Determine if telehealth is suitable for your work with youth and families, plan effective telehealth sessions, and troubleshoot common complications that may arise.
This resource is designed to assist providers who are serving youth and families via telehealth. Whether you are considering telehealth as a feasible service modality or looking to enhance your existing telehealth practice, this guide is here to support you.
Its primary objectives are to help you determine if telehealth is suitable for your work with youth and families, plan effective telehealth sessions, and troubleshoot common complications that may arise. You can use this telehealth guide and best practices to gain insights into strategies for successful telehealth delivery. Make the most of this resource by utilizing the accompanying checklist, which offers a comprehensive overview of key considerations for telehealth sessions.
Different states may have different rules about the practice of telehealth. Professions and states have varied laws about providing services across state lines; for instance, it is often not permissible for a provider licensed in one state to serve a family in a different state without also being licensed there.
Formal training in telehealth and providing services to the communities commonly served via telehealth should be undertaken prior to offering care. Telehealth is an emerging modality with research, professional guidelines, and new technologies evolving rapidly, so seeking continuing education will be key. Important telehealth competencies to acquire and maintain include:
You or your agency should develop thorough policies and procedures specific to telehealth services. You should also provide informed consent to families on these policies, allowing them to understand what they can expect from engaging in telehealth. Such informed consent should include:
It may also be important to have a discussion about circumstances under which telehealth may have to be discontinued.
Telehealth is an appropriate and convenient service delivery model for many concerns, but not for all. Consider the following factors when determining whether telehealth is the right modality for the family:
Is the family open to a telehealth option?
What are the main concerns for the youth?
Will the child or family need assessment or evaluation?
Assess the following technology issues before committing to telehealth:
Telehealth platforms often connect you with families who may be far removed from you both geographically and culturally.
Both the family and you will need to have a safe, well-lit, and distraction-free space from which to meet each time. Other considerations about space may include the following:
For certain types of dangerous home environments or high-stakes evaluations (e.g., forensic, abuse, custody), determine whether the home is a neutral enough environment from which to conduct the meeting.
You should discuss expectations for the session in advance or at the beginning:
Sessions proceed effectively if the youth/family is focused:
For instance, you might ask the youth, “What do you think you can do to make sure you are focused on what we are talking about?”
You can make several preparations ahead of time and modify service provision as you go to maximize participation:
Remember that the virtual environment may be somewhat unfamiliar, artificial, or constraining for some youth. Asking them to sit in front of a computer for a session for an extended period may result in atypical behaviors with regard to their attention, social interactions, behavioral acting out, or frustration tolerance relative to what you would see in typical in-person settings. Also, you may need to consider that having a familiar adult present (e.g., caregiver) to facilitate the session may affect youth behavior (e.g., acting out, concerns about confidentiality). You may need to take additional time for rapport building and refocusing. Alternatively, the use of technology may make services seem more familiar and less intimidating to other youth and result in increased engagement and self-disclosure.
Many aspects of risk assessment and crisis management are the same for telehealth and in-person services; however, some special telehealth considerations may include the following:
Telehealth can take increased attention/preparation and can even cause physical risks for you (e.g., eye strain, back pain). Some providers feel they are not able to be as effective or that they have more difficulty with boundaries in telehealth or work-from-home situations. As such, it is ethically imperative that you engage in ongoing self-assessment and self-care. Activities may include seeking additional professional support, securing reliable technology, creating a comfortable workspace set up (e.g., well-lit, adequate furniture, access to fresh air), maintaining a manageable workload with time for breaks, increasing access to self-regulating strategies, and potentially engaging in co-therapy to provide a sense of collegial support and connectedness.