<<return to InPysch April 2006  

By Bill Campos MAPSConvenor, APS Telephone and Internet-based Counselling and Psychology Interest Group

1. What is telepsychology?

Telepsychology is the provision of psychological services in a technology-assisted environment, including telephone, internet media (written, voice and digital pictures) and video conferencing. Telepsychology differs from services provided via telephone 'helplines'. In the helpline environment, the client chooses the conditions of interaction such as the time and length of call and there is no cost, or minimal cost. Volunteers, often without formal qualifications, commonly staff helplines and the service is available to clients at extended hours, often 24 hours a day. Telepsychology, on the other hand, is a detailed sharing of information between a psychologist and client, with structured sessions and the client providing personal details and payment. The psychologist can make appointments and transfer information via technology in the context of a therapeutic relationship, and continuity of care can be maintained. The psychologist provides services over the telephone and/ or computer similarly to the level of service provided in face-to-face consultation. However, the technology environment provides a different context to the therapeutic process, and therefore requires different skills and awareness of the professional relationship.

2. What advantages does it provide for the therapeutic process?

  • Access to specific professionals and expertise who may be geographically remote
  • Access for clients in rural and remote locations
  • Extended hours of service, with possibility for consistent and continuous care
  • Combination of face-to-face and remote care
  • Possibility of direct and immediate service
  • Client may feel less inhibited which may allow more emotional involvement

3. What are the disadvantages to clients?

  • Verification of authenticity of psychologist may be difficult
    • Confidentiality is limited by the security of the technology
  • Clients may develop 'virtual identities' to safeguard their personal identity
  • Some presenting problems may be less appropriate for telepsychology medium
  • Capacity for crisis intervention may be diminished
  • Misunderstandings may arise due to lack of non-verbal clues

4. What issues do psychologists have to consider?

  • Adherence to privacy legislation
    • Safe and secure storage of personal client information can be complex
  • Duty of care responsibilities (e.g., suicidal client, child protection matters)
    • Need to provide specific information and conduct steps to provide intervention if client provides information that warrants this
  • Boundaries of services (e.g., provision of service to client in an interstate or international location)
    • Ascertain whether services are allowed to be provided and understand accreditation, registration, legal requirements and advertising guidelines of jurisdiction where client is located
  • Adequate assessment of client
    • Client may disclose false or misleading information or technology may limit access to information
  • Technology changes and compatability of electronic equipment
    • Ensure access to up-to-date electronic equipment and software

5. Did you know there are APS Ethical Guidelines for providing services and products on the internet?

These Guidelines were published in March 2004 and are designed to alert psychologists to ethical and practice issues that may arise in the use of this medium.

The Guidelines are available on the APS website or in hard copy from the APS National Office.

6. What does the future hold?

Future developments in telepsychology are reliant on technological advancements. As technology breaks new ground in communication and personalised information, telepsychology can develop into mainstream mental health services. Government departments and private organisations are embracing telepsychology as a way of effectively providing mental health services. Private and public sectors are supporting the call for the establishment of minimum standards for such services and a guide to good practice for telepsychology services. The scope and the effectiveness of this type of service are rapidly being discovered.

7. Want to share your ideas?

The APS Telephone and Internet-based Counselling and Psychology Interest Group was formed in early 2004 and there are currently 164 members. More information on the Interest Group is available from the APS website .

Example of a telepsychology client

A working mother of two young children has recently separated from her husband and is presently very depressed. She is reluctant to discuss the issues with her family, as her relationship with them is poor. She assumes that to talk to family members may create more stress, as she perceives they are making negative judgments about her.

Late one night in a very depressed state, after receiving an email from her separated husband and with the children asleep, she logs on to the internet and goes to a telepsychologist website. On the website she sees that there is an upcoming appointment available in an hour and she confirms that she would like to take this appointment online. While she waits she reviews the psychologist's credentials and payment options, and completes a 20-item depression checklist. Within a few moments she receives an email confirming her appointment and the telephone number to call for the appointment.

She makes the phone call and begins telephone counselling with the psychologist. During the call, exchange of information is provided via email, and at the conclusion of the appointment she is also provided with details of other services such as a general practitioner and a referral to legal support services for further assistance.

A few days have passed and she realises that she will need help in overcoming her depression. She contemplates how she will seek help whilst managing the household and the busy lives of two young children, and still keep this issue private from her family and husband. She is concerned about any implications this may have if she was to seek a divorce from her husband.

Due to the nature of her depressed state, she chooses to confide and discuss her problems with the telepsychologist and she revisits the website to make further appointments.

Bill Campos MAPS can be contacted by email: Bill.Campos@parra.catholic.edu.au