Tele mental health Counseling

OVERVIEW OF THE COURSE 

Telemental health is the use of telecommunications or videoconferencing technology to provide mental health counselling services. In this course, trainees will understand five Papers.

Papers	Title	Topics
Paper 1	Models of Mental Health:	·   Mental health outreach program   Analytical/developmental (Freud, Jung, Erickson, Kohlberg) ·         Behavioral (Watson, Skinner, Pavlov) ·         Cognitive (Tolman, Piaget, Chomsky) ·         Social (Bandura, Lewin, Festinger) ·         Humanistic (Rogers and Maslow) ·         Personality (Erickson’s psychosocial development theory) ·         Positive Psychology (Seligman, Mihaly Csikszentmihalyi,  RabindranathTagore  and Dutta Roy).
Paper 2	Approaches of Mental Health counseling	·         Directive, ·         Non-Directive, ·         Eclectic and ·         Statistical.
Paper 3	Tele-assessment for Anxiety and Depressive disorder	·         Anxiety and Depressive disorder ·         Case history taking (for child, adults, cooperative, Non cooperative). ·         Mental health assessment ·         Screening.
Paper 4	IEC on Mental health and Ethics	·         Ms-Excel, Power Point, CANVA ·         Design of IEC materials for community mental health awareness and counselling, ·         Mental health infographics by software. ·         Ethics of Psychological Assessment and Reporting
Paper 5	10 case history taking report

Tele-Mental health Counselling Internship for Graduate and above  (May and June,2022)

Following the Mental health outreach program. 

Rabindrik Psychotherapy Research Institute Trust (RPRIT) has designed this course consisting of five papers - (a) Models of Mental Health, (b) Approaches of Mental Health counselling, (c) Tele assessment of Anxiety and Depressive disorder, (d) IEC on Mental health and (e) Practicum.

Salient features of the course-

1. Class starts: 8th May, 2022 (Sunday)
2. 2 hours classes per week, Notes will be given in the Google classroom. Total hours of work can be enhanced through your regular practicum, case examination , presentation and attendance of the Institute level workshop.
3. Regular examination will be conducted.
4. Each paper carries 100 marks. Total marks is 500.
5. 75% attendance in the regular classes will give you 5 marks. If not, 5 marks will be deducted.
6. Internship includes 10 case presentation oral and written. Candidates will arrange own cases. Course co-ordinator will give the format.

7. Class ends in June, 2022.
8. Students who submitted the 10 practicum as per format will be called for Viva-Voce.
9. Registration fees: Rs. 3000. This will be used for infrastructure development of the trust.
10. Resource persons: Internal and external faculties of the Institute.
11. Payment to:

RPRIT ; A/C NO : 50200066066029; IFSC CODE : HDFC0001130; BRANCH : HDFC DUNLOP.

12. Academic assistant: Mr. Shreyashi Sharma 

12. Contact persons: Ms. Priya Verma (+91 86190 98870)/ Ms. Anupama Mukherjee (9831 3641 03).

Readings:

B. Scope and Importance

Finance Minister Nirmala Sitharaman, while presenting the Budget-2022-23, said the programme will be launched to improve access to quality mental health counselling and care services which will consist of digital registries of health providers and health facilities, unique health identity, consent framework, and universal access to health facilities.

Ethics of tele counselling

Potential Benefits

• Convenience: Telemental health appointments don’t require travel and often mean less time off work and smoother logistics coordination for things like transportation or childcare. Patients also can schedule appointments with less advance notice and at more flexible hours.
• Broader reach: The technology is available to people who may not have had access to mental health services previously, including those in remote areas and emergency care situations.
• Fewer barriers: For those who may have been hesitant to look for mental health care in the past, telemental health services might be an easier first step than traditional mental health services.
• Advances in technology: As telemental health services have increased, providers have become more familiar with evolving videoconferencing technology, with some switching to entirely virtual practices.

