Psychology Residents Experience Telehealth Frontiers
Professional workshops often include role-playing activities. But they usually don’t involve the workshop leader creating an image on a large screen of the vehicle in front of you being flipped by an IED blast as a volunteer describes a war-zone ambush. That kind of thing definitely makes an impression on an audience.
"People told me they were riveted," said Dr. Barbara Rothbaum, the workshop presenter who operated the virtual reality program while a volunteer psychologist wearing a head-mounted display role-played reliving memories of trauma.
The virtual reality demonstration took place at the third "Using Technology Tools in Clinical Practice: Smartphone Apps, Web Sites, and Virtual Environments" workshop on May 15-16, 2014 at Joint Base San Antonio in Texas. Sponsored by the Department of Defense’s National Center for Telehealth & Technology (T2), the hands-on workshop for psychology residents and other clinicians showed how to integrate technology resources into their clinical practice.
Obviously, not all forms of technology are quite as immersive as virtual reality.
"You’re using technology whether you use a telephone, drive around with a patient who’s afraid of driving, use a computer, videotape a patient and play it back, or have a patient self-monitor behavior on a smartphone," said Rothbaum.
The workshop emphasis wasn’t on using the tools--but on how to use them to help patients. According to Captain Craig Woodworth, a psychology resident who attended the sessions, the presenters described "how to use technology we already use in our daily lives". Woodworth has used T2’s mobile app PE Coach with his patients.
"It makes it more convenient to track patients’ homework," said Woodworth. "They can’t say they lost it, or left it at home, or at the office, so it helps them be more consistent."
The workshop was led by both Rothbaum, a professor of psychiatry and behavioral sciences at Emory University School of Medicine and director of the Trauma and Anxiety Recovery Program and Dr. Peter Tuerk, an associate professor of psychiatry and behavioral sciences at the Medical University of South Carolina (MUSC) and director of clinical supervision for the PTSD Clinical Team at the Ralph H. Johnson VAMC. Both are experts at integrating technology into clinical practice and industry leaders in clinical care and research for service members with posttraumatic stress disorder (PTSD).
"This workshop’s audience was really very engaged—people were pretty open to using technology, and most were either using it or getting ready to use it in their practice," said Rothbaum. "I love working with residents that are now in training since they know how to deal with smartphones and apps."
"The challenge for providers is to get used to using telehealth tools and integrate them into their clinical practice, since this is going to become the standard of care in the future," said Dr. Karl Moe, T2’s chief of staff, who opened the workshop.
During one session in the workshop, a case study was introduced. As the participants learned more info, the presenters kept going back to it and asking the participants what other tools they could use.
"We got them to think--what would be useful clinically for this patient and his family. They added more tools as they received more info. Using any tool that you can is good," said Rothbaum.
Since the workshop, Woodworth says he has been "downloading other T2 mobile applications and trying them out to see what would work" with his patients.
"CBT-i Coach (an app designed for people having difficulty sleeping) is a possibility. Its sleep diary has an easier way to track sleep."
"We have to continue to look at the confluence of behavioral health and technology. The new, more complex relationship is that of a clinician, a patient, and technology," said Dr. Don Workman, chief of the emerging technologies program at T2. "We’re just beginning, and we need to expand."