Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA.
Northern California Veterans Administration, Sacramento, California, USA.
Telemed J E Health. 2021 Sep;27(9):982-988. doi: 10.1089/tmj.2020.0076. Epub 2021 Jan 12.
Asynchronous telepsychiatry (ATP) is an integrative model of behavioral health service delivery that is applicable in a variety of settings and populations, particularly consultation in primary care. This article outlines the development of a training model for ATP clinician skills. Clinical and procedural training for ATP clinicians (n = 5) was provided by master's-level, clinical mental health providers developed by three experienced telepsychiatrists (P.Y. D.H., and J.S) and supervised by a tele-psychiatrist (PY, GX, DL) through seminar, case supervision, and case discussions. A training manual and one-on-one sessions were employed for initial training. Unstructured expert discussion and feedback sessions were conducted in the training phase of the study in year 1 and annually thereafter over the remaining 4 years of the study. The notes gathered during those sessions were synthesized into themes to gain a summary of the study telepsychiatrist training recommendations for ATP interviewers. Expert feedback and discussion revealed three overarching themes of recommended skill sets for ATP interviewers: (1) comprehensive skills in brief psychiatric interviewing, (2) adequate knowledge base of behavioral health conditions and therapeutic techniques, and (3) clinical documentation, integrated care/consultation practices, and e-competency skill sets. The model of training and skill requirements from expert feedback sessions included these three skill sets. Technology training recommendations were also identified and included: (1) awareness of privacy/confidentiality for electronic data gathering, storage, management, and sharing; (2) technology troubleshooting; and (3) video filming/retrieval. We describe and provide a suggested training model for the use of ATP integrated behavioral health. The training needs for ATP clinicians were assessed on a limited convenience sample of experts and clinicians, and more rigorous studies of training for ATP and other technology-focused, behavioral health services are needed. Clinical Trials number: NCT03538860.
异步远程精神病学（ATP）是一种综合的行为健康服务提供模式，适用于各种环境和人群，特别是在初级保健中的咨询。本文概述了 ATP 临床医生技能培训模型的发展。通过三位经验丰富的远程精神科医生（P.Y.、D.H. 和 J.S.）和一位远程精神病医生（P.Y.、G.X. 和 D.L.）的研讨会、案例监督和案例讨论，为 ATP 临床医生（n=5）提供临床和程序培训。培训手册和一对一课程用于初始培训。在研究的培训阶段（第 1 年）和研究的剩余 4 年内每年进行一次非结构化的专家讨论和反馈会议。在这些会议期间收集的笔记被综合成主题，以总结研究远程精神病医生对 ATP 访谈者的培训建议。专家反馈和讨论揭示了 ATP 访谈者推荐技能集的三个总体主题：（1）简短精神病访谈的综合技能，（2）行为健康状况和治疗技术的足够知识库，以及（3）临床文档、综合护理/咨询实践和电子能力技能集。培训模型和专家反馈会议中的技能要求包括这三个技能集。还确定了技术培训建议，包括：（1）对电子数据收集、存储、管理和共享的隐私/保密性的认识；（2）技术故障排除；以及（3）视频拍摄/检索。我们描述并提供了一个用于使用 ATP 综合行为健康的建议培训模型。对专家和临床医生的有限便利样本进行了 ATP 临床医生培训需求评估，需要对 ATP 和其他以技术为重点的行为健康服务进行更严格的培训研究。临床试验编号：NCT03538860。
