App-based therapy platforms may well represent the next evolution of psychotherapy practice. I praised Talkspace a few years ago for offering access to mental health care for many who otherwise would never find their way to a therapist’s office. But the platforms — Talkspace, Betterhelp, and the like — have run into controversy over their confidentiality policies. Therapists using these apps may have little to no ready access to the client’s full name, address, or other information necessary in an emergency.
Sites like Yelp, HealthGrades, and Angie’s List present problems for mental health professionals. We typically cannot solicit testimonials from clients, so most clients do not write reviews. When someone does, though, any response risks breaching confidentiality. So therapists usually stay away from review sites. But that leaves us with little recourse in the event that an online review is harsh, incorrect, or even fake.
These concerns are not merely theoretical. In a 2015 disciplinary case out of California, a therapist attempted to defend himself against what he considered false accusations in a Yelp review from an angry client. The therapist responded to the review, but then changed his mind, and took the response down. By the therapist’s report — and there is no evidence that either the client or the licensing board disputes this — his response to the client was online for no more than three to five minutes.
Many therapists and counselors maintain their electronic health records through the site TherapyNotes. (TherapyNotes and this blog are unrelated.) Last week, TherapyNotes was down for several days following the discovery of a ransomware virus on one of their servers. [Update 7/6: They’ve put that link behind a login wall. Here’s a cached version.] If you use TherapyNotes for your records, you may be wondering what to do now.
In the past three weeks, we’ve discussed what we know and don’t know about online psychotherapy, and four reasons to move your practice online. As you’ve read, online psychotherapy has a great deal of potential, and may be a good fit for your practice. It does, however, come with some risks to both you and your clients. Here, I’ll address some of those risks and how you can minimize them.
As I’ve outlined in the past two weeks, there is a lot we know and a lot we don’t know about online therapy. If you’re considering moving part or all of your practice online, there are a lot of things to consider. Do you have the appropriate technology, and are you comfortable using it? Do you have policies and practices ready for online work? Have you ensured that your online work will be fully legally and ethically compliant, and consistent with best practices like those outlined in the new AAMFT Online Therapy Best Practices guide? Are your clients appropriate for online therapy?
Many therapists wrestle with the choice of whether to practice online. While these are not determining factors — in other words, I’m not saying your final decision should be to practice online, as there’s more to consider than what’s below — here are four good reasons to consider making the move.
Last week, I offered a snapshot of what we know about online therapy. That data shows a great deal of potential for online work. However, there is also a lot that we don’t know about online therapy. In today’s post, I’ll address three of those unanswered questions.
As I mentioned last week, the research base for online psychotherapy is growing quickly. It may be that answers to these questions will be more readily available just weeks or months from now. In addition, the fact that we do not yet have answers to these questions should not stop therapists interested in working online from doing so. But for the time being, these are issues where we as a field are still seeking important information.
The world of online therapy continues to develop rapidly. There are now dozens of videoconference platforms designed or marketed specifically to therapists. The research base is steadily growing. States and provinces are working feverishly to provide clarity in law for therapists working online.
In such a rapidly-changing environment, it can be difficult for therapists to reasonably assess the current state of online psychotherapy. Here’s what we can safely say we know as of April 2017. Unless otherwise noted, “online therapy” here refers to interactive, video-based work. Other forms of technology, including phone, text, and chat, are often used in therapy, but less is known about them.
The Health Insurance Portability and Accountability Act, also known as HIPAA, confuses a lot of therapists. Parts of the law are flexible based on the size and type of entity involved. Other parts apply equally to every covered entity. It’s a big and complex law, one that sometimes scares therapists and counselors away from using technology in their work.
Thankfully, there are a number of good and inexpensive resources for psychotherapists who want to comply with the law. Each of the ones listed below is less than $35.
Twitter has become one of the world’s largest social media sites. An estimated 200 billion tweets are sent each year, or more than 6,000 per second. The Twitter web site gets more than 90 million unique monthly visitors in the US. It’s easy to mistake that data as an indication that everyone is on Twitter, and therefore you should be too. But they aren’t, and you shouldn’t, and I’ve had enough.
Over the past months, a number of readers have privately, and very kindly, asked whether I would be okay with them selling their used copies of my exam prep book, Preparing for the California MFT Law & Ethics Exam, once they’re done with it. In short, I am. But selling isn’t your only option for using test prep materials after you have passed the test you bought them for. And there are a couple of options you shouldn’t take. Let’s run down the list of what you can and can’t do with used exam prep materials.