If you been in therapy before, more than likely it was with a counselor in their office. So what is online counseling like? Let’s dive in to talk a bit about what you can expect from online counseling!
Given the expansiveness of internet accessibility, we are able to access a myriad of supports and services that may have been unattainable before. For some, teletherapy/online therapy/online counseling/telepsychology (pick the name you like, they all mean the same thing!) truly answers a problem they have—they are unable to attend in-person therapy due to location, physical capabilities, transportation issues, or fully booked local clinicians. For others, online counseling provides them the option of accessing a service that works for their schedule, lifestyle, or comfort.
Regardless of what may bring you to the internet for counseling, you should know that telepsychology has been shown to be as effective as in-person therapy. Since it’s inception, researchers have begun to explore whether it’s an approach that should be supported.
The findings of this meta-analysis, and review of additional Internet therapy studies not included in the meta-analysis, provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity and suggest several insights in regard to its application.
Barak, Azy, et al. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26.2-4: 109-160. http://www.tandfonline.com/doi/abs/10.1080/15228830802094429#.VI8vaCvF_hs
Therapists that practice online are bound by the same legal and ethical considerations as in-person counseling. It’s important that therapists have additional training around practicing in telepsychology given it is a different medium of delivering therapy. I appreciate some of the cautions given by the American Psychological Association to those considering web-based therapies.
Is this the right tool to help me? The research hasn’t yet shown that stand-alone therapy online or via texting is effective for everyone in every situation. Some sites advertise that they offer therapy, but those claims may be misleading or false. For example, the people behind the apps may not be licensed or qualified to provide therapy.
https://www.apa.org/helpcenter/online-therapy
Is the therapist licensed? Licensing protects you. Therapist and psychotherapist are not legally protected words in most states, meaning anyone can claim to be a therapist and offer services that may appear as therapy. It may not always be easy to know that you are receiving evidenced-based psychotherapy.
All psychologists and other professional health providers must be licensed by the state in which they practice. Licensure laws protect you by ensuring only those who are trained and qualified to practice receive a license. It also ensures that you have recourse if there are problems with your treatment. Before you sign up for any Web services, find out who you are working with, if he or she has a license, where that license is held and the license number. Most states offer an online, searchable directory of professionals licensed in their state.
Is the psychologist licensed in the state you live? Licenses are granted by each state with their own laws and rules, much like each state determines what residents must know to earn a driver’s license. But unlike driver’s licenses, which allow you to legally operate a car in all states, a health care provider is limited to providing services in the state in which they are licensed. The provider must be licensed in the jurisdiction where you are located, and making that determination may be difficult to do if you don’t know where he or she is physically located.
Is the site or app secure? Will the information I provide remain confidential? Psychotherapy works in part because psychologists ensure that clients have a safe, private space to share deeply personal and sometimes difficult stories, thoughts or emotions. What happens and is said in a therapy office stays there, with the exception of a few situations. The site or app you use should, at a minimum, be HIPAA-compliant and have the ability to verify your identity and your therapist’s identity.
How will you pay for the service? Many insurance companies cover the treatment of mental health and substance abuse disorders — treatment that includes in-person psychotherapy. If you work with a psychologist in her office, your insurance could cover most or all of the fee, depending on whether you need to meet a deductible or have a co-pay. Psychologists will often provide an invoice that you can submit to your insurance company for reimbursement. But online therapy or web therapy services are often not covered or reimbursable by most insurance providers. If you plan to be reimbursed, check with your insurance company first. Otherwise, prepare to pay for the full cost yourself.
Telepsychology can be done through video, phone, and messaging. I have experience providing each of these, in addition to my work with individuals in an office setting. While the approaches may be different, I give my compassion, expertise, respect, and experience to every individual I work with.
Is online counseling ever not appropriate?
Simple answer, yes.
I believe that individuals that have a severe mental illness require a team approach with local practitioners that can meet and collaborate for the benefit of the individual. Online counseling alone would not be an effective intervention.
Additionally, if you have active thoughts of suicide or to harm others, or are in crisis, online counseling is not the right support for you at this time. It is important to access local crisis services. If you are having these thoughts, please call 1-800-273-8255 or text HOME to 741741.
Finally, if you do not have reliable internet, or a device that can connect to the internet, this type of counseling may not be for you. However, even with the best device and wifi strength, online counseling can have it’s glitches. This something that is discussed during the start of services and usually managed with patience, humor, and persistence!