History

Cecil Wittson was a telemental health pioneer that began using one-way, closed-circuit television to deliver psychiatric training to students at the Medical College of Nebraska.  By 1957, Wittson expanded the training network to include Iowa, North and South Dakota – utilizing asynchronous or two-way audio communication.  In 1959, asynchronous video became a reality, driving improvements in consultations and therapy between the Nebraska Psychiatric Institute and the Nebraska state hospital in Norfolk.

Massachusetts General Hospital was the next to advance the usage of virtual care delivery with the first remote clinic, found in Logan International Airport in 1969.  Clinicians at Mass General were providing psychiatric consultations to adults and children located 2.7 miles from the hospital.

The internet and the proliferation of AV capabilities in laptops and cell phones brought along the next level of care and convenience for patients that are seeking behavioral help.  Patients can now choose how and when they want to receive care: either in-person, video-based therapy or text-based therapy.

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A strong therapeutic alliance requires engaging patients in new ways. Reach new levels of care by removing traditional barriers related to scheduling, sharing of educational materials, and even providing easier access when a patient is experiencing a troubling issue.

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Telemental-Health Technology

Technology for telemental health services continues to break down barriers, remove stigmas, and increase access.  Patients can now choose their preferred mode of delivery between text-based therapy and video conferencing.  Progressive practices are even blending delivery methods by providing a level of care that simply was not achievable under traditional in-person models.

Telemental health services are now commonly delivered through HIPAA compliant, cloud-based telehealth suites on virtually any web-enabled device – including desktop computers, laptops, tablets, and smartphones.  Leading telemental health platforms offer:

Online Assessments

Secure Document Storage

Online Scheduling & Calendar

Online Billing

Secure Messaging

PDF Forms & eSign

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Applications

Behavioral professionals utilize telemental health to provide the following forms of behavioral care:

Cognitive Behavioral Therapy | CBT is a form of psychotherapy that is centered on modifying dysfunctional behaviors, thoughts, and emotions in order to treat problems and improve happiness.  CBT therapists focus on encouraging patients to challenge distorted views and change destructive patterns through positive encouragement and solution based care.

Interpersonal Therapy | IPT is typically a short-term treatment plan that lasts two to four months.  During this time the therapist works with the patient to evaluate problems in four basic areas – role disputes, role transitions, unresolved grief, interpersonal deficits.

Emotion-Focused Therapy | EFT is a form of therapy that focuses on relationships and bonding.  Clients and therapists look for relationship patterns and take active measures to trust based and stronger relationships that are healthier and positive.

Group Therapy | This is a form of therapy where a group of patients meets to discuss their issues and challenges together under the supervision of a counselor or therapist.  Group therapy is a beneficial treatment strategy for many individuals including teens, those in addiction recovery, and anyone experiencing relationship problems, anxiety, depression, grief, emotional trauma, or low self-esteem.

Psychotherapy | Psychotherapy is a general term covering the treatment of disorders by psychological means rather than through medicine.

Coaching | Coaching is less therapy as it tends to not focus on healing or the past, but rather identifying goals and removing barriers that limit achievement.

Marriage Counseling | This is a form of psychotherapy for married couples that focuses on identifying and solving problems in the relationship.  The therapy sessions typically involve two people attending counseling sessions together.

Pastoral Counseling | Pastoral counseling is a therapy that incorporates psychology, religion, spirituality, and theology.  This form of therapy works to resolve the same issues as other common forms of therapy but from a religious perspective that ultimately strengthens the relationship with others along with the god of that religion.

Guided Self Help | Guided Self-help is a form of CBT therapy for people with mild forms of depression or anxiety.  Typical therapy approaches involve working through a computer course or workbook with the support of a therapist.  During the course, a therapist will support patients with either face-to-face or telebehavioral appointments

We are telemental health reimagined.

WeCounsel was built to solve the largest challenges in mental health care – maximizing available provider capacity to increase access and remove barriers to care.

Increase
Reach

Expand your reach through opportunities from WeCounsel partners that include primary care groups, hospitals, and emergency departments.

Streamline
Your Practice

Remove the burden of time-consuming tasks by leveraging online scheduling, assessments, billing and eSign capabilities.

