5 - Adjunctive E-Health

Abstract

This chapter discusses some of the advantages and disadvantages of e-health as part of a therapist's toolbox for trying to improve behavioral health. E-health is the use of computer technologies to pursue some of the typical goals associated with healthcare, i.e., the prevention, detection, assessment, and treatment of health problems. E-health becomes an interesting set of possibilities because of the challenges to healthcare systems. The challenges with the healthcare systems are the following: there are access problems such that some groups of individuals (rural, frontier, poor) do not have any or adequate access to care for their problems, there are problems with stigma, there are quality problems such that healthcare (especially behavioral health) varies in ways that are undesirable, and there are cost problems. There are limitations to the web and e-health. It is reasonable to hypothesize that humans have evolved to prefer face-to-face human contact. An e-mail message may not be able to comfort in times of grief or stress as a real human sitting a few feet from us. Although there are models of e-health in which video can be used, it still may be the case that at times being in the room with a client allows the therapist to pick up information that is missed in video. However, these limitations do not imply that e-health is useless. It is a useful tool, particularly in a stepped care model. Individuals who need information and skills training and who may have lower levels of problems may attempt e-health before moving to more intense levels of intervention. This is consistent with the ethical prescription of using the least intrusive intervention for a problem.