J. P. Watson

Bio: J. P. Watson is an academic researcher. The author has contributed to research in topics: Interactive television. The author has an hindex of 1, co-authored 1 publications receiving 6 citations.

Assessment for psychotherapy by interactive television suitable for transmission through telephone links

Abstract: Despite the increased availability of psychotherapy within the NHS, inequalities remain (Holmes & Lindley, 1989). Traditionally, psychotherapy ser vices have been provided from teaching centres in cities and patients have had to travel for treatment. This may account in part for the middle-class predo minance in psychotherapy patients and Holmes ( 1991) has identified the need for psychotherapists to reach out and cater for the disadvantaged in large housing estates and rural areas. While services are changing to meet such needs (Pedder, 1989)there are powerful economic restrictions on service expansion. The potential for communications technology such as interactive television to aid the delivery of general psychiatric services has been reviewed by McLaren et al (1992) and similar arguments apply to the delivery of psychotherapy. This study was performed as part of a project to use a new communications technology, computer based interactive television, to aid the delivery of psychiatric services including psychotherapy. The aim was to get a detailed description of professional user responses to using the system for assessing patients for psychotherapy as a preliminary to a clinical trial.

A prospective satisfaction study and cost analysis of a pilot child telepsychiatry service in Newfoundland.

Abstract: We evaluated user satisfaction with a PC-based videoconferencing system used for child psychiatry assessments and performed a cost analysis. Thirty patients (aged 5-16 years), accompanied by a parent, completed a psychiatric assessment using the videoconferencing system. One of five child psychiatrists was randomly assigned to each assessment. Satisfaction questionnaires were completed after each assessment by the psychiatrist, patient and parent. Parents also completed a cost questionnaire. The telecommunications bandwidth was 336 kbit/s. The psychiatrists stated that they were either 'very satisfied' or 'satisfied' with the telepsychiatry assessments. On a five-point Likert scale (1 = lowest, 5 = highest), 28 of the 30 parents (93%) rated their satisfaction level as 5; the other two rated it 4. All 30 parents (100%) stated that they 'liked' the telepsychiatry assessment and would use the system again. Twenty-nine parents (97%) indicated that they would prefer to use the telepsychiatry system to travelling to see a child psychiatrist in person. Eleven children (aged 5-12) participated and all (100%) said they 'liked' using the telepsychiatry system. Five out of nine children (56%) stated they liked the 'television doctor' better than the 'real' doctor; four said they had no preference. Nineteen adolescents (aged 13-16 years) participated and most were very satisfied or satisfied with the system. Seventeen of the 19 adolescents (89%) said they would prefer to see the psychiatrist on the videoconferencing system to travelling for an assessment, and the same number said that they would use telepsychiatry again. The estimated total travel cost for the 30 patients was $12,849, an average of $428 per patient. The total cost of the telepsychiatry service for the three-month pilot was $12,575, or $419 per patient.

Telepsychiatry at Forty: What Have We Learned?

Abstract: We examined all articles describing video applications of telemedicine for psychiatry (i.e., “telepsychiatry”) that have been published in peer-reviewed journals. We found three reports of video application to continuing education, eight uncontrolled studies or anecdotal clinical reports of video application to assessment or consultation, five clinical investigations including a control group or control condition, three studies evaluating the reliability of administering psychological rating scales by video, and two studies of the cost-effectiveness of telepsychiatry. Although the conclusions of all studies reviewed recommend the use of telepsychiatry, evidence currently available is insufficient to suggest its widespread implementation. Additional studies are needed to determine when and for what age groups and conditions telepsychiatry is an effective way to deliver psychiatric services, and whether it is cost-effective. We recommend that telepsychiatry be employed on a limited basis and be restricted t...

Telemedicine as a means of delivering cognitive-behavioural therapy to rural and remote mental health clients.

Abstract: We explored the feasibility and acceptability of delivering cognitive-behavioural therapy (CBT) via videoconference to clients with depression and/or anxiety living in rural north Queensland. The study involved 15 mental health clients and their five case managers. First, each case manager was instructed in the use of telemedicine for clinical consultation, and given training in CBT. This was done via videoconference. Then the clients were introduced to telemedicine. Following six to eight intensive weekly sessions of CBT, there was improvement in certain clinical outcome measures (i.e. the Mental Health Inventory and the Health of the Nation Outcome Scale). There was a significant improvement (P<0.05 using a t-test) in the client Mental Health Inventory scores before (mean = 109) and after treatment (mean = 148). However, in the absence of a control condition, it was not possible to conclude that the treatment had a specific effect on the disorders studied. Both clients and case managers found telemedicine consultations acceptable. Clients' ratings ranged from 3 to 4.5, while case mangers' ratings ranged from 3 to 5 ('average' to 'much better than average').

A comparison of communication modes in adult psychiatry.

Abstract: The process and outcome of clinical tasks in an acute psychiatric unit were compared using four different communication modes: face to face, telephone, hands-free telephone, and a low-cost videoconferencing system. Six doctors and six patients took part in the study. Four assessment measures were used. The videoconferencing system was positively received by both patients and doctors. Both doctors and patients preferred communication modes with visual cues. However, there were few significant differences between communication modes when using single measures; only multiple levels of analysis can adequately assess the differences between such modes of communication.

An Evaluation of the Use of Interactive Television in an Acute Psychiatric Service

Abstract: This study reports the results of the use of a low-cost videoconferencing system (LCVC) for communication in an acute psychiatric service. Qualitative research methodology was used to examine the use of the LCVC in interactions between psychiatrists, patients and nursing staff, including information on refusals. One hundred and five clinical interactions were studied over four months. The LCVC proved technically reliable and compatible with the performance of a wide range of clinical tasks. However, the results suggest the need for better understanding of the nature and origins of the attitudes that users bring to the use of such communications technology. A framework is presented for the classification of user responses in terms of preexisting attitudes of the users, technological limitations of the system and the mental state of the users. The study demonstrated the potential for interactive television to support many of the communication tasks necessary in a dispersed psychiatric service and for teleps...