Since 2020 TCI has taught telemental health to over 600 graduate students. These were students of social work, counseling, marriage and family therapy, psychology, or public health who completed the TeleMental Health Training Program. Participating colleges varied greatly–small, large, private, public, urban and rural.
Alabama A&M University is one of the colleges TCI has partnered with for the last two years. In March we completed the TeleMental Health Training Program with a group of 31 master of social work fellows from their Behavioral Health Workforce Training Program (BHWTP). The BHWTP Fellows’ participation in the TeleMental Health Training Program is made possible by generous funding awarded to the MSW Program by the Health Resources and Services Administration (HRSA)(MC1HP42067‐01‐00) through its Behavioral Health Workforce Education and Training (BHWET) Program. The purpose of the BHWET Program for Professionals is to develop and expand experiential training opportunities, such as field placements and internships, to improve the distribution and supply of the behavioral health workforce. The development of competencies in the implementation of telemental health is a current and critical skills area in demand across settings in which social workers practice.
Beginning in October and ending in March, the students started with pre-testing, attended four live webinar sessions, and completed the program with post-testing. Each webinar was interactive and immersive, led by TCI’s CEO and telemental health instructor Ray Barrett. Students were able to ask questions, apply concepts to real-life situations, and immediately put the skills they learned into practice with their peers during breakout sessions.
These webinars covered the ten modules that compose the full program:
- Introduction to TeleMental Health
- Legal Aspects of TeleMental Health
- Ethics of Using Technology in Behavioral Health
- Privacy Law for TeleMental Health
- Ethical, Legal, and Clinical Aspects of Selecting Technology
- Emergency Management Planning for TeleMental Health
- Screening for Fit for TeleMental Health Services
- Ethical and Clinical Skills of Video Sessions
- Ethical and Clinical Skills of Phone Therapy
- Cultural Competence and Telehealth
Per the university’s request, TCI measured the learning outcomes for each module or topic area. The assessments are graded on a scale of 0-10. The students’ initial pre-training tests saw an average grade of 5.4/10. After the training series, student post-test grades increased by 55% compared to the pre-test, closing out at 8.4/10.
The greatest area of improvement, according to assessments, was Clinical Skills of Phone Therapy. Phone therapy skills are incredibly important for clinical social workers as they continue to serve remote clients who lack access to high-speed internet.
Many of the fellows shared their experience of the telemental health webinars.
“This presentation was extremely informative. I will be using what I have learned within these lessons within my future practice.”
“I learned in greater detail about best practices with video telehealth and best practices such as camera angles, etc.”
“This training was very informative. The presenter aided my understanding of the inner workings of Telemental health. My only recommendation for improvement would be to include more visual stimuli and discussions in order to keep the class engaged.”
“Being able to assist and work with clients telephonically will make my practice better.”
“I learned a great deal about the legal aspects of Telemental health. I have a better understanding about what is appropriate when practicing across state lines, which will be beneficial to me in the future considering I am interested in opening my own counseling practice using Telemental health.”
“I learned more about HIPAA as far as the details of technology and disclosure. It will prevent breaches of HIPAA.”
“This activity was very informative…The speaker was constantly engaging the class and listening to any questions and comments from students. He seemed knowledgeable regarding the subject.”
“I enjoyed breaking off into groups and practicing how to contact emergency services when a client is having harmful ideations.”
“This gave me a great deal of insight regarding the importance of safety and preparation for practitioners.”
“Everything in the course was new to me. I will now be able to practice TeleMental Health.”
In addition, at the end of each webinar, we asked participants the following questions: “Did this program enhance your professional expertise?”, and “Would you recommend this program to others?” 99% of surveyed participants said “YES” to the first question, and 97% answered “YES” to the second question.
The BHWTP fellows also provided helpful recommendations for improvement, such as increasing slide content and visual stimuli for some of the topics. They also shared other topics they would like to study, such as vicarious trauma, substance abuse, and feminism in social work. The team at TCI considers it an essential part of their job to listen to these recommendations and make adjustments and additional courses to better meet the needs of today’s students and tomorrow’s licensed clinicians.
In the end, we at TCI believe the TeleMental Health Training Program does what it was designed to do, namely, to increase professionals' confidence and readiness for today’s workforce through proficiency in telehealth. We are grateful for the opportunity to continue these relationships with each student, clinician and institution, and we remain committed to being the cutting edge of telemental health success for years to come.