Potential Drawbacks

• Access to technology: Services may be limited by lack of internet connection and devices.
• Quality issues: Varying levels of technological quality can affect how services are provided and received.
• Cost: Evolving technology means updating equipment, platforms, and networks for patients.
• Privacy: Cameras in users’ homes and virtual online platforms pose privacy considerations. Individuals also might be more hesitant to share sensitive personal information with a provider in a situation where others might hear.
• Insurance coverage: The rise in telehealth during the COVID-19 pandemic has led to policy changes to make services accessible to more people. However, it is not known how long such flexibilities will stay in place, and understanding what services are available can be complicated. Coverage and provider licensure requirements vary from state to state.

Finding a Telemental Health Services Provider

Many of the same considerations for finding a provider for in-person mental health services apply to finding a telemental health services provider. Considerations specific to telemental health include:

• Security: As videoconferencing platforms continue to evolve, most providers use secure platforms through which recording isn’t possible. Industry best practices for videoconferencing for telemental health services providers suggest selecting platforms with appropriate verification, confidentiality, and security features.
• Introductory sessions: Meeting a provider for the first time in a virtual environment may make it more challenging to determine comfort level. Initial free consultations may make it easier to determine if a telemental health services provider feels like a good fit.

Learn more about getting help and finding a health care provider on the National Institute of Mental Health (NIMH) Help for Mental Illnesses webpage. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers the Behavioral Health Treatment Services Locator, an online tool to help you find mental health services in your area and to learn whether providers offer telemental health services.

What types of care can I get using telehealth?

The types of care that you can get using telehealth may include:

• General health care, like wellness visits
• Prescriptions for medicine
• Dermatology (skin care)
• Eye exams
• Nutrition counseling
• Mental health counseling
• Urgent care conditions, such as sinusitis, urinary tract infections, common rashes, etc.

What does telehealth mean?

Telehealth — sometimes called telemedicine — lets your doctor provide care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.

There are several options for telehealth care:

• Talk to your doctor live over the phone or video chat.
• Send and receive messages from your doctor using secure messaging, email, secure messaging, and secure file exchange.
• Use remote monitoring so your doctor can check on you at home. For example, you might use a device to gather vital signs or other vitals to help your doctor stay informed on your progress.

Telehealth — sometimes called telemedicine — lets your doctor provide care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.

There are several options for telehealth care:

• Talk to your doctor live over the phone or video chat.
• Send and receive messages from your doctor using secure messaging, email, secure messaging, and secure file exchange.
• Use remote monitoring so your doctor can check on you at home. For example, you might use a device to gather vital signs or other vitals to help your doctor stay informed on your progress.

There are many options to access telehealth if you don’t have a stable internet connection or device connected to the internet. Read more about how to get help with access to telehealth.

Did you know?

Recent federal policy changes about technology use now allow you to receive care using popular video chat programs that you may already be using. During the COVID-19 public health emergency, doctors may use Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Zoom, or Skype.

Ask your doctor what they use at their office.

What types of care can I get using telehealth?

You can get a variety of specialized care through telehealth. Telehealth is especially helpful to monitor and improve ongoing health issues, such as medication changes or chronic health conditions.

Your doctor will decide whether telehealth is right for your health needs. Ask your doctor’s office what your telehealth options are, especially if you are concerned about the health risk of COVID-19.

Care you can get with telehealth

• Lab test or x-ray results
• Mental health treatment, including online therapy, counseling, and medication management
• Recurring conditions like migraines or urinary tract infections
• Skin conditions
• Prescription management
• Urgent care issues like colds, coughs, and stomach aches
• Post-surgical follow-up
• Treatment and follow-up appointments for attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD)
• Physical therapy and occupational therapy

Tip: Are you new to telehealth? Get tips and information on the basics of telehealth.

Your doctor may also ask you to send information that will help improve your health:

• Your weight, blood pressure, blood sugar, or vital information
• Images of a wound, or eye or skin condition
• A diary or document of your symptoms
• Medical records that may be filed with another doctor, such as X-rays

Doctors can send you information to manage your health at home:

• Notifications or reminders to do rehabilitation exercises or take medication
• New suggestions for improving diet, mobility, or stress management
• Detailed instructions on how to continue your care at home
• Encouragement to stick with your treatment plan

Benefits of telehealth

Virtual visits are growing in popularity. Though in-person office visits may be necessary in certain cases, there are many benefits of telehealth care.

