Therapeutic Relationship of Telepsychiatry and Telebehavioral Health: Ideas from Research on Telepresence, Virtual Reality and Augmented Reality

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Authors

  • Donald M. Hilty Associate Chief of Staff, Mental Health, Northern California Veterans Administration Health Care System, CA 95655, USA
  • Karan Randhawa Golden Ear Medical Group, Gardena, CA 90247, USA
  • Marlene M. Maheu Co-Founder & President, Coalition for Technology in Behavioral Sciences, Executive Director, Telebehavioral Health Institute, San Diego, CA 92120, USA
  • Alastair J. S. McKean Assistant Professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
  • Richard Pantera Chief, Neurology and Faculty, Department of Psychiatry & Addiction Medicine, Kaweah Delta Health Care District, CA 93291, USA

DOI:

https://doi.org/10.17140/PCSOJ-5-145

Keywords:

Communication, Engagement, Health, Reality, Relationship, Telebehavioral, Telepsychiatry, Telepresence, Therapeutic, Virtual

Abstract

Objective: This paper explores the therapeutic relationship, engagement and communication for participants using telepsychiatry
(i.e., video; TP), telebehavioral health (TBH) and other technologies.
Methods: The goal of this concept paper is to help clinicians, teachers and researchers consider the intersection of the following
three topics: 1) the therapeutic relationship in psychiatric and behavioral health care; 2) how TBH affects the therapeutic relationship,
engagement, communication, and boundaries; and 3) research findings on telepresence (TPr), virtual reality (VR) and augmented
reality (AR) applied to clinical care. A keyword search focused on concept areas: 1) therapeutic relationship, engagement,
communication, boundaries, clinical; 2) telepsychiatry, telemental or telebehavioral health, telepsychology); 3) psychotherapy via
technology; 4) computer/technology-mediated communication; and 5) telepresence related to technologies (virtual, augmented,
reality, environment).
Results: From a total of 4,712 potential references, 453 were eligible for full text review and 77 papers directly related to the concepts.
From papers’ references and a review of books and popular literature, 12 other sources of information (i.e., papers, books,
other) about TPr and VR were found. Though few studies literally discuss the therapeutic relationship, the impact of technology
on clinical engagement and communication is growing, from clinical (e.g., psychotherapy) and non-clinical (e.g., communication,
TPr) literature. The historical evolution of TPr and VR shows that definitions, foci of studies (e.g., social neuroscience to business)
and assessments vary widely. TP and TBH care can be improved by concepts of TPr, avoiding distractions, understanding
the technology-human interface, measures of TPR for clinical use and the use of simulation for training.
Conclusions: Additional evaluation/research is needed to ensure quality care, training, and evaluation of the therapeutic relationship
while preventing potential pitfalls.

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2019-02-18

How to Cite

Donald M. Hilty, Karan Randhawa, Marlene M. Maheu, Alastair J. S. McKean, & Richard Pantera. (2019). Therapeutic Relationship of Telepsychiatry and Telebehavioral Health: Ideas from Research on Telepresence, Virtual Reality and Augmented Reality. Psychology and Cognitive Sciences , 5(1), 14–29. https://doi.org/10.17140/PCSOJ-5-145

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