Staff Perspective: Technology in Treatment

Staff Perspective: Technology in Treatment

Dr. Sharon Birman

Over the past year, psychotherapy has undergone a revolution inspired by the widespread availability of digital technology. It was not long ago that psychotherapy was considered an intimate face-to-face connection between two people, unassisted by external apparatuses. Even with the increased popularity and accessibility of telemental health, some reservation remains regarding the role of technology in psychotherapy. This can be attributed to a variety of factors, including provider reluctance, the complexity of integrating technology while complying with HIPPA regulations and state laws, and adapting to healthcare reform. Despite the reluctance that some experience, telemental health care has been recognized as a critical agent of change in the field.

Even before the COVID-19 pandemic, large agencies established the benefits of leveraging technology in psychotherapy. For example, the Department of Defense (DoD) TRICARE program was launched in 1988 to provide comprehensive healthcare coverage to all beneficiaries including uniformed service members, retirees, and their families around the world. Given their global reach , TRICARE began to use secure video conferencing to provide medically necessary services, including telemental health services. Similarly, organizations such as the U.S. Department of Veterans Affairs have leveraged telehealth services to reach those who live in rural areas, encounter transportation difficulties or otherwise face barriers to care.

In fact, a large-scale meta-analysis found that telemental healthcare is an extended domain supportive of conventional mental health services, offering providers a wide variety of innovative approaches for intervention. While being comparable to in-person services, telemental healthcare affords effective and adaptive solutions that are often inexpensive and advantageous, particularly in populations with difficulties accessing care (Langarizadeh et al., 2017). In their review of the literature, researchers identified several areas in which telemental health can significantly enhance care.

  1. Capabilities: telemental healthcare allows for automated evaluation, minimizing traditional evaluation methods which are time-consuming and costly.
  2. Online information exchange and support services: new advances in technology and informatics have allowed for increased interaction among providers and patients, facilitating enhanced learning opportunities for training and consultation, while offering programs to better support the psychological needs of consumers.
  3. Psychiatric consultation in medical settings: technology enables mental health consultation in medical settings, such as primary care and emergency departments, providing patients with holistic treatment plans that meet their physical and mental needs.
  4. Asynchronous psychotherapy: asynchronous treatment has enabled remote consultation and continuity of care enhancing access and quality of care for individuals in secluded geographic areas.
  5. Home care and related interventions: provision of care in the home via video conferencing and telephone can enhance follow-up for many patients, while reducing cost (Langarizadeh et al., 2017).

Other experts in the field, such as Imel and colleagues (2017), argue that technology can notably enhance psychotherapy research in the following ways:

  1. Mechanism and process: Modern technologies such as machine learning models, automated speech recognition, and natural language processing algorithms enable the possibility of replacing human evaluators and considerably improving scale and specificity in studying treatment mechanisms.
  2. Training and feedback: Technology enables real-time performance-based feedback, which is critical for the development of skills and expertise. Consistent with cognitive science, this type of specific and immediate feedback outweighs traditional models of psychotherapy evaluation typical for a supervisory interaction.
  3. Technology-mediated treatment modalities: A multitude of smartphone apps (e.g. “PTSD Coach” and “Breath2Relax”) are now available to implement specific components of psychotherapy, including features such as mood tracking, symptom tracking, mindfulness exercises, coping cards, behavioral activation, worksheets and even crisis intervention strategies. Over the past decade, online and text-based mental health services have become exceedingly popular. In addition to providing anonymity and allowing for real-time consultation, these types of technology-mediated services allow providers to meet patients where they are, engaging them during times when they might be pulled to retreat as a result of their symptoms presentation (Imel et al. 2017).

It appears we are in the midst of a technological revolution that has and will continue to impact the practice of mental healthcare. While mental health treatment will likely always involve interpersonal interactions, leveraging technology will help to enhance access and quality of care.

Editor's Note: For more information on this topic, you can watch our webinar "CDP Presents: Technology and Telehealth - Maximizing Treatment Quality and Accessibility Across the Virtual Divide"

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Sharon Birman, Psy.D. is a clinical psychologist serving as a Senior Military Behavioral Health Psychologist with the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.


Imel, Z. E., Caperton, D. D., Tanana, M., & Atkins, D. C. (2017). Technology-enhanced human
interaction in psychotherapy. Journal of Counseling Psychology, 64(4), 385–393.

Langarizadeh, M., Tabatabaei, M. S., Tavakol, K., Naghipour, M., Rostami, A., & Moghbeli, F.
(2017). Telemental health care, an effective alternative to conventional mental care: A systematic review. Journal of the Society for Medical Informatics of Bosnia & Herzegovina, 25(4), 240–246.