Improve
Communication

Offer the flexibility of video sessions or text-based counseling between sessions. You can also leverage document sharing to provide clients with valuable educational materials, versus providing printed copies.

Bill
Effortlessly

Offer the flexibility of video sessions or text-based counseling between sessions. You can also leverage document sharing to provide clients with valuable educational materials, versus providing printed copies.

Related Terms

Telecounseling
Telecounseling is the process of providing counseling or talk-therapy remotely through the use of HIPAA compliant software with the goal of resolving personal, psychological or social issues.  Services can include video conferencing and text-based therapy.

Online Counseling
Online counseling is the process of providing guidance and assistance in resolving personal, psychological, or social problems and to help improve that person’s attitude, behavior, or character through connecting with a professional on the internet.  This can be done via email, live messaging, text messaging, Instant Messaging (IM), video conferencing, or audio messaging.  An online counselor is considered a subgroup of telemental health professionals.  Telemental health is a subset of telemedicine and telehealth which are terms that are used interchangeably.

Telepsychology
Telepsychology is the study of the human mind and emotions along with the mental characteristics of a person or group using telecommunication technologies and online observations and studies. Psychologists are the mental health professionals who study and then evaluate the behavior and mental characteristics of people. These mediums and technologies could include email, text messaging, or video conferencing on a phone, tablet or computer. Telepsychology makes accessing patients easier from far distances and helps the patient access help in the comfort of their home. A telepsychologist is considered a subgroup of telemental health professionals. Telemental health is a subset of telemedicine and telehealth which are terms that are used interchangeably.

Telepsychiatry
Telepsychiatry refers to the observable behavior in a subject through online technologies.  It applies to the delivery of care and psychiatric assessments through mediums not limited to video conferencing, email, instant messaging, video conferencing, and audio messaging. Telepsychiatry is considered a subgroup of telemental health.  Telemental health is a subset of telemedicine and telehealth which are terms that are used interchangeably.

Online Therapy
Online therapy is the treatment or healing of a mental, behavioral, or physical disorder by psychological means via a connection to a provider through the internet.  It is also known as e-therapy, e-counseling, teletherapy or cyber-counseling.  A variety of mediums are used to connect providers to patients including email, Instant Messaging (IM), live messaging, text messaging, audio messaging, or video conferencing.  Online therapy can be accessed through devices that access the internet including computers, phones, and tablets.  An online therapist is considered a subgroup of telemental health professionals.  Telemental health is a subset of telemedicine and telehealth which are terms that are used interchangeably.

Telebehavioral Health
Telebehavioral refers to the process of observing behavior in a subject through online technologies.  Telebehavoioral is considered a subgroup of telemental health.  Telemental health is a subset of telemedicine and telehealth which are terms that are used interchangeably.

HIPAA Compliance & Security

HIPAA is the Health Insurance and Accountability Act that provides provisions for data security and safeguards for medical information.  It governs how medical and Personal Health Information is managed.

HIPAA compliance and security are paramount to telemedicine.  As with all forms of health care, the security of personal health information, PHI, is paramount.  A robust telemedicine suite must provide technological safeguards designed to protect PHI.  Examples of this include:

  • Messaging should be managed through a secure portal
  • Data must be secured and encryption is recommended
  • The company supporting the platform must offer a Business Associate Agreement (BAA) that legally obligates the organization to adhere to HIPAA along assuming the risk for the responsibilities of managing PHI
  • Other elements of HIPAA require business associates to maintain procedures and protocols for employees that may come in contact with PHI

Growing Reimbursement Opportunities

Legislators and insurance payors were slower to support virtual care delivery, but a lot has changed over the last few years.  As of January 2019:

  • 49 states and Washington, DC have legislation that allows for Medicaid reimbursement for some form of live video
  • 39 states have parity laws requiring that telemedicine services be reimbursed at the same rate as in-person care
  • Medicare continues to advance reimbursement for virtual care, especially for behavioral services and rural populations

Telemedicine reimbursement continues to improve through state and federal legislation, along with updates with individual payors

Learn About Reimbursement