Social withdrawal and isolation are tell-tale signs of post-traumatic stress disorder. Many who suffer from mental illness are prone to these symptoms. While telemedicine may be designed to deliver healthcare remotely in the more literal sense, there is no reason it cannot be used to treat our nation’s multitude of veterans, victims and seniors suffering from PTSD.
Telemedicine is also referred to as telehealth. Fittingly enough, when applied to matters of mental health, the term ‘telemental health’ has been used. Experienced telehealth practitioners are already aware that all arrangements made on both ends of the connection play a role in the success of any session’s outcome. No detail should be dismissed. The quality of the video images, proper lighting and stationary chairs make for a good start. For a patient with PTSD, it all comes down to safety, comfort and trust.
With proper planning and preparation, it should not matter that patient and clinician are not in the same room. Let’s not spare any details as we consider what makes for a successful telemental health session with a patient suffering from post-traumatic stress disorder.
- Treatment protocol does not need to change much at all. If the treatment is evidence-based, location should not matter.
- Always implement pre-treatment orientation sessions to assess patients’ motivation, not to mention their understanding of the treatment and technology.
- Have copies of any patient materials on hand, such as worksheets and handouts, while explaining or reviewing them.
The planning and preparation of the professional only accomplishes so much. What tends to trigger social withdrawal and isolation in PTSD victims is something called hyperarousal. It is a symptom where the body’s fight or flight mechanism is being activated repeatedly. The patient is always on high alert, scanning his or environment for danger. This is known as hypervigilance.
Remember, there may be no one with the patient on their end of the process. The utmost care must be taken in terms of digging deep into their trauma. In fact, that approach is not recommended. Instead, there is basic PTSD education, symptom management, coping skills training and stress management.
Two other familiar features of post-traumatic stress disorder could complicate matters for telehealth interventions. The flashbacks that have always been associated with surviving PTSD are collectively referred to as intrusion. Intrusion affects the patient’s ability to be present or pay attention. Along with that, these survivors are known to “numb” themselves to avoid feelings. Also, known as constriction, the symptom is associated with apathy, indifference and disassociation with people, places and things that are reminiscent of the trauma. All of the above will make individuals difficult to read or access in any situation. This must be kept especially in mind while treating them remotely.
The bottom line is that all of the above leaves PTSD patients more than a bit fatigued. Even if they muster the will to travel locally, the nearest facility may still need to remotely access the level of care they require. Either way, ‘tele-‘ refers to the distance, which is solved by technology. ‘Health’ and ‘medicine’ still require a personal touch. Mental health provides an excellent opportunity for telehealth practitioners to refine the more subtle aspects of their profession.