What is Online Therapy? 3×3 Tips

woman and computerThere are different names for it, tele-therapy, video therapy, distance therapy, among others, but they all refer to the same thing: counseling over an internet video platform.

Online therapy is gaining popularity. I’ve been using online therapy in my practice, Triangle Psychological Services, for three years.

Here are 3×3 tips to help you understand what it is, the benefits and how to insure privacy and ethical treatment.

3 Descriptions

1. A therapist uses a secure, HIPAA compliant video platform with a client.

I like to use Skype as my video platform. It’s free and very easy for anyone to use. All that is needed is a computer with a webcam and an internet connection. If the webcam isn’t built into the computer, one can be purchased for a reasonable cost at any store selling electronics.

2. Online therapy works well for individual therapy for ages from adolescent through adulthood.

It does not work well with children. Talking is not the best way for children to express their experiences and feelings. Play and art are often incorporated into therapy with children, which is not be possible over the internet.

3. Access your therapy appointment from the comfort of your home at the click of a button.

The therapist sits at her desk in front of the computer screen,with the video platform open and clicks the “call” button next to the name and number for her next client. The client, who is also sitting in front of his computer screen with the program open clicks the “answer” button. Both client and therapist will see a live image of the person on the the other end as well as a small image of themselves. One can choose to use headphones and/or ear buds, but this is not necessary; the sound is emitted right out of the built-in computer speaker.

3 Advantages

1. Online therapy is a great option for an individual who lives in an area in which there are no clinicians offering the specialty needed.

In my practice in North Carolina, I integrate psychology and the Christian faith. I am also a Catholic. There aren’t many Catholic psychologists around who practices from a Christian anthropology of the person. We exist, but we are few and far between. It is not unusual for a Catholic to call me from a North Carolina location that is hours away. This is a great option for these individuals.

2. Online therapy is a much better option than telephone therapy.

It is said that communication is 80% body language and 20% verbal.Therapist and client need to see each other.
As a therapist who has done both, I prefer online video therapy because I can see the person’s facial expressions and body language. This is such an essential part of the therapeutic process. The client is able to do the same, which is helps build trust.

3. Online therapy is a great option for individuals who reside in rural communities.

People living in rural communities are often very limited when it comes to seeking therapy or other psychological services.  This is especially true when it comes to seeking a specialist such as a PTSD therapist or a Catholic therapist. Because of online therapy, they now have a much wider array of mental health options.

Three Ethical Considerations

1. Most professional organizations recommend that psychologists, therapists, counselors, psychiatrists practice online therapy only within the state in which they are licensed, or if practicing in a state in which they are not licensed, they do so only temporarily.

Regulations to protect individuals seeking and using psychological services and therapy are overseen by the State in which the professional practices. It is this body that licensed the individual in their particular discipline. Professionals are required to work within the bounds of these regulations or they are in jeopardy of losing their license to practice. In regards to online therapy, regulations governing the practice of online therapy have not yet been identified by many state boards because it is so new. However, practice guidelines are available from many states and a few new organizations building certifications for online therapy.

Prior to providing online therapy, I researched this issue carefully and thoroughly. Although there is no clear cut answer, here is what is generally recommended. The State Boards usually have a regulation that allows an out-of-state clinician to provide services to clients for a specific period of time, lets say 10 sessions or 5 months. After whatever period of time the designated by the Board, the Board requires the clinician to obtain licensure in their state in order to continue providing services in their state. The reason for this is because when a client feels their psychologist has committed an ethical breach, it is the State Board to whom it is reported. It is the State Board who will investigate, and if necessary, sanction the clinician. If the clinician is not licensed in the state where the client resides their State Board has no jurisdiction over that professional. The client can not turn to the Board of the state wherein the clinician is licensed because they only oversee what occurs in their state.

2. Quiet, uninterrupted, private space is important for the effectiveness of therapeutic process, even when an individual is conducting the online therapy session at home or from the workplace.

When I begin working with a client via online therapy, I provide explicit directions about the the need for boundaries regarding space and time during their online session. A few times at the outset clients did not set the boundaries well and the therapy session was interrupted several times. The clients recognize the need to set clearer boundaries and manage their environment in a way that they are not interrupted and have privacy.

3. The online video platform must be HIPAA compliant in regards to encryption.

Encryption scrambles the online data so that it can’t be “read” by others.I like Skype for this reason also. Skype uses military level, 256-bit encryption, which is much higher than that required by HIPAA.

For more information, read our Online Therapy FAQs.

Patti M. Zordich, Ph.D., Director/Founder Triangle Psychological Services, Cary, NC, www.trypsych.com, 919.380.1000