• Limited physical contact reduces everyone’s exposure to COVID-19
• Virtual visits ensure you get health care wherever you are located – at home, at work or even in your car
• Virtual visits cut down on travel, time off from work, and the need for child care
• Virtual health care tools can shorten the wait for an appointment
• Increased access to specialists who are located far away from your hometown

Telehealth is not a perfect fit for everyone or every medical condition. Make sure you discuss any disadvantages or risks with your doctor.

Get tips for finding a doctor who provides telehealth.

Telehealth: What to Know for Your Family (PDF) — from the Centers for Medicare & Medicaid

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https://docs.google.com/forms/d/e/1FAIpQLSfgbVejYsv1iLH-pmhm6VEtuFnunKlgj2aOl86tk7pqwmdCcA/viewform

Syllabus 

Paper 1. 

 

Telephone counselling based Rabindrik Psychotherapy 

 

Paper 1: Counselling and Psychotherapy- 

Unit 1: Theories and types.

1.1.1. Psychodynamic theory

1.1.2. Behavioristic theory

1.1.3  Humanistic theory

1.1.4  Cognitive Behaviour therapy 

1.1.5  Rabindrik Psychotherapy.

 

Paper 2: Counselling techniques 

Unit 1: Directive 

Unit 2: Non- directive

Unit 3: Eclectic 

 

 

Paper 3: Counselling tools

Unit 1: Non-testing tools 

3.1.1: Interview

3.1.2  Observation 

3.1.3. Anecdote 

3.1.4. Cumulative records 

3.1.5. Sociometry

3.1.6.  Autobiography 

Unit 2. Testing tools

3.2.1. Ability

3.2.2. Achievement test

3.2.3. Aptitude 

3.2.4. Personality

 

Paper 4 Rabindrik Psychotherapy

Unit 1: Introduction to Rabindrik Psychotherapy- Definition, Meaning, Postulates.

Unit 2: Layers of consciousness, Flows in consciousness.

Unit 3: Counselling tools- Rating scale of path and goal oriented values, Mathematical modelling, Ranking Rabindra sangeet, Rabindra sangeet association.

Unit 4: Counselling techniques: Story therapy, Drawing or painting, Dance therapy.

 

Paper 5  Life skills

 

 

 

 

 

 

 

 

 

 

Unit 2: Introduction to Rabindrik Psychotherapy- Definition and Meaning. 

Unit 3: Layers of consciousness, Flows in consciousness.

Unit 4. Rabindrik Values and Postulates.

 

Paper 2: Psychological Conflicts 

Unit 1: Theory and Types.

Unit 2: Conflicts in Shyama, Chitarngada

Unit 3: Conflicts in Chandalika and Valmiki Pratibha

Unit 4: Cognitive distortion.

 

Paper 3: Assessment and Classification 

Unit 1: MS-EXCEL spreadsheet, Questionnaire based Data entry, data organization and symptom severity.

Unit 2: Case history taking.

Unit 3: Mental status examination.

Unit 4: Mental health screening tools

 

Paper 4: Introduction to Telephone based counselling: 

Unit 1: Definition, Meaning, Scope and Stages.

Unit 2: Mental health counselling.

Unit 3: Educational counselling.

Unit 4: Geriatric counselling.

 

Paper 5: Practicum 

Case presentation on 

Telephone based counselling to 2children , 2 adults and 2 seniors

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Telephone counselling refers to any type of psychological service performed over the telephone. Aim of the current course is limited to School Psychology. In telephone counselling, as opposed to Helplines, the counsellor aims to provide services over the telephone similarly to the level of service provided in face-to-face consultation at an agreed fee.

 

Telephone counselling can be divided into four characteristics. These are: intake, triage and assessment, relaying information and follow up.

 

Intake 

 

Intake is typically the first interaction between the client and the counsellor during telephone counselling.  It is imperative for the counsellor upon intake to ensure they are actually speaking to the intended client and that the phone call is not recorded and not listened to by anyone else.  Due to the loss of visual cues, it becomes more critical with telephone counselling to use understandable language and encourage the client to describe in detail the issues of concern. The counsellor should listen to understand the client and not interrupt, and should provide the client opportunities to elaborate on the information provided.  The counsellor can use such techniques as open ended questioning to obtain relevant information.

