Pivoting to Telehealth

“Everyone really rose to the occasion and made a collaborative investment in our patients and our programming to keep people safe while maintaining continuity of care,” says Jodi Pultorak, LCSW, Executive Director of Outpatient Services at Princeton House, who helped coordinate this effort.

Behavioral health providers were trained using a HIPAA-secure videoconferencing platform called BlueJeans, and therapists began facilitating virtual group therapy sessions three hours a day for three or five days per week, depending on patient acuity. Outpatients also have had virtual access to medication check-ins with psychiatrists, family meetings, individual therapy when needed, and allied clinical therapy sessions like yoga, music, and art.

In addition to providing essential care, Princeton House clinicians have found that maintaining connections with others in this way during a time of social distancing was critically important to patients.

“Many patients were so happy to see other members of their group, and they readily welcomed new individuals they hadn’t met before,” says Pultorak. “A video platform has far-reaching advantages beyond phone therapy sessions, including the ability to read body language and expressions while enabling a stronger care connection.”

Tips for Effective Telehealth Sessions

Whether you’re continuing social distancing protocols or making virtual therapy part of your offerings moving forward, below are some tips to create an engaging, comfortable therapeutic environment for both provider and patient.

Set Up the Scene

• Find a quiet space with minimal distractions. 
• Center yourself on the screen so you are visible from the waist up, enabling patients to benefit from your body language.
• Sit up tall with your device’s camera at eye level.
• Use soft, diffused natural lighting when possible.
• Use expressions, gestures, nodding, and “leaning in” to engage patients.
• Give it a test run to make any necessary adjustments.

Pin Down the Etiquette

Encourage patients to be:

• On time
• Present (not walking around or making coffee)
• Dressed appropriately and out of bed, which also has a mental health benefit

Guide the Group

• Aim to limit any group therapy sessions to nine people. 
• Ask patients to indicate agreement by nodding or showing a thumbs up, and to raise hands when they have questions.
• Call on individual group members for their responses to questions.

Acknowledge the Glitches

• If the dog barks or the doorbell rings, acknowledge the distraction and then move on.
• Ask patients periodically whether they’re experiencing any technical difficulties. 
• Request patience and show compassion for the situation.
• After a disruption, try a grounding exercise to re-engage patients.

Maintain a Work-Life Balance

• When possible, use a room separate from your main living space or bedroom to conduct therapy sessions.
• Mentally center yourself before and after a session.
• Set boundaries, including a schedule that doesn’t bleed into leisure and family time.
• Virtually connect to friends and family often.
• Seek support, feedback, and advice from colleagues who are also working independently.

“Everyone has been directly affected by this crisis, and we’ll be seeing the behavioral health repercussions for the foreseeable future,” says Pultorak. “It’s more important than ever to be vigilant with ourselves and our patients, and to refer patients to a higher level of care when needed.”

For more information about outpatient services, visit princetonhouse.org or call 888.437.1610.

Article as seen in the Summer 2020 issue of Princeton House Behavioral Health Today.