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Practical tips for telepsychiatry sessions

CrossCurrents

In some ways, a remote consultation is just like a face-to-face one: Practitioners strive to develop a good rapport and relaxing atmosphere.  But clearly, distance and technology create a barrier between practitioner and client, which gives telepsychiatry its own unique dynamic. Here are some tips from Canadian experts on how to best navigate the technology and conduct successful consultations.

Orient clients to the technology and the process. At the start of each session, consultants should introduce themselves and anyone else in the room, says Toronto pediatric psychiatrist Dr. Tony Pignatiello. Introduce the program fully and explain what's going to happen. New clients will feel more comfortable if they understand basics like where to sit and how loudly they may need to speak. And they should be forewarned about any delay time they may notice while talking over the video interface.

Use humour. Pignatiello says humour can be a good way to break through the barrier of distance. Although many kids are not intimidated by telepsychiatry's video interface, they may be bored at the prospect of sitting in a room with a talking head on a screen. Pignatiello uses a friendly demeanor and light humour to engage and involve kids.

Have objectives. Lack of personal contact makes it challenging to keep telepsychiatry sessions focused. Halifax pediatric psychiatrist Dr. Herb Orlik suggests that consultants should confirm each session's objectives at the beginning and work hard to stay on topic. Doctors should beware of the tendency for sessions to slip into what Orlik calls "general advice mode."

Let kids get involved. Orlik says kids often become most engaged with the process when they are given control. He lets teenagers operate the camera zoom lens, letting them decide how close-up or far away the screen shot will be. "A camera on a teenager's face can feel very intrusive. If they have control over the zoom, they can get more comfortable with the session."

Cindy McGlynn