Telehealth and telepsychological services for individuals with disabilities
By Lawrence Pick, PhD
The rapid growth of information and communication technologies has led to increased interest in the development and provision of telehealth service delivery models. The integration of these relatively new models within the field of psychology has sparked discussion regarding a number of ethical and professional practice issues. With respect to ethics, discussions concentrate on issues surrounding confidentiality, privacy, fees and reimbursement, and professional competency, as well as assessment and intervention. In the legal realm, dialogue focuses on informed consent and assent, mandated reporters, HIPPA, and emergency situations. There are a paucity of laws, policies, and guidelines, however, concerning the use of telehealth service models by psychologists. The American Psychological Association has acknowledged the need for national guidelines for telepsychology by establishing a joint task force with the Association of State and Provincial Psychology Boards. Additionally, laws, policies, and guidelines specific to the provision of telehealth and telepsychology are being developed by specific states and psychology licensing boards.
There has been little emphasis on the relevance of these emerging models, guidelines, and practices for underserved populations, especially individuals with chronic illness and disability. There are approximately 54 million people in the United States with a disability. A large number of these individuals have increased need for health services, but are often unable to access appropriate onsite programs and services for any number of reasons. One of the advantages of using telehealth and telepsychology models with these populations is the potential to improve necessary access to appropriate health care. For example, telepsychology can provide individuals with disabilities living in rural communities with increased access to professionals who are culturally and linguistically competent. Conversely, there are a number of unique barriers or obstacles for persons with disabilities within this novel service delivery model. Individuals with disabilities have higher rates of unemployment and underemployment resulting in limited income and reduced access to the technology and equipment required to benefit from telehealth services.
The APA Committee on Disability Issues in Psychology (CDIP) is exploring the specific issues faced by individuals with disabilities who elect to receive telehealth and telepsychological services, as well as the qualification and needs of professionals working with these constituents. Additionally, CDIP has begun to examine how telehealth and telepsychological models can be applied to other underserved individuals by collaborating with the APA Committees on Rural Health, Ethnic Minorities, and Aging. CDIP hopes to forge alliances with other APA task forces, committees and divisions interested in developing telehealth work products for the benefit of psychologists and their constituents.