When Raymond Barrett first created a telehealth training certificate program in 2014, he believed it was essential to include the ethical and legal standards for social workers, and these standards continue to shape the content of the Telemental Health Training Certificate (THTC) Program today. Some examples are the NASW Code of Ethics, state and federal laws, and best practices for technology-assisted social work. And in addition to these, the THTC Program meets CSWE’s educational and policy accreditation standards.
In this interview, Dr. Peters talks about the Foundation for Recovery Science and Education (FoRSE) Program, and how it’s equipping treatment providers with data to empower the design, modification, and delivery of clinical services. Even though the National Association of Addiction Treatment Providers (NAATP) has been around since 1978, the substance-use profession has encountered numerous barriers when attempting to standardize addiction treatment.
Over the last few decades, establishing evidence around treatment outcomes has become increasingly popular across the entire mental health profession. Dr. Peters says that providers’ desire to “want to measure how they are doing” led the NAATP to develop FoRSE to support providers who don’t have available comparative data to evaluate the strength of the services that they offer to clients.
Chris McLaughlin, MSW, LCSW, talks about the importance of counseling competencies when working with LGBTQ+ clients. Chris uses his knowledge and experience of the LGBTQ+ community to provide an in-depth look at common areas of concern for this client population, and where clinicians often fall short.
During the interview, Chris talks about the immense value of respecting whatever a client shares, and that bringing parents or guardians into the conversation can be “a delicate balance.” Ordinarily, Chris says that his “rule of thumb is to always follow the lead of the youth,” and that his role is to never out youth to their parents—even if safety issues are present. According to Chris, “regardless of the presenting concern,” he always asks questions about sexual orientation and gender identity with his clients. For some youth, they may have never encountered an adult who expressed interest in these issues; and for others, they may be waiting for a safe enough space to be vulnerable.
In this video interview, Ray Barrett of the Telehealth Certification Institute sits down with internationally known cognitive-behavioral researcher and psychiatrist, Dr. Jesse Wright. During the interview, Dr. Wright shares how his decades of research experience have helped validate the clinical power of computerized cognitive behavioral therapy (CCBT). Dr. Wright emphasizes that computer-assisted therapy is not about eliminating the person in the process, but “use computer programs to help build skills, teach some of the basic concepts, rehearse patients, help them do…homework or action plans, and do some of the routine things that cognitive therapists often have to do.”
Dr. Wright started researching the potential of using computer-assisted technology or multimedia as a hybrid therapy model in the 90s, so there are numerous articles and studies that point to the effectiveness of CCBT. In fact, Dr. Wright found that the remission rates were “more than double in people who received computer-assisted cognitive therapy” compared to treatment as usual.
In this video interview, Dr. Katherine M. Hertlein’s talks with Ray Barrett of TCI about integrating technology into couple and family therapy sessions. Dr. Hertlein uses her experience as a Professor in the Couple and Family Therapy Program at the University of Nevada, Las Vegas, to emphasize the importance of telebehavioral health competencies when training counseling graduate students—and what skills practicing clinicians can learn to optimize client care.
In general, the couple and family therapy fields were slow to embrace telehealth as a worthy format for clinical work. According to Dr. Hertlein, “there was a fear around [using telehealth]” because of the significance placed upon the therapist-client relationship. But when COVID-19 set in, there was a stronger wave of acceptance for online counseling.
In this video interview, Dr. Dominguez, the Founder of Shaping Change, describes how she uses applied behavior analysis with her clients. According to Dr. Dominguez, therapists aim to teach clients new skills while also addressing challenging behaviors with this “hands-on type of therapy.”
Examples include adapting to client learning styles through “visual cards” that cue clients to a therapist’s instruction, or by determining a client’s preferred method for communicating. In Dr. Dominguez’s experience, she’s noticed that when you teach practical skills to clients, there is usually a corresponding decline in challenging behaviors.
In this video interview, you’ll hear how Texas Tech University Health Science Center's Master of Science in Clinical Mental Health Counseling Program - directed by Dr. Logan Winkelman - is training graduate students in telemental health competencies through their innovative online counseling curriculum.
Telehealth and telemental health services can be thought of as essential modalities that fill a crucial gap in service delivery. Dr. Winkelman explains that, at some point, students will “offer some form of telecounseling” during their careers, so learning it during a master’s program can give students a leg up once they graduate.
