Utilizing Distance Technology for Mental Health Counseling

Distance counseling (telecounseling) is a method of service delivery with potential to supplement traditional mental health counseling. Background information on telecommunications technology is provided and discussed in relation to distance education and telemedicine. The challenges of using this mode of communication in mental health settings involve potential technological difficulties, discomfort with technology, relationship development, access to technology, and ethical issues. Strategies are recommended to combat these challenges. Advantages of distance mental health counseling include increased resources, cost-effectiveness, convenience, and efficiency. Although telecounseling will not replace the conventional mode of service delivery, it could become an essential component to improve the accessibility of mental health counseling. Today's mental health counselors are faced with many challenges that have an impact on the services they provide. One challenge involves serving consumers with mental illnesses who are unable or unwilling to travel to mental health agencies. For instance, some individuals have illnesses, domestic obligations, and/or live in geographic locations that do not allow for frequent trips to mental health agencies. In particular, individuals with mental illnesses may not be able to access traditional treatment due to the nature of their disorders. Bond (1995) indicated that individuals with chronic mental illnesses have impairments in areas of living such as self-care, self-direction, interpersonal relationships, learning, and independent living. These individuals typically have difficulty functioning in their living, learning, and working environments. Further, individuals with chronic mental illnesses often lack the energy and initiative necessary to travel to mental health agencies. Additionally, the presence of specific mental illnesses such as panic disorder with agoraphobia can cause individuals to become totally housebound (Swinson, Fergus, Cox, & Wickwire, 1995) and unable to access mental health services. Individuals with mental illnesses are underserved, and many never receive counseling (Sampson, Kolodinsky, & Greeno, 1997; Swinson, Cox, & Woszczyna, 1992). These individuals need counseling to increase their functioning and quality of life (Anthony, Cohen, & Farkas, 1990). One remedy for these problems is to supplement traditional services with distance mental health counseling (telecounseling) for individuals unable or unwilling to travel to mental health agencies. Telecounseling, a concept derived from telemedicine and distance education, involves counseling and support when distance or time separates the consumer from the counselor. Although telecounseling has been discussed at length in the medical and educational fields, no reports found in the literature discuss the direct application of distance technologies to mental health counseling. This article is designed to provide a brief background on distance technology services. Furthermore, it focuses on the special challenges, advantages, and ethics associated with providing counseling to individuals via telecounseling. Strategies recommended for effectively applying technology to the mental health profession are also addressed. BACKGROUND The ability to provide services at a distance relies on a variety of technologies from simple systems (e.g., telephone, audio and videotapes) to more complex systems, (e.g., Internet, audio conferencing, facsimile machines, and real-time video). The use of the telephone as a component of health care has been discussed at length in the literature. Telephone communication systems have been key to suicide hot lines, 24-hour counseling services, and mental health consultation in inaccessible regions. Furthermore, counselors have used telephones to assess obsessive-compulsive disorders (Baer, Brown-Beasley, Sorce, & Henriques, 1993) and to test for the human immunodeficiency virus (HIV) (Frank et al. …