临床与咨询心理学导论 22 - Technology

L22 Technology & Psychotherapy 

参考文献：Pomerantz, A. (2013). Clinical psychology: science, practice, and culture (3rd ed.). Thousand Oaks, CA: SAGE Publications.

22.1 Reasons to Use Technology in Psychological Services

• About 20% of people meet criteria for a mental disorder in any given year

• Most people do not receive any treatment services

- 59% received no treatment at all

- 16% met with a mental health professional specifically trained in psychotherapy and counseling (e.g., psychologist, social worker, counselor)

• Patient-level barriers to care: economics, gender, etc.

• Systems-level barriers to care: Not enough mental health professionals available

Technology in Everyday Life & Changes in Internet & Device Use

Internet for Health Information: Technology already commonly used for health-related topics by most adults in the U.S.

Internet for Mental Health Resources

• Evidence that the Internet is an important source of information related to mental health

• Survey of 337 patients in a psychiatry department

- Sample included both inpatient and outpatient clients

- Internet users: 71% used it for reasons related to mental health

• 57.8% for information on mental disorders

• 43.7% for information on psychiatric medication

• 38.8% for information on mental health professionals

22.2 Telepsychology

• Telepsychology: Provision of psychological services using telecommunication technology - Use of technology-based tools in the direct delivery of psychological services: Telehealth, Telemental health, Cybertherapy, eTherapy, eMental Health, Online/Internet Therapy, etc.

• Wide variety of forms that telepsychology takes now:

- Secure videoconference software

- Interactive websites with practice tools and resources

- Internet-based self-help programs

- Emailing and texting

- Apps

- Virtual reality programs for exposure therapy activities

• Additional areas where programs are being developed:

- Socially assistive robotics

- Video games and gamified programs

- Resources based in social media platforms

Evidence Supporting Telepsychology

• These are newer treatments, so we are still collecting data to evaluate their efficacy and effectiveness

• So far…results are very promising!

• Treatment studies, randomized controlled trials, reviews of studies, and meta-analyses indicate that outcomes for telepsychology are similar to those observed in face-to-face treatments

• Meta-analysis of internet-delivered CBT (Andrews et al., 2018)

- Major Depressive Disorder

- Panic Disorder

- Social Anxiety Disorder

- Generalized Anxiety Disorder

• 64 trials were included in the analyses

- Significant improvement with treatment

- Patients were satisfied to very satisfied

- No difference when internet-delivered CBT was compared to face-to-face CBT (9 studies)

22.3 Challenges in Integrating Technology

• Need for more research and evidence

- Many questions related to the efficacy of apps

• Client engagement with tools

- Telepsychology tools that do not involve therapist contact present special challenges for keeping clients engaged

• Security-related concerns

- Special requirements for videoconference programs

- Major privacy concerns related to apps and online programs that save user data