Eleven years ago I ventured briefly into the world of providing online counseling services. It was short-lived because there was not enough interest from potential clients in online counseling. At the time, there was a sense that online interventions would revolutionize counseling, and that it might even become a preferred method of treatment for many. While online counseling, also known as telemental health, and e-therapy, hasn't "taken over" the field of therapy in the past decade, electronic delivery methods have steadily grown.
According to APA’s Center for Workforce Studies, the use of videoconferencing jumped from 2 to 10 percent between the years 2000 - 2008, and the use of email for service delivery tripled during that same time frame.
The ethical concerns and uncertainties surrounding online counseling haven't changed much in the past decade. Is it really confidential? What problems are appropriate to treat online? Can you treat clients across state lines? What ages are appropriate to treat?
Professional guidelines and state laws still don't clearly outline what's appropriate and what's not when it comes to working with clients online which brings up a lot of anxiety for therapists, including me.
In spite of the questions that linger, my clinic is venturing into the world of online therapy this month. There is enough evidence of it's effectiveness, new secure delivery platforms, and enough client interest to offer online services.
Here's how my colleagues and I are managing our own anxiety about offering online counseling:
1) Pre-screening clients for appropriateness of online counseling prior to initial session.
2) Online counseling training for my therapists who are interested in offering online counseling.
3) Signed consent form by client acknowledging risks and benefits of online service delivery.
4) Working online with clients in our state.
5) Selecting a secure, easy-to-use online counseling platform. (We decided to go with CounSol)
If you're afraid of online counseling, here are a few resources that might help you get the courage to try offering services online:
- Here's a helpful and brief summary of research on the effectiveness of online therapy effectiveness.
- This site gives a side-by-side comparison of multiple online counseling platforms TeleMentalHealthComparisons.com.
- Excellent online training from Zur Institute covering several areas of practice consideration - Telehealth: The New Standard: Ethical, Legal, Clinical, Technological & Practice Considerations
- Here's another helpful online training series with several online therapy training modules Online Therapy Institute.
Do you provide online counseling services? Why are why not? I want to hear about your experiences!