Telehealth Grant Baseline Survey Insights & Answers

In June, the telehealth grant team sent out a survey to the Family Solutions therapist asking about all things telehealth! Therapists were asked how they felt about telehealth? Any biases toward telehealth? And even what kind of trainings our staff would like in order to feel more comfortable with virtual services. 

From the survey, it seems like many of staff generally feel comfortable providing telehealth, especially with what they had to learn so quickly during the pandemic; however, there are always areas of improvement! The biggest area that people noted wanting to learn more about telehealth is in being able to engage with clients in the best way possible, especially with children. This is one of our big goals with the grant - being able to provide resources and trainings to help the Family Solutions clinicians feel more comfortable and confident in providing virtual sessions to all of our clients, but especially the children we work with. Many responses expressed concerns over the limitations of telehealth and its effectiveness.

Several key questions were raised regarding HIPAA-compliant platforms, official telehealth certifications, specialized training for specific populations or virtual modalities, best practices, and relevant regulations. Addressing many of these topics is already planned, and our goal is to offer comprehensive information, training, and resources to ensure both clinical and non-clinical staff at Family Solutions feel as equipped, confident, and comfortable as possible when delivering or discussing telehealth services.

What This Tells Us

The results of this survey showed that our staff is really taking into consideration how they can be the best clinician for each of their client's. A huge part of being a therapist is continuing education in order to maintain clinical standards, practices, and ethics to keep up with the world around us. Technology has changed so much, and especially how it is used in healthcare, and this survey shows that our staff is really paying attention to what that means for their work with clients. 

General Questions

Is telehealth counseling effective?
Yes! Lots of research has shown that there is not a difference between the effectiveness of in person sessions versus telehealth, which means the virtual work that we are doing is just as effective. Now, this isn’t to say that telehealth is a good fit for every single client - that is still an important clinical judgement clinicians can make on a client-to-client basis. 

What are the best practices for telehealth?
The best practice for conducting a telehealth session, is to treat it like you would an in-person session. This means, that telehealth sessions should meet the same clinical standards you would have for an in-office client. Maintaining confidentiality and privacy, limiting disruptions and distractions, and the space you hold for a client is expected to be the same across all platforms a session may be held.  

What are the best tools and resources to use when conducting a virtual session?
There are many options out there! Keep checking around this website for more information as the telehealth team gathers more resources and training opportunities. 

What are relevant telehealth regulations I need to know?
Right now, in North Carolina, there are no additional requirements or trainings a clinician must have in order to provide telemental health services. It is just expected that clinicians maintain the same standards of care during virtual sessions, as they would in person.

Can I practice over state lines virtually?
While there many compacts coming into play across the country, which would increase the ease that a clinician can practice across state lines, not every state is granting privileges yet. There are also many nuances to being able to practice across state lines when it comes to legal authority and which state's rules to follow. 

Specific Questions

The following are specific questions therapist asked in the survey responses, that we want to ensure get addressed: 

How hard is it to be licensed over state lines, and is our practice preparing to offer telehealth to reach populations outside of the immediate vicinity?
Getting licensed in another state would probably be just as challenging as getting licensed in the first time, because each state has their own licensing and supervision requirements. There is legislation across the US on different compacts that would allow clinicians to practice outside of their state of licensure (practicing across state lines via telehealth). There are only a handful of states currently granting privileges to those outside of its borders.

However, there are also a lot of things to consider when practicing across state lines, with the biggest concern around legal jurisdiction. The laws that are to be followed are of the location of the client, so if you are located in North Carolina and your client is in Ohio, you are required to follow Ohio counseling laws. What does the state where your client is, say about duty to warn? Mandatory reporting? Laws pertaining to LGBTQ and reproductive rights? These are all things you would need to be aware of in the state your client is located in.

At this time, Family Solutions is not preparing to practice outside of the state of North Carolina; however, we are hoping to expand access to quality mental health services to rural counties within our state, especially in the Piedmont region. 

What is the status of legislation/licensure board collaboratives on the provision of interstate therapy via Telehealth, or when will we be able to provide therapy across state lines without being licensed in multiple states?
North Carolina has joined the Counseling Compact and the Social Work Licensure Compact but neither are granting privileges yet, which means there is no availability yet for multi-state licensure.