Building Rural and Technology Literacy Skills

December 11, 2018

Nancy Roget
Thomasine Heitkamp
Joyce Hartje
Mountain Plains Addiction Technology Transfer Center


Since its inception in 1993 (one of the original ATTCs), what is now the Mountain Plains ATTC has focused on creating research-based SUD treatment/recovery products that can easily be inserted into existing curricula by behavior health faculty, which helps make research functionally relevant within the context of a discipline. Typically, these Curriculum Infusion Products (CIPs) include PowerPoint slides, videos, classroom exercises, and case scenarios.  Recently, the Mountain Plains ATTC created a new product called Slide Decks for You (Slidedecks4you), which is a shorter version of the CIPs. Both types of products are available on the Mountain Plains ATTC website.


Workforce Shortages


Rurality3 is a unique diversity issue that acknowledges how economic, religious, historical, and geographic factors in rural areas combine to create a culture that influences behavioral health outcomes. 
Behavioral health practitioner workforce shortages in the US remains high, especially in rural areas. In fact, 85% all US federally designated mental health professional shortages are in rural areas.1

A recent study2 found that rural counties lacked access to: psychiatrists (65%); psychologists (47%); and psychiatric nurse practitioners (81%). However, advances in technology in 2018 have increased access to web/mobile technologies, especially for rural populations. These advances look to decrease the digital divide and address workforce shortages by affording practitioners the opportunity to deliver behavioral health services virtually.

Ruralityis a unique diversity issue that acknowledges how economic, religious, historical, and geographic factors in rural areas combine to create a culture that influences behavioral health outcomes. This issue of a rural culture is important as many rural patients move to urban areas or drive to urban areas to receive services, ensuring that most practitioners will face the influence of rural culture.

Rurality and Technology 


Surprisingly, the use of videoconferencing to deliver behavioral health services is not new. In fact, it has been around for almost 60 years. An article published in 1961 described the use of videoconferencing to deliver group counseling to mental health patients.

Since that time, numerous studies have been conducted examining videoconferencing with patients with mental health disorders but fewer studies conducted with SUD patients. Several recent systematic reviews provide an excellent overview of videoconferencing-based behavioral health services identifying three similar themes: 1) patients report high satisfaction with services delivered through videoconferencing; 2) practitioners report more concerns about forming effective therapeutic relationship via videoconferencing; and 3) videoconferencing has been used effectively with different types of patients/conditions.5,6,7

Education at the preservice levels needs to be enhanced to focus not only on utilizing these new technologies, but delivering behavioral health services that include knowledge, attitude, and skill development about rurality to build literacy.
Even though there is a strong research/literature base for the influence of rural culture and videoconferencing, many academic programs currently do not include these topics in their curricula. While the social work field routinely conducts behavioral health research in rural areas, most social work education programs do not provide specialized course work on rural issues.8

Calls to implement technology training for psychiatrists, behavioral health therapists, and frontline workers appear in two 2017 articles.9,10

Although there is an increase in access to rural patients using technology, many behavioral health practitioners find themselves unprepared to provide services, as their cultural and technology literacy skills are insufficient. Education at the preservice level needs to be enhanced to focus not only on utilizing these new technologies, but delivering behavioral health services that include knowledge, attitude, and skill development about rurality to build literacy. To address this gap, the Mountain Plains ATTC has created a CIP that blends rurality and technology that can be easily introduced in existing behavioral health curricula to help prepare a workforce to be both technologically and culturally competent.


References


1.   Mackie, P.F.E., Zammitt, K., & Alvarez, M. (2016). Practicing Rural Social Work. Chicago, IL: Lyceum Books.

2. Andrilla, C.H.A., Patterson, D. G., Garberson, L. A., Coulthard, C., & Larson, E. H. (2018). Geographic variation in the supply of selected behavioral health providers. American Journal of Preventive Medicine, 54(6), S199–S207.

3.   Smalley, K. B. & Warren, J. C. (2012). Rurality as a diversity issue. In K. B. Smalley, J. C. Warren, & J. P. Rainer (Eds.),  Rural Mental Health: Issues, Policies, and Best Practices (pp.37-48). New York, NY: Springer Publishing Co.

4.   Wittson, C. L., Affleck, D. C., & Johnson, V. (1961). Two-way television in group therapy. Mental Hospital, 12, 22–23.

5.   Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., … &Thorp, S.R. (2012).Videoconferencing psychotherapy: A systematic review. Psychological Services, 9, 111–131. http://dx.doi.org/10.1037/a0027924

6.   Batastini, A.B., King, C.M., Morgan, R.D., & McDaniel, B. (2015). Telepsychological services with criminal justice and substance abuse clients: A systematic review and meta-analysis. Psychological Services. Advance online publication. http://dx.doi.org/10.1037/ser0000042

7.   Chakrabarti, S. (2015). Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World Journal of Psychiatry, 5(3), 286-304.

8.   Moore, W.R., Pearson, F., Rife, J.C., Poole, K.J., Moore, L.S., & Reaves, A.M. (2016). Reinventing social work education and service delivery in rural areas: An interdisciplinary model for serving vulnerable populations. Contemporary Rural Social Work Journal, 8(2).

9.   Torous, J & Weiss-Roberts, L. (2017). The ethical use of mobile technology in clinical psychiatry. The Journal of Nervous and Mental Disease, 205(1), 4-8.

10.  Nemec, P.B & Chan, S. (2017). Behavioral health workforce development challenges in the digital era. Psychiatric Rehabilitation Journal, 40(3), 339-341.



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