University Distinguished Professor of Counseling Psychology Timothy Elliott, pictured, and Professor of Health Promotion and Community Health Sciences Jim Burdine, both at Texas A&M, are responsible for establishing the Telehealth Counseling Clinic with help from community partners. (Texas A&M University Marketing and Communications photo/Mark Guerrero)
Majority of clients report improved quality of life after TCC treatment
Since 2009, the clinic has provided 900 clients with approximately 9,000 free counseling sessions, a monetary value of more than $1 million in services based on an average cost of $120 per session. Clients are required to be age 13 or older, and each participates in an average of nine 45-minute sessions, available in English, Spanish or Mandarin.
Approximately 65 percent of the clients are uninsured, which makes delivering the services free of charge essential to the clinic. Many of them use emergency rooms as their primary care settings for both physical and mental health problems, including attempted suicides and the intense physiological symptoms that accompany panic and anxiety attacks.
During their first sessions, 42 percent of clients report having suicidal thoughts, and nearly half of them say their mental health problems make working, managing their homes and getting along with others difficult. Often, they also are dealing with physical health problems, and most are experiencing financial difficulties.
By alleviating depression and establishing safety plans for clients, the clinic is improving and even saving lives. From a practical standpoint, the clinic also helps to avoid the expenses associated with some emergency room visits as well as inpatient hospital stays that cost an average of $23,000, McCord said.
Group therapy, the latest addition to the clinic’s offerings, connects multiple residents from different counties for sessions through telehealth technology. This type of therapy has proven particularly valuable in rural areas where finding five individuals with the same issue who are available to meet at the same time is often challenging. Generally, group therapy provides clients with the benefits of the shared experience, a complement to individual counseling.
After five counseling sessions, the majority of the clients show significant clinical and statistical decreases in depressive symptoms, and almost all of them report dealing more effectively with their problems.
Eventually, the clinic aims to offer in-home videoconferencing, especially in rural areas without public transportation systems. This offering is not expected to change the role satellite clinics play in serving clients.
“There is still a digital divide for rural areas with poor Internet connectivity, and clients may not have computers or smartphones, or their phone data plans may not support home video sessions,” McCord said. “From a clinical perspective, getting severely depressed clients out of their houses for appointments at satellite clinics is often a valuable part of their treatment plans.”
While videoconferencing is the clinic’s main mode of conducting counseling, telephone sessions also are available to clients in their homes and workplaces. Some clients take advantage of phone sessions from their cars during their lunch breaks at work.
TCC aims to improve, increase telehealth training nationally, globally
Since 2009, the TCC has trained more than 50 doctoral students in telepsychology and involved more than 40 researchers in its program.
In addition to counseling and research, the students perform their fair share of social work. On behalf of their clients, they communicate with mental health authority caseworkers, welfare offices, food banks and physicians, when necessary.
Many students choose to pursue careers in telepsychology so they can use their knowledge and experience to make a difference in provider shortage areas, sometimes their hometowns, across the nation and around the world, McCord said.
“It’s awesome serving the surrounding community, but the change agents we are creating, the leaders at the cutting edge of what we are doing in health care, sending out Aggies to go change the world, literally, now that’s something to invest in,” McCord said.
A gap exists between the telepsychology wants and needs of consumers and communities, and the telepsychology training provided students entering the workforce, as well as professionals already in practice.
“This is why I am so passionate about helping other programs add telehealth training to their clinics,” McCord said.
The faculty and students have produced over 40 conference presentations, papers and research posters, and composed 10 articles published in peer-reviewed journals.
Five continuing education units, including telehealth 101, laws and ethics of telehealth, and managing crises and emergencies in telehealth, are available online. The online training helps fulfill the clinic’s mission to extend mental health care to areas without adequate resources, and nominal fees for the courses help sustain the program.
Additionally, training provided by TCC faculty provides financial support. For example, the U.S. Department of Defense recently hired McCord and her colleague to train Army and Air Force mental health practitioners on a United States Air Force base located in Italy.
McCord and her colleagues are in the process of developing a comprehensive sustainability model for the program to cover operating expenses in the absence of grants that soon end. Most grants, such as those secured to launch the clinic, do not provide funding to sustain existing programs.
“Our students are learning creative ways to find funding outside traditional channels,” McCord said. “With a lot of hustle, anyone can provide these services to the underserved.”
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