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.
Technology
Responding to a Yelp review can cost you
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.
What to do if you were affected by the TherapyNotes outage
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.
The risks of online psychotherapy
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.
Four reasons to move your practice online
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.