4.5 Teletherapy, Telehealth, and Use of Technology

Telehealth is the use of digital technologies to deliver medical care, health education, and public health services by remotely connecting multiple users in separate locations. Telehealth services are not new: healthcare providers have been providing care remotely since the invention of the telephone in the 19th century. Over time, new technologies aided the communication process and the Covid 19 pandemic greatly increased the use.

Teletherapy is mental health counseling over the phone or online with videoconferencing. The COVID-19 pandemic led to reduced access to medical and mental health care, so delivering behavioral health care via telehealth was one way to address this issue. When using teletherapy, nurses should treat clients as if they are sitting across from them and focus on eye contact and empathetic expressions to build a connection, just during a face-to-face encounter.^[1]

Providing nursing care via telecommunications is a subset of telehealth. Nurses are involved in remote patient monitoring, collaborating with the healthcare team, and communicating with patients and their families. Nurses must be aware of potential barriers affecting patient use of telehealth (such as lack of Internet access or lack of support for individuals learning new technologies), as well as state and federal policies regarding telehealth and their nursing license across state lines. The American Psychiatric Nurses Association (APNA) website discusses numerous concerns for nurses who engage in telehealth activities, including policy, access, and outcomes.

In addition to teletherapy, technological advances are reshaping nursing care in constantly changing ways. Patients are now monitoring their moods and sleep cycles and turning to cellphones to seek coping skills^[2]. A few examples are:

Smartphone applications: Patients can use these tools to track moods, access guided exercises, and assist in mindfulness practices. Some apps use cognitive behavioral techniques to assist patients who need help. Artificial intelligence (AI) based applications that can screen patients and analyze speech and written data to detect trends are currently in use and AI chatbots are offering coping strategies. The FDA has approved several apps, such as Rejoyn, for patient use in monitoring emotions, thoughts, and medication effects. Gaming apps now address skill acquisition for learning coping skills and regulating emotions.

Wearable technology: Individuals are using devices, such as smartwatches, to monitor sleep patterns, exercise, heart rates, and emotional states. Patients may present with quantitative data to aid care. For example, a nurse could view a smartwatch history as part of an assessment on how well the patient is responding to sleep hygiene interventions.

Peer support: Online support communities have become sources of education, encouragement, and a sense of belonging. Nurses can steer patients and their families to resources such as the National Alliance on Mental Health (NAMI) as well as diagnosis-specific websites.

Nurses need to be aware of technology that their patients are using and assist them in making wise choices. Not all apps or online support technologies provide sound information. The rapid development of AI resources is poised to change healthcare in many respects. Nurses need to stay informed on mental healthcare technologies so they can provide accurate information.