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Tips for making the most of your first mental health telehealth appointment

By Dr. Sabrina Stutz, pediatric psychologist at CHOC Children’s

Mental health services don’t always need to be carried out in person. Services can be delivered via a smartphone, tablet or computer. You and your child can engage in mental health services for telehealth from any private location with internet access.

If you are new to mental health telehealth services, here’s a guide for how you can prepare for your visit virtual appointment and what to expect, plus benefits of telehealth for mental health and answers to some commonly asked questions.

What happens before my first visit?

  • CHOC’s psychology team will email you a secure link for your virtual appointment. It is recommended that you practice signing onto the teleconference link prior to your visit.
  • We will also email a link to consent to mental health evaluation and treatment, for you to review and sign prior to your appointment.
  • We recommend that you find a place with stable internet service and good lighting in which you and/or your child can speak openly and freely with privacy.
  • Please ensure that a parent or adult caregiver will be physically present in the same location as the child at all times during telehealth mental health visits in case of emergency.

Who needs to be at the first telehealth mental health session?

Both a legal guardian and the child should be present at the beginning of the first session to go through the consenting process. It is recommended that the primary caregiver and the child be in the same physical location for the first appointment.

What will we talk about?

Your clinician will introduce themselves and confirm that a legal caregiver and child are present. They will review and confirm your contact information in the event of technology disruption or an emergency. Then, your clinician will review the consent process and answer any questions about using the teleconferencing software.

After the family consents to services, the clinician may wish to speak to the parent(s) and child separately. Your provider will review your concerns and your child’s history, and will offer feedback and recommendations/resources at the end of your visit. They will also answer any questions or concerns you may have about your child’s symptoms.

Is telehealth therapy as effective as in-person therapy?

Yes! Telehealth-delivered therapy techniques have been studied for over a decade. Many evidence-based therapies have research to prove that they are just as, if not more effective when delivered via telehealth. Cognitive behavior therapy (CBT), trauma-focused interventions, and parent-coaching models all have research to support their effectiveness when delivered online by a trained, licensed provider. Some minor adaptations can be made to ensure appropriate delivery of most evidence-based outpatient therapeutic interventions online.

What are the benefits of receiving mental health therapy via telehealth?

Telehealththerapy is a great way to access mental health services from the safety, comfort and convenience of your own home. Here are some of the other benefits of telehealth delivered therapy that families and clinicians have shared:

  • Families find it easier to attend sessions.
  • Families have flexibility in their schedule when cutting out commute time.
  • There are reduced childcare costs for untreated siblings.
  • Families save time, especially during high-traffic appointment times or when living far away.
  • Therapy is still accessible when on vacation within the state of California.
  • Children who might be nervous to do therapy feel more at ease using telehealth for a first session. Then, they are more likely to follow-up with telehealth mental health sessions afterwards.
  • Family members in separate locations can both attend a therapy session without having to be in the same location.
  • Parents at work can call in on their breaks to participate in family sessions.
  • Children and families are better able to remember and use coping skills when they have learned and practiced them in their own home environment.
  • Clinicians can see and live-coach families through difficult home-based situations like picky eating at mealtimes, setting behavioral limits such as a time out, or supporting a child in accepting a medical intervention such as  injections, pill-swallowing or nebulizers.
  • Clinicians have a richer and more nuanced understanding of families when they can see them in their home environment.
  • Clinicians can make more personalized and immediate recommendations. For example, “That looks like a great spot to put a reminder to check your blood sugar! Let’s create a reminder together and put it up during our session today.”

My child has trouble keeping their attention on the screen. What can you do for them?

The mental health community has created inventive and engaging ways to keep a child engaged over telehealth! Your clinician will talk with you and observe your child to assess their capacities for sustained attention, and can adapt interventions to fit their needs. For some children, we may ask parents to print out or set up certain activities before the therapy session to help facilitate. Other engagement strategies include share-screen therapeutic drawing and games such as Pictionary or Heads Up, gratitude scavenger hunts, “show and tell” topics, and parent-assisted relaxation exercises. If a child is unable to interact over telehealth, parent training models in which the therapist helps coach the parent to interact therapeutically with their child, are available.

How can I ensure my privacy?

 CHOC clinicians hold your confidentiality and privacy rights during telehealth sessions as seriously as they do when you come to the office. During a mental health telehealth appointment, your clinician will be in a private space where no one can see or hear them, and will be using secure, encrypted video conferencing software. We recommend that you access any mental health telehalthe services through your own password protected device on a password protected internet network to maximize your privacy. You may also wish to use headphones in order to have a more private conversation when sharing a home with others. For some very sensitive conversations, some families have chosen to step out to their cars or another more private location.

I have to work, but my child is home with another adult. Can we do a mental health visit via telehealth?

 For the first session, it is best if a legal guardian and their child can be together in the same location. Please contact your clinician for questions about special circumstances. For follow-up sessions, it will be up to you and your clinician to determine whether it is appropriate for the parent to call in from work while the child is at home with another trusted adult caregiver. Please talk to your clinician in advance of any adjustments that might need to be made for the supervision of your child during scheduled therapy sessions.

What if my child has very serious mental health symptoms?

If your clinician feels that your child’s mental health symptoms are too severe to manage over telehealth, they will review their recommendations and alternative options with you.

If you are concerned your child may be having a mental health emergency, do not wait for a telehealth mental health appointment. Instead, contact one of the crisis lines below, go to your nearest emergency department, or call 911.

  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Crisis Text Line: Text HOME to 741-741
  • Orange County Crisis Assessment Team: 866-830-6011

If it becomes clear to a mental health clinician during the course of a telehealth session that your child is having a mental health emergency, the clinician will advise you to go to the nearest emergency room or call 911.

Learn more about mental health services at CHOC

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2 thoughts on “Tips for making the most of your first mental health telehealth appointment”

    1. Telehealth visits are billed the same way as in-person appointments. You may be billed your standard co-pay for a visit. Telehealth visits feature your primary care physician or specialist, so you can expect the same high-quality care you’d receive at any CHOC appointment.

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