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Through my studies at Damascus University in my native Syria and Yale School of Medicine, I came to see that psychiatry is truly unique among medical fields. To me, it’s the only specialization that takes into account the totality of the human experience. We look at biological aspects of the body, particularly the brain, but we also delve into social and interpersonal influences; personality; core beliefs, values, and attitudes; and behavioral patterns. And through years of practicing at Connecticut Behavioral Health Associates in New London county, I’ve found that while successfully treating the psychiatric client relies in large part on the objective skills of the clinician, we must also must bring our personality, life experience, and system of beliefs to our work. For this reason, I believe psychiatry epitomizes the very best in human interaction—and that can still be achieved through telepsychiatry.
While telepsychiatry has been in existence for a long time, its practice has long been limited by constraints related to the technology, clinician and client preferences, and reimbursement issues due to insurance companies not covering this service or paying much less for it.
As described above, the pandemic has challenged all of us to be more flexible and creative as we attempt to find solutions to the difficulties it presents. Faced with the need to provide continued care to our psychiatric and behavioral health clients in and around New London, Connecticut Behavioral Health Associates removed all barriers to telepsychiatry, and this means of service quickly became the norm, allowing clients to both receive the care they need and remain safely in their homes.
With time and accumulated experience, the pros and cons of telepsychiatry have become more evident, as summarized below:
Advantages of Telepsychiatry:
1. It opens treatment opportunities to people previously unable to receive the care they needed due to illness, lack of transportation, or temporary disability, without the services required in order to attend in-person sessions throughout Connecticut or wherever their therapist is based.
2. When someone is traveling, is busy at work and can’t take time off to go to an appointment, or is temporarily indisposed, they can still receive consistent and timely care.
3. By seeing the client in their home environment, the provider gets a unique insight into their lifestyle and habitat.
4. Clinician time is better utilized, with fewer no-shows and cancellations. With flexible scheduling, a client can be seen in a crisis, as the appointment can be more easily arranged and timely.
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Telepsychiatry from a Doctor's Point of View
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I believe psychiatry epitomizes the very best in human interaction—and that can still be achieved through telepsychiatry.
Despite the challenges, telepsychiatry has allowed us at Connecticut Behavioral Health Associates to continue to provide consistent, clinical care through a safe and healthy means during the pandemic. Several problems and obstacles remain to be worked out for an even smoother delivery of services, but it's clear that telepsychiatry is here to stay. We look forward to the day when the client and clinician can choose between remote and in-person appointments in our New London office based on their individual preferences, unique needs, and situations. By this, we at CBHA can, without any compromise or deficits in our ability, maximize the quality and effectiveness of clinical care to each and every client.
If you have further questions about telepsychiatry or would like more information, visit our website at www.ctbehavioralhealthassociates.com or call us at (860) 437-6914.
Connecticut Behavioral Health Associates
Sponsored by Connecticut Behavioral Health Associates, P.C.
Disadvantages of Telepsychiatry:
1. Tangible clinical observations, such as tremor, rash, and darkening under the eyes, are not so easily seen and may be missed. Also, the clinician may not see the whole person, only the head and shoulders, limiting first-hand information about movement and physical abilities.
2. Intangible clinical observations, such as energy, body language, a clearer impression of mood, and other subtle vectors, might not be detected. The exchange of emotional warmth is more limited through technology.
3. There are concerns about confidentiality and privacy, despite the provider stressing the need for this. The clinical office often offers a “safe place” where clients feel comfortable sharing their personal thoughts and feelings. Homes don’t always offer this, as demonstrated when some clients use their vehicles as the place from which they attend their telepsychiatry appointments, even in cold weather.
4. Technical difficulties are inevitable. Sessions may be cut off prematurely, or the images or sound may not be perfectly clear. Many older people, and the cognitively challenged, may have difficulty understanding and effectively signing on or using the technology.
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Now, instead of the intimate, in-person exchange that is typically the foundation of treatment, we must interact through the safe distance of technology via telepsychiatry.
he COVID-19 pandemic has changed many aspects of our lives—how we live and work, where we go, whom we see, and more. These
changes are certainly quite evident in the practice of medicine—particularly psychiatry, whose hallmark is the profound interpersonal relationship between provider and client.
By Bassam Awwa, MD