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Technology based
therapeutic interventions

by Dr. Alison Darcy 14 February 2008

Facilitating the move to providing community care, service providers and clinicians have capitalised on recent technological advancements. The Internet has dramatically impacted on the way people communicate, learn, and share information, and this change has occurred rapidly. Motivated by the need to bridge the gap between inpatient and outpatient care, or more practically to overcome common hurdles related to geographical location, and by the cost-effective nature of such routes, the needs of all levels of health care systems are being addressed by use of the Internet (Schmidt, 2003) and this is not just a question of moving with the times. There is also a motivation that is embedded in the media themselves. Service providers have offered interventions via analogue (telephone) or digital technologies with the aim of overcoming shame via invisibility, or enhancing therapy through removing from the equation the disturbance caused by the presence of a problematic body – in other words, creating “closeness through distance” (Skårderud, 2003, p. 156).

Since the establishment of the Samaritans in the 1950s, telephone counselling has become widely available and popular. It has been suggested that people with a rane of mental health problems may prefer this type of counselling due to convenience, anonymity and confidentiality (Hugo, Segwick, Black & Lacey, 1999). Manualised CBT programs have been successfully adapted to a CD-ROM medium (Williams, Aubin, Cottrell, & Harkin, 1998) offering greater interactivity with material than traditional manuals. And there is some suggestion that the use of technology may actually facilitate people in getting help, where they wouldn’t otherwise have (Robinson & Serfaty, 2001; Darcy and Dooley, 2007). In fact, the use of email by health practitioners, has become so commonplace that the American Medical Association developed guidelines for the use of Internet technologies in clinical practice nearly 5 years ago (American Medical Association, 2004).

Palmtop computers, text messaging (SMS), and virtual reality have all been successfully used in the treatment of people with mental health difficulties. Some of these treatment methods – telemedicine, for example – have been especially developed to overcome the common hurdle of reaching patients who are remote, while others – SMS, for example - also provide a means through which the patient can instantly communicate at any time, thereby potentially alleviating stress and/or anxiety, a common comorbid feature of many disorders. The Internet has brought a variety of systems through which these advantages can be exploited. Through embracing the tools of the future it may be possible to inexpensively tackle some of the problems inherent in traditional service delivery models.