Computer-assisted Cognitive Behavior Therapy and Mobile Apps for Depression and Anxiety: Evidence-based Digital Tools for Clinical Practice.

Purpose Of Review: Provider shortages and other barriers to traditional mental health care have led to the development of technology-based services designed to enhance access and improve the efficiency and convenience of treatment. We reviewed research on computer-assisted cognitive behavior therapy (CCBT) and mobile mental health applications to assess the effectiveness of these methods of delivering or augmenting treatment, evaluating patient and provider uptake, and making recommendations on the clinical use of these tools in the treatment of depression and anxiety.

Results: Research on CCBT has found solid evidence for efficacy when the use of a therapeutic computer program is supported by a clinician or other helping professional.

Examining Burnout and Perspective on Videoconferencing in the Mental Health Workforce.

To examine burnout and perspectives on videoconferencing over time for the mental health workforce. Members of an academic psychiatry department completed two anonymous surveys about virtual work and burnout 18 months apart (T1 = 274, response rate = 66.8%; T2 = 227, response rate = 36.

Patient Experiences With Telemental Health During the COVID-19 Pandemic.

Telemental health (TMH) was an effective and relatively well-accepted way of delivering mental health care prior to the COVID-19 pandemic and has become widely adopted through the pandemic. Although recent findings show telehealth remains relatively well accepted across health care broadly, little is known about how patient experiences of TMH may have changed through the pandemic as many sectors were virtualized. These findings describe patient experiences with TMH at an outpatient mental health clinic approximately 1 year after the clinic rapidly transitioned to full TMH due to COVID-19.

Rapid Conversion to Telemental Health Services in Response to COVID-19: Experiences of Two Outpatient Mental Health Clinics.

The COVID-19 pandemic triggered changes across health care systems, with many sectors seeing significant drops in patient visits. Rapid transition to telemental health (TMH) allowed for the continued delivery of mental health care. Although several guidelines and best practices are available for the methodical development of a TMH service, there are few documented procedures on rapidly converting to fully virtualized services.

Experiences of Mental Health Clinicians and Staff in Rapidly Converting to Full-Time Telemental Health and Work from Home During the COVID-19 Pandemic.

The mitigation strategies for the COVID-19 pandemic pushed much of the mental health workforce to rapidly convert to full-time telemental health (TMH). For many people, this occurred in the context of working from makeshift home offices with novel distractions. We describe the results of an online survey of mental health clinicians and staff regarding their experiences in rapidly converting to full-time TMH and work from home (WFH) during COVID-19.

Telemental Health Response to the COVID-19 Pandemic: Virtualization of Outpatient Care Now as a Pathway to the Future.

The use of telemental health (TMH) has fostered the continued provision of mental health care during the COVID-19 pandemic, and ultimately prevented the significant drop in clinical visits as experienced by other health care disciplines. Many health care providers and systems rapidly virtualized care to include visits occurring in what previously were defined as nontraditional locations such as provider and patient homes. Emerging data and reports suggest that this rapid virtualization of mental health services occurred safely and effectively.

Advancing Treatment of Depression and Other Mood Disorders Through Innovative Models of Telepsychiatry.

Rapid changes in health care technology are advancing mental health care. Telepsychiatry, in the form of live interactive videoconferencing, has demonstrated its ability to improve access to high-quality mental health care, specifically in the treatment of patients with depression and mood disorders. This article reviews the advances in telepsychiatry in the treatment of depression and mood disorders.

Computer-Assisted CBT and Mobile Apps for Depression: Assessment and Integration Into Clinical Care.

A surge in the development of computer-assisted cognitive-behavioral therapy (CCBT) and mobile apps for depression has provided many tools with potential for enhancing treatment delivery. This article assesses progress in evaluation and implementation of CCBT and mobile apps for depression, with a focus on providing practical information on clinical applications. Advantage and disadvantages of these technologies are identified, outcome research is reviewed, and recommendations are made for clinical use.

Establishing Telemental Heath Services from Conceptualization to Powering up.

Telemental health is a demonstrated and effective aspect of the overall mental health system and considered a standard of care for many treatments. Adoption has not been as robust as expected and failure to properly develop implementation plans is a significant barrier. This article provides an overview of a step-by-step planning process to more effectively implement and sustain telemental health programs.

Technology-Based Mental Health Treatment and the Impact on the Therapeutic Alliance.

Purpose Of Review: Telemental health, which is treatment mediated by technology, is an increasingly common method of delivering mental health care. However, its impact on the therapeutic alliance is unclear. This review examines studies of telemental health and its impact on therapeutic alliance.

Computer-Assisted Cognitive-Behavior Therapy and Mobile Apps for Depression and Anxiety.

