The demand for online therapy is growing, especially in rural areas where access to mental health services is limited. At face value, it sounds like a wonderful option. Who wouldn’t want to meet with a therapist from the comfort of home? Barriers of time and distance no longer apply in cyberspace.
Who is a candidate?
Not everyone who wants or needs mental health services is an ideal candidate for online therapy. For starters, both therapist and client must be comfortable with using audiovisual technology via the Internet. Both must possess the necessary technology, too. Without those basic tools, online therapy is impossible.
Beyond technology, certain mental health issues are better suited for online therapy. Others are best addressed in person. Anyone dealing with severe psychiatric symptoms such as suicidal thoughts, hallucinations, paranoia, psychosis, or uncontrolled depression or mania needs to be treated in person.
Otherwise, most life challenges can be effectively treated with online therapy. Relationship issues, workplace stress, grief, career or education issues, life transitions, parenting, and many other concerns are all appropriate for online therapy. Even milder, well-controlled depressive or anxiety disorders can, with the appropriate safeguards, be successfully treated online. As with face-to-face therapy, the key factors for success are the therapist’s skill and the strength of the rapport between you and your therapist.
What to look for in an online therapist
The American Psychological Association has developed Guidelines for the Practice of Online Therapy. Other mental health specialties have adopted similar guidelines. In addition, therapists can take advantage of special programs like the ones available at the Online Therapy Institute or Telebehavioral Health Institute.
They may have continuing education credits in courses or seminars on the practice of online therapy. There are many ways to obtain specialized training. What’s important is that your online therapist has made the effort to keep his or her skills current.
Legal to practice
In a perfect world, any properly trained therapist would be able to offer online services to anyone, anywhere, anytime. Health care laws, insurance reimbursement policies, and state licensing boards have not caught up with technology. That’s why it’s important that your therapist be licensed and insured to legally practice in your state.
Some state licensing boards strictly forbid the delivery of mental health services to residents of that state without a state license. Others are more flexible, allowing an out-of-state therapist to counsel a limited number of residents for a limited time. Some offer guest therapist licensing while a minority don’t care at all. Nevertheless, it is your therapist’s responsibility to understand and comply with the mental health practice laws in your state.
Important things to know
- Online therapy is real therapy, not a short-cut. Expect to do the same kind of work as traditional therapy. It is simply a new way to receive services.
- The best form of online therapy involves real-time, live, bi-directional audiovisual communication. This allows you and your therapist to observe your body language and hear tone of voice—crucial aspects to effective therapy.
- Online therapy rates are comparable to traditional therapy. Insurance coverage varies, so check with your insurance provider before hiring an online therapist.
What about therapy via text, instant messenger, or email?
We have become comfortable communicating our most private thoughts in these very public spaces. It is easy to develop a false sense of security using this type of technology. Mental health services offered via Skype, unencrypted email, and text or public instant messenger platforms are red flags. You may be comfortable talking to your best friend using these options, but they do not offer the information security necessary for health care delivery services.
The law requires a certain level of security to protect your privacy.
Mental health services are regulated by state and federal laws. Each type of therapist is also bound by professional ethics that require them to protect your privacy. The most recognizable of these laws is the Health Information Portability and Accessibility Act (HIPAA). It regulates what information can be shared, with whom, and provides specific details on how health care professionals must secure your protected health information.
It is difficult for your therapist to ensure that your privacy is protected when you are trading text messages. Even email messages are not secure without encryption. Ethical therapists will offer an online platform that is HIPAA-compliant where information is exchanged and stored in an encrypted environment.
Secure technology is only part of the equation.
There are online platforms that offer mobile-friendly counseling platforms. While the technology may be secure, encrypted, and HIPAA-compliant, that doesn’t necessarily mean your conversations are completely private. No platform can ensure the security of your own technology. If you choose to use you cell phone for a video chat with your therapist on public WiFi at a local restaurant, your conversation is not private and there’s nothing your therapist can do about it.
Think carefully about striking a comfortable balance between ease of access and protecting your privacy. Only you will be able to decide what risks are acceptable to achieve the convenience you desire.
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Headache disorders counselor and advocate Tammy Rome maintains a private practice specializing in treating clients with Migraine and other headache disorders. She also volunteers as vice chair of the American Headache and Migraine Association and as president of The Cluster Headache Support Group. You can read more of Tammy’s work on her website and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.