Beyond mimicry of traditional care

Expanding the ivsion of online consulation beyond direct psychotherapy suggests many other usefull goals ,even for POTS, the answering machine, and the fax. areas in which audio and video distance communication maybe applied include screening and case  acquosition, assessmen, diagnosis, collaborative treatment planning, informed consent, therapeutic interventions and motivation enhancment, crisis respose, client and familyueducation, case management , medication support, consulatation ,case supervision, traning, and continuing professional education.



  the  impact of the electronic medium on outcome and  process is evolving ; we can only speculate abot its future. certainly, the psychomatric properties or many clinical assessment instruments will be alterrd by administering tests and questionnaires remotely, and conclusions based on them shoul not be trusted untill the instruments have been recalibrated . simikarky, the professionl's ability to discern risks and benefits or to measure success or failure  of a service may be different whene psychotechnologies are incorported to mediate therapeutic relatiionships. circumstances strkongly influence cognitivprocessing ,as reflected in the language style and jargon  that characterize various communication media how  people speak on  ham radios  versus citizens; band radio or how they  writen in  e-mail versus snaol mail, for example. thise change in language use may have a  profound , but currently uncertain, impact on  electronically mediated treatment.

In general, studies to date have not shown significant degradation in outcome whene mental health service is delivered over two-way audio or vidio system instead of in person. absence of proof in not of absence. it is simply too early in the use of technology in psychotherapy for research to have provided the answers many clinicians  would like to have  before working with high-risk and potentially suicidal or homicidal patients.