Terri K. Lankford, LPCS
Telehealth often goes by a lot of names: Distance Counseling, Remote Therapy, Telemental Health, and even E-Therapy.
In this time of social distance, stay-at-home orders, and dealign with the Covid-19 Crisis, it’s gained a serious influx of users in just a few short weeks as we work to protect our community and our health.
But telehealth has been around way before the last few weeks, here at Rise & Thrive, we’ve been offering it as a form of interaction since our creation (and before when it was just the owner, figuring this private practice thing out). Luckily, we had a great colleague and friend encourage us to take this on as a part of the service offered about 4 years ago!
Telehealth has allowed our clients to do therapy in the comfort of their homes or offices and sometimes in their cars, when you need it. There’s really not much we can’t do over a telehealth session that isn’t the same as sitting in the office!
Sometimes we would run into barriers, concerns, or hesitations when considering using tele-health as a therapy office. As such, some of the reasons why tele-health may be a good fit for you, could include:
Transportation (including access, costs for transit and/or parking, vehicle dependability)
Caregiver responsibilities (including eldercare, childcare, and partner care)
Accessibility (including physical limitations, mental health limitations)
Convenience (available when you are available—even during lunch hour)
Weather (weather is either unpredictable or epic—who wants to commute
Work/Life balance (asking for time off work is a drag)
Comfort (who doesn’t want to have therapy in slippers and a dog in our lap)
Privacy (no waiting room encounters)
Safety (ideal for victims of intimate partner violence or other safety concerns)
As some of you know we’ve also been using it to keep everyone in our office healthy before this past month as well! We highly encourage anyone who isn’t feeling the least bit well to stay home, not spread potential germs. We use telehealth as an option to our late cancellation policy when clients may have had to previously cancel an appointment because you’re not feeling well and maybe you don’t want to go to the doctor so normally you’d have incurred a late cancellation fee... we have the option to still see you and not charge you for missing if you choose!
You also have the opportunity to get increased access to your provider! Normally we are bound by the hours when the office is available. By providing our clinicians with the option to work from home as well, you get more access to their extended work from home hours!
WHY NOT A LARGE COMPANY?
Online counseling practices became popular with the explosion of TalkSpace and BetterHelp (in fact, most of us have likely seen the ads with Michael Phelps about TalkSpace)—and many of these larger companies provide financial benefit to engage with them… such as being cheaper. However, these platforms typically provide low reimbursement for clinicians triggering concerns of clinician turnover and inappropriate ethical considerations. Additionally, when a service is far more cost effective than market value additional concerns are raised about client privacy and ensuring client data is not being sold to offset the cost effectiveness for clients.
HOW DO WE DO TELEHEALTH ANYWAYS?
Telehealth sessions are conducted via a HIPAA compliant platform built into the client portal. (Typically not done with Skype, Facetime, or Google hangouts when your provider does not hae a BAA, Business Associate Agreement, in place. No additional log-in information required and sessions can be conducted via desktop, laptop, tablet, or mobile device.We use a HIPAA compliant telehealth video platform via the electronic health record system Simple Practice. While many of you have already used this platform without issue, for those of you who have not, it’s easy!
Those client who receive text and/or email appointment reminders, it includes a link which will bring you to a virtual "waiting room" for the appointment. If you do not receive your link, you reach out to your therapist and we can send it to you manually. If you are using an iphone, tablet or ipad you will likely have to download an app. It will prompt you to do this if need be. We do strongly encourage client to use earbuds if possible to enhance the quality of hearing on both ends and to increase confidentiality.
We do go over any safety issues and try our best to discuss the best place for minimal distractions, but overall you get to choose where your session is done from! That’s a part of the convenience!
EVIDENCE BASED SNAPSHOT
There are multiple academic articles supporting the effectiveness of online therapy. While we cannot list them all, these are a few to help you make an informed decision if online therapy is an appropriate choice for you.
Ruwaard, J., Lange, A., Schrieken, B., Dolan, C. V., & Emmelkamp, P. (2012). The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS one, 7(7), e40089.
Kemmeren, L. L., Van Schaik, D. J. F., Riper, H., Kleiboer, A. M., Bosmans, J. E., & Smit, J. H. (2016). Effectiveness of blended depression treatment for adults in specialised mental healthcare: study protocol for a randomised controlled trial. BMC psychiatry, 16(1), 113.
Wentzel, J., van der Vaart, R., Bohlmeijer, E. T., & van Gemert-Pijnen, J. E. (2016). Mixing online and face-to-face therapy: how to benefit from blended care in mental health care. JMIR mental health, 3(1).