Technology in Practice ☆
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Cited by 4 publications
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Select literature on the use of computers in office-based psychology practice for support of administration and practice management, assessment, and treatment is reviewed. Characteristics of successful applications and the factors that affect their adoption are also reviewed. Although psychologists have adopted computer applications for business and administrative activities and for psychological assessment, there are few applications used in clinical practice for treatment. This article suggests that task demands associated with psychological treatments do not take advantage of the capabilities of computers and reveal their weaknesses. Usability, practical, and economic factors are what determine the adoption of technology-based applications. Developers of new products should ensure that they accommodate to rather than change the current structure of office-based psychology practice.In the 1970s, I heard about the impact that managed care would have on clinical practice but was taken by surprise at the rapid and extensive change. Therefore, with increasing concern, I read the literature that appeared over the past decade on computer applications to practice. I worried that once again I would be unprepared for the coming revolution. I envisioned more savvy and entrepreneurial colleagues making the transition to telehealth, e-health, online counseling, Internet therapy, online assessment, computer-assisted therapy, and therapy using virtual reality. My concern was increased by authors who when discussing computer applications typically included arguments asserting that the innovations should be adopted because they would result in treatment efficacy, consistency, reliability, and cost effectiveness. As a result, patients who were currently underserved or not served would have access to care (e.g., Griest, 1998;Jacobs et al., 2001;Sturges, 1998). Others asserted that the profession was unprepared for the growth of therapy over the Internet (e.g., Alleman, 2002). Thus, a great deal of literature and professional effort have addressed the legal, ethical, and professional standards that must guide the new service environment (e.g., American Psychological Association Ethics Committee, 1997;Buchanan, 2002;Maheu & Gordon, 2000;Reed, McLaughlin, & Milholland, 2000).The fact that the psychologists I spoke with were not adopting the new technology in support of their services was cold comfort because they were no more prepared for managed care than was my practice. Furthermore, the literature characterizes psychologists as lagging behind in incorporating technology into their practices (Farrell, 1989;McMinn, Buchanan, Ellens, & Ryan, 1999). Psychologists are often described as resistant to technological innovation, and their nonadoption of applications has been attributed to their ethical concerns (American Psychological Association Ethics Committee, 1997;McMinn et al., 1999), their commitment to humanistic values
Select literature on the use of computers in office-based psychology practice for support of administration and practice management, assessment, and treatment is reviewed. Characteristics of successful applications and the factors that affect their adoption are also reviewed. Although psychologists have adopted computer applications for business and administrative activities and for psychological assessment, there are few applications used in clinical practice for treatment. This article suggests that task demands associated with psychological treatments do not take advantage of the capabilities of computers and reveal their weaknesses. Usability, practical, and economic factors are what determine the adoption of technology-based applications. Developers of new products should ensure that they accommodate to rather than change the current structure of office-based psychology practice.In the 1970s, I heard about the impact that managed care would have on clinical practice but was taken by surprise at the rapid and extensive change. Therefore, with increasing concern, I read the literature that appeared over the past decade on computer applications to practice. I worried that once again I would be unprepared for the coming revolution. I envisioned more savvy and entrepreneurial colleagues making the transition to telehealth, e-health, online counseling, Internet therapy, online assessment, computer-assisted therapy, and therapy using virtual reality. My concern was increased by authors who when discussing computer applications typically included arguments asserting that the innovations should be adopted because they would result in treatment efficacy, consistency, reliability, and cost effectiveness. As a result, patients who were currently underserved or not served would have access to care (e.g., Griest, 1998;Jacobs et al., 2001;Sturges, 1998). Others asserted that the profession was unprepared for the growth of therapy over the Internet (e.g., Alleman, 2002). Thus, a great deal of literature and professional effort have addressed the legal, ethical, and professional standards that must guide the new service environment (e.g., American Psychological Association Ethics Committee, 1997;Buchanan, 2002;Maheu & Gordon, 2000;Reed, McLaughlin, & Milholland, 2000).The fact that the psychologists I spoke with were not adopting the new technology in support of their services was cold comfort because they were no more prepared for managed care than was my practice. Furthermore, the literature characterizes psychologists as lagging behind in incorporating technology into their practices (Farrell, 1989;McMinn, Buchanan, Ellens, & Ryan, 1999). Psychologists are often described as resistant to technological innovation, and their nonadoption of applications has been attributed to their ethical concerns (American Psychological Association Ethics Committee, 1997;McMinn et al., 1999), their commitment to humanistic values
Technology, professional practice, and ethics: Survey findings and implications.
If a psychologist loses treatment records because of a computer failure, is it an ethical violation? The widespread growth of technology has outpaced the development of ethical standards for questions such as this, resulting in areas of uncertainty for psychologists. Four hundred twenty psychologists in independent practice rated the ethicality and their frequency of using 40 technologies. Technologies pertaining to the support functions of a psychologist's office are commonly used, butthose technologies directly affecting clinical services are rarely used. More than half of the 40 items received equivocal ratings on ethicality, suggesting psychologists need guidelines and training for the use of technology in professional practice. A typical day in a professional psychologist's office might include photocopying or faxing confidential records, electronic claims filing, using a computerized voice mail system, scoring personality tests on the computer, and so on. A few psychologists might also provide supervision by means of electronic mail (Email) or exposure treatments with virtual reality. How common are these various technologies in psychological practice, and what are the ethical implications of emerging technological advances within the profession? When Pope, Tabachnick, and Keith-Spiegel (1987) published survey results concerning the ethics of professional psychologists, their report provided an important "real-world" glimpse into the practices and beliefs of American Psychological Association (AP A) members providing professional services. The authors were careful to note that the norms of professional practice should not necessarily determine ethical standards but correctly observed that professional ethics codes are most effective when those developing the codes are aware of the dilemmas and tensions confronting members of the organization. Although the AP A has been diligent to keep ethical standards current through changing practice environments, the rapid rate of change observed among electronic technologies creates unprecedented challenges for professional psychology's national organizations and ethics committees. The APA Ethics Committee ap
Today's rapid rate of technology change introduces both opportunities and challenges for psychologists. A Technology and Practice Questionnaire was sent to 1000 psychologists in independent practice, half of whom were contacted by e-mail and the other half by U.S. mail. A total of 237 of the 433 deliverable surveys sent by U.S. mail were returned (54.7% response rate), but only 49 of the 458 deliverable surveys sent by e-mail (12.9% response rate). Respondents were asked to rate the frequency of 51 behaviors in their practice and to indicate whether the behavior is ethical. The results suggest a relatively low rate of technology use among independent practitioners and a high degree of ethical uncertainty regarding the use of various technologies in practice. Implications for training and practice are considered.
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