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The growth of technology-assisted services over the past several years in many disciplines has been astounding. Although the mental health, substance abuse, counseling, and employee assistance fields have traditionally been "low tech," opportunities to provide increased access and additional services to clients through technology-enhanced products are now being recognized and more enthusiastically explored by employee assistance and mental health professionals. Health care disciplines have embraced the term "telehealth" to refer to these technology-assisted services.
Telehealth is defined as "the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision, education, and information across distance" (Kirby et. al., 1998). Behavioral telehealth is simply the application of the same technology to provide behavioral health services.
In most instances, the term telehealth has superceded the term telemedicine, though sometimes the two are used interchangeably. The media commonly used in telehealth delivery include telephones, video teleconferencing, Web sites, Web-enabled communications (such as e-mail and on-line chat interactions), and video streaming, which adds a video component to on-line chats.
The telephone, the most basic of the technology media, has been utilized by individual counselors, employee assistance (EA) professionals, and managed care companies for many years to conduct assessments, make referrals, and provide consultation, counseling, case monitoring, and follow-up services. Since the 1960s and 1970s, the telephone has served as a critical intervention tool for crisis counseling, such as that provided by suicide and depression hotlines.
Some EA professionals still question the efficacy of using the telephone for assessment and counseling, yet several major U.S. employers offer only telephone counseling (with no face-to-face option) for employee assistance program (EAP) services. This service delivery model is not without controversy. For example, some providers offer telephone "consultation" but shy away from calling these services "counseling."
Despite the widespread use of the telephone in behavioral health activities and the recent introduction of Internet/Web site/e-mail access options, few service delivery programs have written, clearly defined operational policies and procedures to guide mental health professionals …