culturally tailored SHUTi-BWHS program was more effective at engaging participants with the program, as a greater proportion completed the full intervention. Program completion was associated with greater improvements in sleep.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Culturally Tailored, Internet-Delivered Cognitive Behavioral Therapy for Insomnia in Black Women

et al. 2022

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“…Visit reimbursement across insurance companies gradually increased from 2018 to 2020, when all insurance providers reimbursed for telehealth visits. Insurance-related complexities continue to be a challenge when out-of-state patients seek care at the PPMC, though multiple states and licensing boards are advocating for interjurisdictional practice (e.g., Psychological Interjurisdictional Compact, PSYPACT) [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating Telehealth Implementation in the Context of Pediatric Chronic Pain Treatment during COVID-19

Richardson

Parker

Chavez³

et al. 2021

Children

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Telehealth has emerged as a promising healthcare delivery modality due to its ability to ameliorate traditional access-level barriers to treatment. In response to the onset of the novel coronavirus (COVID-19) pandemic, multidisciplinary pain clinics either rapidly built telehealth infrastructure from the ground up or ramped up existing services. As the use of telehealth increases, it is critical to develop data collection frameworks that guide implementation. This applied review provides a theoretically-based approach to capitalize on existing data sources and collect novel data to inform virtually delivered care in the context of pediatric pain care. Reviewed multisource data are (1) healthcare administrative data; (2) electronic chart review; (3) clinical health registries; and (4) stakeholder feedback. Preliminary telehealth data from an interdisciplinary pediatric chronic pain management clinic (PPMC) serving youth ages 8–17 years are presented to illustrate how relevant implementation outcomes can be extracted from multisource data. Multiple implementation outcomes were assessed, including telehealth adoption rates, patient clinical symptoms, and mixed-method patient-report telehealth satisfaction. This manuscript provides an applied roadmap to leverage existing data sources and incorporate stakeholder feedback to guide the implementation of telehealth in pediatric chronic pain settings through and beyond COVID-19. Strengths and limitations of the modeled data collection approach are discussed within the broader context of implementation science.

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“…In some sources, public interest considerations were implied by the regulatory activities discussed, such as preventing the worsening of public health due to relaxed prescribing rules (35) and preventing incompetent, unethical, unlawful, or negligent practice when services are provided virtually. (36)(37)(38)(39)(40)(41)(42) The literature highlighted several virtual care concerns that impact the public interest created by current regulatory structures. Articles also used terms such as protecting (or enhancing) public safety, health, and welfare in the context of regulating professional practice.…”

Section: Most Literature Did Not Explicitly Focus On the Public Inter...mentioning

confidence: 99%

Protecting the public interest while regulating health professionals providing virtual care: A scoping review

Leslie

Myles

Schiller

et al. 2022

Preprint

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Technology is transforming service delivery in many health professions, particularly with the rapid shift to virtual care during the COVID-19 pandemic. Health profession regulators must navigate legal and ethical complexities to facilitate virtual care while upholding their mandate to protect the public interest. The objectives of this scoping review were to examine how the public interest is protected when regulating health professionals who provide virtual care, discuss policy and practice implications of virtual care, and make recommendations for future research. We searched six multidisciplinary databases for academic literature published in English between January 2015 and May 2021. We also searched specific databases and websites for relevant grey literature. Sources were screened in duplicate against specified inclusion criteria. Fifty-nine academic articles and 18 grey literature sources were included. Data from included sources were extracted and descriptively synthesized. We identified five key findings. Most literature did not explicitly focus on the public interest aspects of regulating health professionals who provide virtual care. However, when the public interest was discussed, the dimension of access was emphasized. Criticism in the literature focused on social ideologies driving regulation that may inhibit more widespread use of virtual care, and subnational occupational licensure was viewed as a barrier. The demand for virtual care during COVID-19 catalyzed licensure and scope of practice changes. Virtual care introduces new areas of risk, potential harm, and inequity that health profession regulators need to address as technology continues to evolve. Regulators have an essential role in providing clear standards and guidelines around virtual care, including what is required for competent practice. There are indications that the public interest concept is evolving in relation to virtual care as regulators continue to balance public safety, equitable access to services, and economic competitiveness.

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Expanding our Reach: Telehealth and Licensure Implications for Psychologists

Cited by 13 publications

References 6 publications

Effect of Culturally Tailored, Internet-Delivered Cognitive Behavioral Therapy for Insomnia in Black Women

Effect of Culturally Tailored, Internet-Delivered Cognitive Behavioral Therapy for Insomnia in Black Women

Evaluating Telehealth Implementation in the Context of Pediatric Chronic Pain Treatment during COVID-19

Protecting the public interest while regulating health professionals providing virtual care: A scoping review

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