What Professionals Need to Know About Online Therapy

What You Need To Know About Online Sessions

In mid-march, the group practice that I am part of made the decision to transition from traditional face to face counseling sessions to online only sessions. The state of Mississippi had only a few cases of COVID-19 but the licensing board for counselors made the decision to loosen restrictions. Prior to the pandemic counselors needed specialized training and certification to offer tele-mentalhealth but now any licensed professional counselor can offer online sessions.

Initially, I was unsure about doing sessions over video. I enjoy the energy exchange that comes with face-to-face therapy. Would clients actually benefit from talking to me over secure video the same way they would in my office? I was not convinced that the quality of sessions could be the same.

online therapy session

Why Clients Like Online Sessions

Ease of access – clients can have a counseling session from home, work, wherever they are. They do not have to worry about child care, taking time off work, or transportation.
Comfort – clients feel more comfortable at home than they do in an unfamiliar office. They also do not have to worry about someone they know seeing that they are going to therapy.
Those with disabilities do not need to worry about finding an office that is accessible.
Caregivers of the elderly, ailing partners or parents, or immuno-compromised individuals who are ill themselves do not have to leave home.

Online Therapy Has Been Successful For Nearly 20 Years

When the decision was made to continue online only sessions through the end of April, I decided that it was time to do some research. I was surprised by what I found! While it seems new, telemental health has actually been around for a while! The VA has been using mental health services through telehealth for veterans for almost 20 years. In some cases, online mental health services for depression and anxiety actually had better outcomes for clients than face to face services did!

There are many considerations a mental health professional needs to address prior to beginning online sessions.

Does your professional liability insurance cover online sessions? Not all policies are created equal so it’s worth double-checking that you are covered.
What secure video platform will you be using? As Zoom video has become popular for online classes “zoom bombing” has also become popular. Zoom Bombing is when unauthorized users join a zoom session and disrupt it in some way. My practice uses SecureVideo but there are many other HIPAA complaint secure video platforms. Make sure that whatever service you choose is HIPAA complaint. You may need a business service agreement with the video provider.

While restrictions have been loosened to allow for use of non-secure platforms like FaceTime and Skype it is always advisable to err on the side of caution.

3. Do you have a video consent release for clients to sign? Just like with in-person counseling sessions informed consent is a step that should not be skipped. The link above is an example of an informed consent for online counseling release.

4. Are you familiar with best practices for online therapy? Even though my particular license requires no additional tele-mentalhealth certification I took an online training course to familiarize myself with best practices. As I often tell clients “some things you don’t know that you don’t know!”

find online therapy

Important Things to Cover With Clients

At a minimum you need to cover the following:

Where the client will be during sessions. At the beginning of each session verify that they are in the specified location. In case of emergency it is essential that you know where to dispatch emergency services. This can include not only a client with suicidal ideation but something like a medical emergency. Be sure to have the physical address.
Who is their emergency contact? Get a name and phone number at the bare minimum.
Whether they will be using a phone or computer for sessions.
What type of internet connection they will be using. Are they using home wifi or their phone’s 3G/4G?
How will you handle technical problems? Is it up to them to reconnect with you or will you be reaching out to them via phone?
Will you charge a cancellation fee if they cancel last minute or “no show” for an online appointment?
Are you seeing all the same populations as you do face to face? Will you still see children, families, couples or will it be limited to individual adults?

“Online therapy isn’t simply doing psychotherapy online. It’s a different medium, requiring a new set of skills that a professional must learn and master before seeing clients online.” – Dr. John M. Grohol

video therapy session

While I was hesitant initially, I have found that in practice online video sessions are a great way to connect with clients during this time. Many of us are self-quarantining and states are issuing stay-at-home and shelter-in-place orders in an attempt to stop the spread of COVID-19. I plan to continue offering online sessions even after face-to-face sessions can resume. Before educating myself, I had no idea how much research has been done on online therapy! I had no idea how effective it has proven to be.

I hope this has opened your mind to online therapy and given you a good start in transforming your therapy and counseling practice during this unusual time.