Applied Behavior Analysts Using Technology to Provide Therapy Remotely

Telebehavioral health consists of an applied behavior analyst working at a remote location, providing the same kind of evaluations and therapy they would in the office, but through live videoconferencing. Several different names may be used to describe this approach to applied behavior analysis and other therapies provided remotely:

  • Telehealth
  • Teletherapy
  • Telepractice
  • Telemedicine
  • Teleconference
  • Teleconsultation
  • E-counseling
  • E-therapy
  • Cybercounseling
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A lack of qualified applied behavior analysts and an increase in incidences of autism have spurred interest in telebehavioral health. Telebehavioral health serves as an alternative to in-person behavioral health services and often bridges the gap in areas where there may be a lack of qualified behavioral health professionals. Even for families that live in communities where ABA services are readily available, remote therapy sessions can be a very convenient way to maximize the frequency of therapy and augment the benefits of in-person sessions.

ABA services can be delivered from any two locations with an Internet connection and a secure audio/video platform (two electronic devices, with webcams and microphones).

Using Technology to Fill Gaps in Autism Services

A Michigan State University pilot study found that telehealth services helped parents of children with autism improve their child’s social communication by receiving training in behavioral intervention techniques like ABA.

The pilot study, funded by the Department of Defense’s Congressionally Directed Medical Research Programs, involved 28 parents of children with autism. All parents completed one self-directed online lesson per week, for a total of 12 weeks. They then practiced the intervention technique with their child. Half of the parents also received two coaching sessions per week from a therapist via video conferencing.

Parents in both groups saw improvement in their stress levels, which is an important finding because parents of children with autism often experience more stress than other parents.

Another study conducted by the University of Iowa found that parents of children with autism that use an online platform to meet with specialists and learn communication techniques and therapies like ABA can improve treatment at home and increase the family’s ability to communicate with an autistic child. The study also found that parents can significantly lower their treatment costs by using telehealth.

The study found that the annual treatment costs for a child with autism could be reduced from $6,000 to about $2,100 when families used telebehavioral health rather instead of in-person treatments.

While telebehavioral health services reduced the difficulty and expense associated with travel and improved access for families in rural locations, it also allowed applied behavior analysts to train parents to use ABA on their own in certain situations.

The Growing Demand for ABA Services Spurs the Growth of Telebehavioral Health

Telebehavioral health services have enjoyed a boom in recent years. The global market for telehealth is expected to reach $34 billion by the end of 2020, according to a market research report by Mordor Intelligence. North America accounts for more than 40 percent of the global market, with several factors driving growth:

  • An aging population
  • Increased incidences of chronic diseases
  • Rapid rise in the software market

In the behavioral healthcare market, telehealth services have increased significantly because many payers now recognize it as a legitimate form of treatment. Many Medicaid programs and private insurers now cover and reimburse telebehavioral health services.

Further, the American Psychological Association, the Telemental Health Institute, the American Psychiatric Association, and others all have guidelines related to telehealth services. More information regarding practice guidelines for telehealth services can be found here.

Telebehavioral health services provide many benefits for provider organizations, patients, clinicians, and communities, particularly rural and underserved communities. It is also a cost-effective way to improve access to specialized mental health services.

For example, in recent years, most states have implemented autism insurance mandate laws requiring health insurance companies to cover the cost of services related to the treatment of autism spectrum disorders. One such covered service is ABA, largely recognized as one of the most effective therapies for the treatment of ASD. Because most states now require insurers to cover the cost of ABA, demand for this behavioral therapy has skyrocketed, creating a demand for services that exceeds the scheduling capabilities of qualified applied behavior analysts.

Telebehavioral health services can help fulfill this demand by eliminating the need for on-site provider availability, which then eliminates travel time and expense for both providers and patients.

Other benefits of telebehavioral health include:

  • Increased number of consumers serviced
  • High consumer satisfaction
  • Greater consumer convenience
  • Improved recruitment and retention of mental health professionals, including applied behavior analysts
  • Timely service and reduced waits
  • Better coordination of care across the mental health system
  • Decreased geographic disparities in health
  • Reduced stigma associated with mental health services

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