Purpose Of Review: We reviewed research on computer-assisted cognitive-behavior therapy (CCBT) and mobile applications with the goals of assessing the effectiveness of these newer methods of delivering or augmenting treatment and making recommendations on the clinical use of computer tools in psychotherapy of depression and anxiety.

Recent Findings: Research on CCBT has found solid evidence for efficacy when the use of a therapeutic computer program is supported by a clinician or other helping professionals. Lower levels of efficacy or ineffectiveness typically have been found when computer programs are used as stand-alone treatments.

Best Practices in Videoconferencing-Based Telemental Health April 2018.

Telemental health, in the form of interactive videoconferencing, has become a critical tool in the delivery of mental health care. It has demonstrated the ability to increase access to and quality of care, and in some settings to do so more effectively than treatment delivered in-person. This article updates and consolidates previous guidance developed by The American Telemedicine Association (ATA) and The American Psychiatric Association (APA) on the development, implementation, administration, and provision of telemental health services.

Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use.

Purpose Of Review: This review provides an overview of the current evidence base for and clinical applications of the use of virtual reality (VR) in psychiatric practice, in context of recent technological developments.

Recent Findings: The use of VR in psychiatric practice shows promise with much of the research demonstrating clinical effectiveness for conditions including post-traumatic stress disorder, anxiety and phobias, chronic pain, rehabilitation, and addictions. However, more research is needed before the use of VR is considered a clinical standard of practice in some areas.

Randomized controlled trial of prolonged exposure using imaginal exposure vs. virtual reality exposure in active duty soldiers with deployment-related posttraumatic stress disorder (PTSD).

Objective: Prolonged exposure (PE) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD) but there is limited research with active-duty military populations. Virtual reality exposure (VRE) has shown promise but randomized trials are needed to evaluate efficacy relative to existing standards of care. This study evaluated the efficacy of VRE and PE for active duty soldiers with PTSD from deployments to Iraq and Afghanistan.

Evaluating the benefits of a live, simulation-based telebehavioral health training for a deploying army reserve unit.

Telebehavioral health (TBH) has previously been reported as underutilized in the Afghan Theater of Operations despite efforts to expand the number of operational TBH sites. A lack of training on TBH services and equipment was identified as a probable cause. The National Center for Telehealth and Technology (T2) provided members of the 1972nd Medical Detachment (Combat Stress Control [CSC]) U.

Synchronous telehealth technologies in psychotherapy for depression: a meta-analysis.

Background: Many patients suffering from depression lack immediate access to care. The use of synchronous telehealth modalities to deliver psychotherapy is one solution to this problem. This meta-analysis examined differences in treatment efficacy for psychotherapy administered via synchronous telehealth as compared to standard nontelehealth approaches.

The use of collaboration science to define consensus outcome measures: a telemental health case study.

The purpose of this document is to provide an overview of a collaboration science process used to develop recommendations for the field of telemental health (TMH) in the selection of outcome measures that best reflect programmatic impacts. A common use of group development techniques in medicine is the development of clinical guidelines, which typically occurs using one of two methods: the nominal group or the Delphi method. Both processes have been faulted for limited transparency, reliability, and sustainability.

The use of deployable telehealth centers by military beneficiaries to access behavioral healthcare: an exploratory evaluation in American Samoa.

Some U.S. Military Health System (MHS) beneficiaries face unique challenges accessing available behavioral healthcare because of the nature of their occupations, deployments to and permanent duty stations in isolated geographies, and discontinuity of services.

Home-based telemental healthcare safety planning: what you need to know.

Telemental health (TMH) care provided directly to the home is an emerging area of care delivery. TMH care involves awareness of safety issues and adequate safety planning, although detailed practical recommendations for home-based TMH safety planning are absent in the literature. With this article we aim to increase awareness of safety issues associated with home-based synchronous TMH treatment and to discuss recommendations for consistent safety planning that can inform the development of standard operating procedures, emergency protocols, and overall good TMH practice.

Usability and feasibility of smartphone video capabilities for telehealth care in the U.S. military.

The two-way audio/visual capabilities on the latest smartphone platforms bring new possibilities for the delivery of healthcare services to users. Because this technology is so new, the feasibility and the basic usability of the technology need to be evaluated before more research is conducted on its application in the telehealth field. The purpose of this study was to conduct preliminary usability testing of smartphone two-way video capabilities for potential telehealth use for U.

mHealth data security: the need for HIPAA-compliant standardization.

The rise in the use of mobile devices, such as smartphones, tablet personal computers, and wireless medical devices, as well as the wireless networks that enable their use, has raised new concerns for data security and integrity. Standardized Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant electronic data security that will allow ubiquitous use of mobile health technologies is needed. The lack of standardized data security to assure privacy, to allow interoperability, and to maximize the full capabilities of mobile devices presents a significant barrier to care.