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E-Therapy Guidelines

Introduction

1. The Center for Substance Abuse Treatment (CSAT) of the U.S. Department of Health and Human Services (HHS) has been especially interested in building substance abuse treatment capacity through electronic means (E-therapy) for hard-to-reach and traditionally under-served populations.

A. True

B. False


Overview-What is E-Therapy

2. E-therapy is the use of electronic media and information technologies to provide services for participants in different locations, and it can do each of the following EXCEPT:

A. Include a range of services, including screening, assessment, primary treatment, and after care

B. Provide more accessible modes of treatment than the traditional ones to those who actively use the recent development of technology, such as adolescents and young adults

C. Provide text-based forms of communication such as telephoning and videoconferencing

D. Be provided as a sole treatment modality, or in combination with other treatment methods


3. E-therapy's asynchronous communication is facilitated through instant messaging, chat rooms, telephone, and videoconferencing, and it is not recommended for use with other treatment strategies.

A. True

B. False


When is the Use of E-Therapy Appropriate?

4. Which of the following is NOT one of the specific groups that experts have identified as people for whom E-therapy may be suitable?

A. Persons located in remote and rural areas such as American Indian/Alaska Native territories

B. Underserved populations such as the elderly and the developmentally disabled

C. Ethnic and racial minorities, women with children, and people from low-income families

D. Adolescents and young adults who have a familiarity with computers and the Internet and a willingness to utilize technology


How Effective is E-Therapy?

5. Determining the degree to which E-therapy is effective should be based on both empirical research demonstrating a reduction in symptoms and:

A. Client perceptions of the care they received

B. The diversity of clients who chose E-therapy

C. The percentage of those who sought online therapy and then later moved on to face-to-face treatment

D. All of the above


The Efficacy of Specific Approaches

6. A 2003 study by Castelnuovo and colleagues indicated that the Internet can improve treatment delivery in the areas of :

A. Motivational and cognitive behavioral therapies

B. Individual and self-help therapies

C. Interpersonal and talk therapies

D. None of the above


Summary

7. A challenge associated with E-therapy includes the ______________, which is the term used to characterize disparities in access to computers and the Internet.

A. Technological shortcomings

B. Electronic discrepancies

C. Automated deficiencies

D. Digital divide


Evaluation: Introduction

8. Research on substance abuse treatment using E-therapy is sparse, and evaluation of programs using E-therapy as a stand-alone treatment is limited to research on alcohol abuse treatment services.

A. True

B. False


Outcome Measures and Clinical Significance

9. Evaluation criteria for screening and assessment of substance use disorders generally include at least two measures: biochemical markers and patient self-reports.

A. True

B. False


Outcome Measures and Effectiveness

10. Which of the following is NOT one of the issues that need to be addressed to facilitate the successful integration of evaluation and e-therapy?

A. Ethnic and cultural mistrust for mental health and substance abuse treatment services and providers in communities of color

B. Technology failures, contingency planning for disconnections, crashes, and other breakdowns

C. The potential client's social connectedness to family, friends, coworkers, or classmates

D. Barriers in communication, such as the inability to tap into nonverbal communication and cues


Process of Care

11. The process measure that asks, "Does the technology enhance service delivery or clinical management?" is called:  

A. Technical capacity

B. Diagnostic accuracy

C. Therapeutic impact

D. Diagnostic impact


Design Considerations

12. Experts believe that advancement of E-therapy in substance abuse treatment must be science-based and substantiated by data or other relevant information, and that _________________ provide the strongest study design.

A. Randomized controlled trials

B. Descriptive studies

C. Case reports or anecdotes

D. Case-controlled studies


13. CSAT reports that substance abuse treatment is effective at reducing primary drug use by approximately ___  percent, criminal activity by ___ percent, and alcohol- and drug-related medical visits by ___  percent.

A. 40; 70; 40

B. 45; 75; 45

C. 50; 80; 50

D. 55; 85; 50


Summary

14. Common outcome measures for substance abuse treatment that should be considered if using E-therapy include abstinence, reduced use, decreased symptoms, improved functioning, and engagement and retention.

A. True

B. False


Cultural and Linguistic Competency-Knowledge of Culture and Ethnicity

15. Linguistic competence is especially relevant in the delivery of services via electronic forms of communication, and English-proficient providers cannot assume that all persons accessing E-therapy services understand English as well as the clinician.

A. True

B. False


Barriers to Cultural Competence

16. The four counseling inadequecies that may be encountered when delivering culturally appropriate mental health treatment online include all of the following EXCEPT:

A. Lack of culturally appropriate online interventions and evaluation tools

B. Lack of awareness about communication styles

C. Limited access to technology in communities of color

D. Lack of information about negative stigma associated with mental health treatment


Legal and Regulatory Issues

17. To date, New York and Texas have passed the most comprehensive legislation related to the conduct of E-therapy, and only clinical psychologists or medical doctors licensed in the State of New York can administer E-therapy to clients who are state residents.

A. True

B. False


Ethics

18. While a few organizations have ethics codes created specifically for E-therapy, others have adapted their existing codes of ethics to include electronic communication.

A. True

B. False


Administrative Issues

19. For a licensed therapist practicing E-therapy, experts recommend securing clients’ electronic records by utilizing password protection programs and: 

A. Computer network firewalls

B. Wiping software

C. Document encryption

D. All of the above


Administrative Responsibilities-Client Records

20. Electronic client files and online communications are protected by very different regulatory procedures and confidentiality polices than those required for the storing of paper records.

A. True

B. False


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