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How Teletherapy Fits into an Effective Behavioral Health Program

How Teletherapy Fits into an Effective Behavioral Health Program

Social workers are an invaluable part of any organization, delivering high-quality, value-based care to patients and providing invaluable support to the care team. When it comes to a holistic, long-term approach to care, having access to quality therapy or counseling services is of the utmost importance. These services are also required for any healthcare organization seeking to become a CCBHC.

This month for National Social Work Month, we’re looking at how teletherapy fits into an effective behavioral health program. If your healthcare organization is considering incorporating counseling services into your behavioral health program — or expanding your existing programs — licensed clinical social workers (LCSWs) can be a good place to start.

This piece will break down the benefits an LCSW can bring to your organization, the different treatments and modalities they can provide, and why teletherapy might be the best way forward for your team.

What LCSWs bring to the table

LCSWs are highly-trained providers who can provide a wide variety of services, depending on their specialization. The two biggest categories for these specializations are micro and macro social work. In general, macro social is looking at the larger population and making a difference there, whereas micro social work is working with individuals or family units. In most cases, your organization will likely be looking at LCSWs who specialize in individuals or families.
Because LCSWs deliver counseling and therapy services rather than psychiatric or medical services, they cannot prescribe. But, importantly, they can diagnose patients and should be familiar with the DSM-5.

Common treatment modalities that LCSWs specialize in include:

  1. Cognitive behavioral therapy (CBT): Commonly referred to as “talk therapy,” CBT hones in on how thoughts and feelings influence behaviors — and how those behaviors can lead to psychological problems. LCSWs can utilize CBT methods to help patients identify and work through these thoughts and behaviors.
  2. Crisis intervention model: The crisis intervention model is commonly used for individuals experiencing crisis and trauma and consists of seven stages: Conducting a psychosocial assessment, rapidly establishing a rapport, identifying the crisis cause, enabling the patient to express their emotions, establishing safe alternatives for coping, creating an action plan, and following up with the patient.
  3. Solution-focused therapy: This treatment modality involves an LCSW working closely with a patient to identify a problem and create a solution plan based on that patient’s individual strengths. This short-term practice model helps individuals cope effectively with the challenges they’re facing.
  4. Dialectical behavioral therapy (DBT): DBT is a modified approach to CBT. The primary goals of DBT are to enable people to develop healthy ways to cope with stress, regulate their emotions, and improve their social relationships. While DBT was initially created to treat patients with Borderline Personality Disorder (BPD), it has proved effective for those experiencing eating disorders or substance use disorders.

Additional treatment modalities that LCSWs can utilize to benefit your healthcare organization’s behavioral health program include motivational interviewing, mind body bridging, brainspotting, eye movement desensitization and reprocessing (EMDR), and acceptance and commitment therapy.

How LCSWs fit into your organization’s treatment strategy

Their ability to effectively diagnose patients makes LCSWs an effective first line of treatment or screening for health systems, outpatient clinics, and community health centers. Having LCSWs available for initial patient interactions is often more efficient for most healthcare organizations. Additionally, it’s more cost-effective to have an LCSW on hand to manage less acute diagnoses that don’t need medication management. Then, for more acute diagnoses, an LCSW would be able to refer the patient to a psychiatrist or PMHNP on your care team.

In most outpatient settings, LCSWs can function as part of a larger integrated care system where they need to provide access to counseling services and psychotherapy along with medication management and psychiatric care. Having LCSWs be the first line of defense in your treatment plan can be beneficial to pointing patients in the right direction and identifying the best path forward for their care plan.

From a behavioral health standpoint, it’s hard to overstate the value an LCSW or counseling provider will bring to your organization. But it’s important to find the right provider for your organization, your patient populations, and your goals. Opening yourself up to teletherapy providers can help you through that process.

Benefits of LCSWs in the ED

In the emergency department (ED) setting, LCSWs are critical to patient satisfaction and a hospital or health system’s reputation in the community. Whether they’re helping someone access food vouchers, connecting a patient to ancillary services, or talking with a patient’s family members, LCSWs are thinking about the patient’s holistic needs.

LCSWs often serve as a communication link between nurses, physicians, and other support staff. They often help prepare patients for transitions, imaging, labs, and admission. LCSWs can also help with patient and family communication through their hands-on approach to care – including helping families understand a patient’s illness and engaging with the family to help them feel supported after they leave the ED.

In the ED, LCSWs take ownership of the psychosocial dimensions of a person, and in psychiatry, that’s critical. These psychosocial dimensions include relationships, living situations, access to housing, finances, and food. These components are essential to the wellness and decision-making that goes into treatment formulation for the patient in the ED.

How LCSWs can help your organization build an effective integrated care model

As part of an effective integrated care model, a combination of medication management and psychotherapy is necessary. That means your organization will likely need to build up a program that includes therapists or counselors on staff — or potentially expand the counseling services you already have.

There are studies showing that utilizing CBT or other therapy modalities can effectively treat less acute diagnoses without medication. And, if you have a good LCSW, you can utilize their services in addition to medication to assist the overall success of your treatment plans for a given patient.

Why teletherapy services may be the best fit for your healthcare organization

There’s no denying that, for an LCSW, the rapport they can create with a patient is key to their improvement. But it’s a common misconception that it’s more difficult to build that connection over video. A well-trained LCSW can absolutely build just as strong a therapeutic relationship virtually as in person. Almost every in-person modality an LCSW can specialize in can be translated effectively in a virtual setting – including brainspotting and EMDR.

That means if your organization is cutting yourself off from engaging in teletherapy, you’re limiting the quality of your program — and your ability to expand it.

Additionally, embracing teletherapy in your organization means patients can take the session wherever they’re most comfortable. With that freedom, some patients can be more willing to open up. The flexibility to choose their locations can also decrease no-show rates or open up access for people experiencing conditions that may make it difficult for them to feel motivated to leave their homes.

However, you may still have patients who prefer seeing their provider in person. So, when possible, we would recommend offering both in-person therapy or counseling services and teletherapy services.

How your organization can set your LCSWs (and your treatment team as a whole) up for success

When bringing LCSWs in or expanding your teletherapy services, it’s important to ensure those providers feel valued. There can be a tendency to undervalue LCSW when compared to psychiatrists. It’s important to make sure they feel like they’re part of the team.

Then, for your own organization, you should work to identify the particular specializations or modalities you need when staffing LCSWs. And remember, if you are open to teletherapy services, partnering with a vendor like Iris Telehealth can help you identify carefully vetted, high-quality providers for your organization. If you’re interested in learning more about Iris Telehealth’s LCSWs, contact us today, and we’ll get the conversation started.

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