Dr. Winkelman points out that most training vendors have a broader focus on “telehealth or telemedicine [content, but it] …just doesn’t dive deep enough for [learning] telemental health counseling.” Dr. Winkelman decided to outsource the program’s telemental health training to the Telehealth Certification Institute (TCI) because she didn’t want to be “behind the curve” on evolving online counseling standards. For Dr. Winkelman, the underlying message was clear—it’s “too big of a topic to get wrong.”
Because TCI’s 10-course TeleMental Health Training Certificate (THTC) Program provides graduates eligibility to sit for the Board Certified-TeleMental Health Provider (BC-TMH) credential—which has been approved by the Center for Credentialing & Education—there’s an immense added value for new mental health counselors. As soon as graduate students apply for their first job, they demonstrate a commitment to offering alternative counseling options that meet client needs; and since the online environment is so complex, students with advanced training can become online leaders and advocates at their practicum sites.
According to Dr. Winkelman, the need for telehealth counseling skills “is not going anywhere,” and “offers the opportunity for clients to get counseling services that they wouldn’t otherwise take advantage of.” To be an inclusive mental health professional, it’s important to utilize a variety of strategies and technologies to make counseling possible for everyone.
Logan Winkelman, Ph.D., LPC-S, NCC, is an Assistant Professor and Program Director for the Master of Science in Clinical Mental Health Counseling Program at Texas Tech University Health Sciences Center. She has worked in higher education for the past 9+ years. Her scholarly interests include access to mental health and wellness resources through telehealth, emotional intelligence, biofeedback, as well as aging and longevity topics. To learn more about, Dr. Winkelman or the Texas Tech Master of Science in Clinical Mental Health Counseling Program, you can visit the counseling homepage.
In this video interview, Dr. Tanja Jovanovic talks about her research on trauma, resiliency, and the use of a remote monitoring device in therapy sessions. Dr. Jovanovic describes how the Mindfield eSense Skin Response App measures a client’s degree of skin conduction—data that reflects the client’s level of distress—so that clinicians can track the client’s progress during a therapy session or across multiple meetings.
According to Dr. Jovanovic, this type of objective data is useful for mental health professionals because clients often “get detached” when talking about their trauma. As a result, clients tend to underreport their discomfort. By using a reliable device to measure points of activation, the therapy context itself becomes a container for analyzing in-session client outcomes. In one of her research studies where prolonged exposure therapy was implemented via virtual reality technology with military veterans, Dr. Jovanovic found that if clients “responded more [physiologically] before going into therapy, the therapy worked better.”
In this video interview, Dr. Ebony White talks with Ray Barrett about the American Counseling Association’s Anti-Racism Commission. During the discussion, Dr. White explains how the commission is addressing “the historical racism and continued exclusionary practices that have existed in the [counseling] profession and the [ACA] organization.”
On an individual level, Dr. White says that tasks call on the ACA to play a larger “role in [using] decolonized theories and interventions…specifically with Black clients [and] making sure that anti-Black racism, reform, advocacy, and activism is occurring at all levels”—with an additional emphasis on leadership pipelines for marginalized populations.
Dr. White supports the commission’s efforts to actively review ACA bylaws and procedures to move beyond “just using language” or a “blanket approach to rooting out racism in the profession.” On the national and state levels, the group is also pushing for congressional action and research that targets oppressive policies and under-researched topics. According to Dr. White, “document[ing] the history of racism in the profession” is a key part of the process.
For behavioral health organizations that are interested in applying anti-racism policies, Dr. White recommends honoring “the expertise of the people who are often left out of the conversation” and giving power to the consultants who are proposing changes. By requiring consultants to sign off on new policies, the authenticity of the consultant’s observations is deeply respected. Moving from a bottom-up to a top-down approach—by establishing a vision for change at the leadership level—increases the likelihood that changes will be transformative and long-lasting.
Dr. Ebony White is a Licensed Professional Counselor, and Clinical Supervisor. She is an Assistant Clinical Professor in the Department of Counseling and Family Therapy and the Program Director of the Master in Addiction’s Counseling program at Drexel University.
She is also the Executive Director of the Center for Mastering and Refining Children’s Unique Skills (MARCUS), the President-Elect of Counselors for Social Justice, and the Immediate Past Chair for the North Atlantic Region of the American Counseling Association. You can learn more about Dr. White by visiting her website or through MARCUS. Register for Dr. White’s “Race, Power and Privilege: Addressing Cross Cultural Dynamics in Supervision” course here.