by Taryn Thrasher
The rapid transition into remote work has been jarring for all of us. During these unprecedented times, the work of the professionals we serve remains essential to society. At WPS, it is our mission to support practitioners while supplying them with the most accurate and reliable testing methods available. We intend to continue assisting in your ability to unlock the potential of your clients through tele-assessment. Due to coronavirus, many of you may be trying tele-assessment for the first time. Check out the following five tips for transitioning into teletherapy and assessment.
1. Educate Yourself: Utilize APA’s Telepsychology Best Practice 101 Series which is being offered for free in response to the COVID-19 crisis. The Telepsychology Best Practice 101 is a holistic introduction to the practice of telepsychology. According to the APA website, “Each 2-hour webinar details the competencies needed for tele-practice, including critical ethical, legal, clinical, and technical issues, together with reimbursement strategies. The series discusses practical ways to leverage a variety of technologies with a focus on video conferencing.” This continuing education course is a good intro for those new to telepsychology. If you are short on time to adjust, check with your professional organization for discipline specific resources.
2. Watch for updates: Do your best to keep up with changes in billing practices.
- The APA has been working hard to get the Centers for Medicare and Medicaid Services (CMS) to expand access to telehealth services. According to a billing update on March 30, psychological assessment, neuropsychological testing and group psychotherapy can now be billed through telehealth in Medicare during the COVID-19 crisis.
- The Office of Health Care Financing made an additional announcement on April 6, “Effective March 31, 2020, psychologists providing services through telehealth should use the place of service (POS) that would have been reported if the service had been provided in-person. CMS is making this change to identify when it is appropriate to pay a non-facility fee, rather than a facility fee which would have automatically been included under POS 02.”
Changes are happening rapidly so it’s important to be aware of news alerts and messages from professional organizations.
3. Assess your office and technology: The ability to effectively engage in tele-psychological services relies on your grasp of technology in combination with your ability to adapt these processes to ethical telepsychology. Consider looking over this Office and Technology Checklist for Telepsychological Services provided by the APA before beginning each session. Major points from the checklist are as follows:
- Consider if telehealth will work for this client. Assess the clients access to internet and webcam technology. Will you be able to effectively evaluate this client over video?
- Take inventory of the software that you own. Make sure that this technology is HIPAA compliant, secure and that you have reliable internet access.
- Before each session, prepare for as much as you can. Having plans for technology failures, crisis situations and billing hiccups can make for a smoother experience overall.
4. Use Best Practices for Assessment
Adapting assessment services to working remotely has posed a unique challenge for practitioners. Many assessments are standardized using in person contact, which makes administering them over videoconferencing software a less than ideal endeavor. According to APA guidance, there are a few key principles to be mindful of when conducting telehealth assessments:
- Avoid sending your client assessment materials that might jeopardize the security of the measure.
- Do your best. These are novel situations, which require novel solutions. Be considerate of your client’s circumstances (age, mental health condition, physical ability) and ensure that the clients environment is as distraction free as possible
- Anticipate a change in data quality. If the validity of the measure being used will be dramatically affected by the remote experience, be sure to adjust. Use your professional judgment to substitute tests and subtests with more accessible measures for the time being. Contact the test publisher for suggestions for suitable substitutions.
- Widen confidence intervals when interpreting data from tele-assessments. The information provided by these tests should be used as a small piece of a larger clinical picture. Be sure to include any adjustments to the assessment process in your write up.
- Uphold the same ethical standards that you would in person.
5. Make Self Care a Priority
Remember to take time for yourself. Yes, the folks you serve need extra support right now but so do you. You might feel tempted to work longer hours to meet the growing needs of your clients, however you must remember that it is impossible to pour from an empty cup. Honestly assess your emotional, psychological and spiritual wellbeing on a regular basis. Seek personal psychotherapy and other resources for health as needed. Schedule time for yourself, it can be easy for the work life balance to be disturbed when there is no physical separation from your workspace and home. Spending time with your kids, going on walks and speaking with loved ones is especially important right now. To neglect your self-care is doing a disservice to all those who rely on you both professionally and personally.
We hear you, and are honored to support you in these difficult times. Following these five tips will hopefully ease some of the stress of abruptly adjusting to a new professional landscape. Please do not hesitate to reach out to WPS with questions and concerns about using our assessments remotely. We sincerely hope that you and your family remain safe and healthy. Thank you for all that you do.
Taryn Thrasher is a research assistant at WPS.