Online therapy options can supplement sessions or it can sometimes replace it!
Serving residents of Florida, Washington DC and Missouri
Many clients really would like 24/7 access to their therapist. One of the things that therapists often talk about is how neat it would be if we could get a “bird’s eye view” or “be a fly on the wall” in our clients lives. We could compare what clients report to what we see – and as a fly on the wall we would have a much better “picture.” The belief is that with that bird’s eye/fly on the wall perspective therapists could help clients better. When clients journal, chat and share via secure messaging what is for them their real time situation, I get to read it after the fact. And for me, it is still in REAL TIME reporting – for the client. Kind of cool huh? The digital server option does that!”
By: Kurt LaRose MSW LCSW CHT and LICSW
Since opening my practice in 2005 (treating clients in Florida, later in Washington DC and most recently expanding to Missouri) I have always included digital technology in the services delivery model. In 2012 as the digital technology moved to actual secure platforms – I added the digital server to my practice as a way to enhance client access to services. My clients get better faster, because they have so many options to access services, as the video above summarizes. Today my clients can now sign up for asynchronous therapy – meaning they can log in day or night, generate a shared journal, a query by email and even share files to be reviewed – and get a therapist reply within 24 hours (see the prices and fees section for more information on asynchronous services and see our article about encryption as there are limitations based on licensing laws and the number of clients enrolled in the monthly subscription plan).
Florida, DC and more recently Missouri can access online services!
My clients enjoy a 24 hour patient portal where they can, at anytime day or night, share a confidential journal, they can send a secure email asking a question about something that happened related to a recent session, they can review shared files from their sessions and ask to review their records. My clients benefit from the online therapy platform (even those who are seen in my office use it) because they schedule their own appointments. Clients do not feel pressured to schedule because I’m not asking them to do so (yes, I make recommendations and I will occasionally follow-up if a client stops scheduling as a matter of patient care). Self scheduling helps clients attend sessions (whether it is an actual online therapy session or a face to face session) arrive for sessions more motivated; that’s because clients seek care when it is most needed. Further self scheduling helps my clients manage their costs for care. If a client is in serious crisis they are able to communicate with me via the secure server. Sometimes that communication is synchronous or asynchronous—but clients feel more connected just by having a place to go to reach out, privately—anytime day or night.
If you can an order a product online, you can set up secure, confidential and private online therapy. It’s easy. Answer some questions, provide your billing information and schedule!
As the mental health and behavioral health world continues (still) to struggle with the world of digital interactions, more and more clients (young and old alike) are accessing care here. Why? I’ve been doing it for years and my clients are just getting better, faster.
Are there limitations to online therapy? Sure. Because in an online format there is not the brain to brain physical interactions (that is the emotional brains cannot sense one another as occurs in a face to face model) in some ways it is MORE work on the therapist. Users can read my article on the topic in a link below as well. Many clients however, will only access care via a digital platform (due to anxieties, or phobias, limitations in travel and other barriers). Plus, for those clients who only want to schedule, get text reminders of appointments and be seen face to face—they interact with the server very, very little!
Every client working with the practice, office, online or even onsite has a personal and secure digital practice portal giving them full access 24 hours a day! The portal is your online supplement to office services. Online therapy clients can use online services, such as video, chat, email and journal based therapy. All clients can schedule to be seen in face to face too. Now, office, online and onsite mental healthcare is at your finger tips.
Licensing can affect online therapy access as well. Why? A resident of DC and a licensed DC therapist can do online therapy—really from virtually anywhere there is internet access. And because state and federal regulators have yet to figure out a national licensing credential—online therapy ONLY clients (those who are not seen in the office or onsite) must work with a professional who is licensed from the same state where the client lives. Now, a resident from anywhere could come to my DC office and be seen face to face (we’re both sitting in the same jurisdiction where I’m also licensed) or they could be seen face to face in my Florida visits. In part, this is why I’m licensed in three jurisdictions—I can see FL, DC and MO clients online—no matter where I am or where they are.
If you’re seeing a therapist online from another state, who is NOT licensed in the state in which you reside, this may not actually be an approved licensing practitioner (you can check with your local licensing boards to be sure this is an option). So how come some organizations can treat online for all 50 states? Interestingly, federal and state agencies do not have to follow the same licensing standards as do private practitioners (so the veterans administration, for example can provide online therapy in all 50 states if they want to). Some private insurance companies will offer online therapy in different states, but generally they are linking a licensed therapist in your state to you). As time progresses, it is my guess that one day there will be a nationalized licensing standard so that private practitioners can treat clients online—no matter where they both live and work. Why? Clients are demanding the services, just like college students are doing for online degrees (and colleges and state regulators in at least 48 states have made THAT possible)!
Unlike various video based platforms claiming to provide “online therapy” the server I use is encrypted, from client to therapist and therapist to client. I will not name the other services out there, but unless the platform for online services says “HIPAA Compliant” it is NOT secure for health information sharing. My digital practice server meets the compliance standard for HIPAA security, ensuring client information is kept confidential. Plus it allows for electronic management of all records and billing matters (increasingly a requirement in the mental health profession by private and federal contracting standards).
Here’s a quote about “encryption” by LaRose ….
… Encryption means that you receive in a “location” (a file directory) jibberish until you use a highly sensitive password to log in. That is when someone sends you information, it may look like a language on the screen but once it is saved or sent it is placed in the file directory as “#1;lkjd-89uaj?xx///fkjt5002” (for example) which is now encrypted. For it to be un-encrypted the receiving party must have their own user name and highly sensitive password. Once the sender logs in encryption is undone for the sender and until the receiving party logs in the data for the (and anyone else who may try to access it) is jibberish. Mental health records have to be highly protected by state and federal laws. Some secure platforms will not only require highly sensitive passwords (letters, numbers, upper and lower case plus symbols for example) but they will include security certificate verification software that continually checks that the URL (the domain and the sub-directories or sub-files within in the URL) to make sure the the secure socket layering (SSL) is active and working. Going further though, secure platforms will also require users to go through a manual robot verification step to ensure that it is a person sitting behind the screen. Then, and this would be a fourth layer of security protection, some secure platforms will authenticate (or allow for 2-step authentication settings) the device. The secure and encrypted platform used by TalkifUwant includes all of these layers of protection (and the secure server also has non-daisy chained servers) located in different cities and in different states…. Quoted from https://talkifuwant.com/connectnow
I have presented as a lead presenter on digital services models and am published on the topic. The server I use is one that I am so thrilled about, and that my clients really, really like having that I re-sell it to other providers helping them enter the digital age of mental health services.
So—if you want an online therapy platform with 24 hour access to your therapist (synchronous and asynchronous options) either as your only type of therapy (video, chat, journaling, file sharing, self scheduling, records access and text reminders) or as a supplement to your face to face sessions, you’ve come to the right place!
Rev. 6/10/19; 8/17/20; 9/5/20