Can video counseling serve as a useful and accurate tool for assessment and treatment of substance-using patients who live a good distance from primary treatment sites? A reader contacted me the other day and would like some guidance from her colleagues as her facility plans to incorporate use of this technology.
Kathy Wikman is an addiction counselor who works at the Jonathan Wainwright VA Medical Center in Walla Walla, Wash., and she is admittedly skeptical about the potential of video in place of face-to-face counseling. Kathy writes that “some of my general concerns include completing accurate assessments in the absence of ability to smell (!), observe body language, and even check out physiological indicators of withdrawal (can’t see those pupils at all on VTEL, or see if there’s a tremor in those hands, which are not in view).”
Wikman adds, “I also wonder about the difficulty of establishing a sound therapeutic relationship using a ‘television.’ The technology seems a bit ‘cold’ to me.”
The VA facility in Washington is seeking to use video telephone counseling in screening, assessment, and individual and group counseling, and hopes this could lessen the amount of time that clinicians have to spend traveling to community-based outpatient clinics scattered across the service area.
What are your experiences with use of video technology in clinical services for people with addictions? Should our reader be optimistic or wary about the possibilities?