One challenge that therapists face with this style of counselling is to develop quick trust and rapport. The development of rapport may influence the caller’s behaviour and attitude towards therapy.  Just as physical appearance provides first impression about the therapist in a traditional face to face therapy, so does the voice in telephone counselling. The therapist is encouraged to maintain a steady pace with a soft tone in their voice to demonstrate empathy and understanding. Counselling is best viewed if preceded by empathic discussion and questioning.

Details to be taken and recorded upon intake include specific demographic information about the client, the date and time of the call, the client’s name, contact information, the specific questions and concerns of the client and the responses given by the therapist.

Triage and Assessment

Following the collection of general information from the client, the therapist should assess the client’s level of knowledge and concern to ascertain the presenting problems and the level of risk. The first primary goal in gathering such information is to determine the client’s suitability for telephone counselling, because some clients may not be suitable for counselling through this mode. The following are some examples of when a client may not be suitable for telephone counselling: when there is high risk of harm, when there are high levels of anxiety, when a review of medical records is necessary or when the client presents with severe problems. If committing to telephone counselling with a client, it is important to contract with them a specific scheduled time for the counselling session whereby they do not call at anytime expecting to be able to talk through issues.

Relaying Information

It is also important for the therapist to establish if it is an appropriate time for the client to talk and that the client is in a private location. This is because, unlike face-to-face counselling, the therapist does not have any control over the therapeutic setting in which the client resides for the session. So clarifying the suitability of the place and timing of the session for the client who is calling must occur. It is also very important for the therapist to avoid giving confidential information to a person who is not the client, thus they must refrain from leaving messages on answering machines with identifying information other than name and contact number.

Since there is no face to face interaction between the client and the counsellor, verbal and vocal cues are paramount. The therapist must ensure that information is given at a reasonable pace through the use of clear simple terms that avoids jargon and should include pauses to ensure the client understands and allows space for them to respond (Ormand Haun, Cook Duqutte, Ludowese & Matthews, 2000; Kenny & McEachern, 2004). The therapist should strive to maintain a compassionate unhurried voice and avoid raising the modulation of words at the end of sentences. The counsellor should also be aware of background noises such as computer keyboards and co-workers.

Also, as with any face to face counselling session, continual reassessment of the client’s emotional status is important (Ormand Haun, Cook Duqutte, Ludowese & Matthews, 2000). Because of the difficulty of assessing emotional responses on the telephone, it is particularly important for the counsellor to purposefully elicit such responses.  Before concluding the call, the therapist must summarise the information briefly and reemphasise any follow up that is necessary.

Follow Up

Documentation should occur immediately following the telephone counselling session. The therapist must document the information provided by the client and other pertinent aspects of the call like with any case notes when seeing clients face to face.

Ref: https://www.aipc.net.au/articles/introduction-to-telephone-counselling/

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Rationale for Telehealth with Children with ASD

Telehealth has been used in clinical care for children and adolescents with developmental and behavioral concerns and disorders for several years. Telehealth is beginning to be viewed as an appropriate avenue of intervention given the limited supply of providers (and their general location in urban or suburban settings) and the nature of the encounter which relies on more observation and interviewing and less procedures (Soares & Langkamp, 2012). In fact, for certain situations, telehealth might even be considered superior to in-person encounters. In ASD, this could be due to the novelty of the modality and that the separation (physical and psychological) allows for more naturalistic observations (Pakyurek, Yellowlees, & Hilty, 2010). Since children and adolescents with ASD may not “travel well” to tertiary centers, the reduced burden of travel may also allow for more baseline/typical presentation and telehealth may also alleviate the geographic access barriers (Soares, Johnson, & Patidar, 2013). The remainder of this chapter will review the literature regarding telehealth and diagnosis and treatment, as well as the feasibility and practical implementation of telehealth in ASD. Additionally, given the complex neurodevelopmental profile of many with ASD, telehealth allows multiple specialty providers to work with an individual which may provide a greater level of interprofessional care and collaboration among professionals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310994/