Online Therapy

Online therapy is a method of delivering therapy, such as speech therapy, occupational therapy, or mental health counseling, via the Internet. Online therapy has many different names (e.g., e-therapy, teletherapy, distance therapy, web therapy).

Is online therapy approved?

Yes. Many national organizations approve of online therapy:

  • Online speech therapy is approved by the American Speech-Language-Hearing Association (ASHA).
  • Online occupational therapy is approved by the American Occupational Therapy Association (AOTA).
  •  Online physical therapy is approved by the American Physical Therapy Association (APTA).
  • Online mental counseling and other related therapies are approved by the American Psychological Association (APA), the American Counseling Association (ACA), and the National Association of Social Workers (NASW).

Is online therapy effective?

A large body of research has indicated that online therapy is as effective as in-person therapy. Your provider can discuss this in more detail with you and provide you with specific research outcomes.

How does online therapy work?

To participate in online therapy, you need a computer or a mobile device, an Internet connection, a built-in or external camera and microphone, and headphones. Your teletherapist will schedule an online session and conduct therapy using a teletherapy (telehealth) platform such as TheraPlatform.

Is online therapy secure and private?

Teletherapists should use a secure, HIPAA-compliant, and fully encrypted telehealth or teletherapy platform to provide online services. It is teletherapists’ ethical responsibility to ensure that the privacy of their clients is protected. TheraPlatform meets and exceeds all HIPAA standards while general video conferencing tools used by the public, such as Skype, are not HIPAA-compliant.

Does insurance cover online therapy?

Many insurance companies do cover online therapy.  Therapists and their clients should contact insurance companies to verify online therapy coverage.

20 Tips for Smooth Online Therapy (Teletherapy) Session

The TheraPlatform Team has a few tips to help you make your teletherapy or telepractice session as smooth as possible. These tips are useful when using, but they are applicable to any videoconferencing tool you might use when providing teletherapy or telepractice services.

1. Learn how to use the platform—practice with your friends or family members before you meet your clients live online.

2. Learn all the technical requirements for using the platform, including required internet speed, etc.

3. Learn basic troubleshooting tips such as how to select the appropriate microphone in the settings.

4. Make sure you and your client do not use any other video tools (such as Skype) during the session. All other video tools must be turned off, so the videoconferencing platform can work properly (otherwise you will not see each other).

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5. Make sure that neither your computer nor your client’s computer runs updates or installs software during your online session. It would slow your connection.

6. Do not conduct a session on a brand new computer, because the first time you turn it on, it will likely begin updating already installed programs and installing new programs automatically. Keep in mind that it may take a whole day for the computer to install and update everything. This tip also applies to your client.

7. Make sure that no one at your house or the client’s house tries to stream videos (such as Netflix) or play online games during a session because it can slow the connection.

8. Make sure that neither you nor your client leaves too many browsers and websites open, especially the ones that have online games. It is better to have one browser with a website open at a time. If you need to access several websites during your session, keep a list of the links handy in a Word document and be ready to copy/paste one link at a time, as needed. If you have too many websites open, your connection can slow down.

9. Make sure that your background is minimalistic, and not distracting. It will help your camera focus on you better, and it will help your client to focus better too. Consider positioning your computer/camera against a plain wall or hanging a plain piece of fabric behind you.

10. Consider wearing plain, solid-color shirts (pastel or jewel tones) and avoid bright colors or stripes. Very bright shirts and shirts with busy patterns (stripes) can create a distracting optical illusion.

11. Avoid wearing shiny jewelry, as it can be distracting.

12. Avoid wearing jingly jewelry, as the microphone will pick up the noise, making it difficult for the client to understand you.

13. Limit background noise, including fans, barking dogs, phones, etc.

14. Communicate with your client in advance to ensure that he or she has the right equipment and set up for the session and feels comfortable using the computer.

15. Forward these tips to your client in preparation for the session.

16. If you must type progress notes during the session, consider muting your audio, as keyboarding is loud, especially if you both use headphones.

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17. If you decide to use headphones during teletherapy, consider headphones with a background-noise canceling feature.

18. If you decide to screen-share websites during your session, make sure you review the particular site ahead of time. Many online games and websites include ads that are distracting or inappropriate.

19. Allow yourself some time before each session (at least 5–10 minutes) to stretch and prepare for the next client.

20. Consider offering your new client a free short session to test everything and briefly educate him or her about how you will conduct the session.

Advantages of online therapy

Online therapy has been proven to be as effective as in-person therapy. However, you should contact your therapist or health care provider first to determine if online therapy is right for you. Here are some benefits or advantages of online therapy or teletherapy:

  •  Easier access: Clients who live in remote areas or who have limited mobility or limited access to transportation may be more motivated to participate in online therapy.
  • Reduced cost: Online therapy eliminates the costs associated with travel time and gas.
  • More consistent therapy: Online therapy decreases absences due to poor weather conditions or sickness, allowing clients to participate in therapy regularly.
  • More intense therapy: Online therapy can be scheduled more frequently, as clients do not have to commute long distances
  • Increased progress: Since online therapy provides more intense therapy, it can accelerate progress.
  • Better access to specialists: Online therapy can allow individuals in remote areas to get help from specialists who may not be available in their geographic location.
  • Psychological comfort: Online therapy can help with eliminating the social stigma related to receiving mental counseling or other therapy.
  • Flexibility: Clients have access to more specialists and can select specialists who can work with their schedules.

Complying with Federal and State Laws in Online Therapy

Online therapy, or telehealth, is a field that is rapidly evolving. As technology continues to advance, so do how we can deliver therapy. While the rules and regulations are straining to keep up, some guidelines can help therapists to protect themselves as well as their patients. Whether you are a mental health therapist, social worker, behavioral therapist, or speech therapist, if you are interested in doing therapy with your patients online, you will need to do your due diligence to make sure that you remain in compliance.

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General Guidelines

When you begin to make plans for your teletherapy practice, wondering where to start may be a bit overwhelming. However, it might be helpful to begin the process by turning to your professional association. For example, the American Psychological Association (APA) offers Guidelines for the Practice of Telepsychology, which state that “Psychologists should make reasonable effort to be familiar with and, as appropriate, to address the laws and regulations that govern telepsychology service delivery within the jurisdictions in which they are situated and the jurisdictions where their clients/patients are located.” But what are the laws in these states?

State Laws

When it comes to complying with state laws, you may want to start by checking with your state legislature or state licensing board. For example, if you live in New York, the New York State Office of the Professions provides links to relevant “Laws, Rules, & Regulations” for each profession (psychologist, social worker, etc.). Once you have a good understanding of your state’s laws that relate to your specific profession, you’ll still need to do some more research for the states in which your clients reside if you plan to serve people that live outside of your home state. And then, there are still federal laws to contend with.

Federal Laws

When you begin your teletherapy practice, it is vitally important to have an understanding of relevant federal laws. You could start at the Federal Laws and Regulations page at USA.gov. From there you can find your way to relevant legislation like the Health Insurance Portability and Accountability Act (HIPAA). While the process may be cumbersome, you may have a partner through it all in the form of the platform that you choose for your teletherapy practice. A secure and HIPAA-compliant platform is required by law when providing teletherapy, and TheraPlatform was built to meet and exceed all HIPAA requirements. This is why having a partner like TheraPlatform with you through the process can make delivering your services so much easier.

Teletherapy can be a wonderful way to reach isolated populations and those that prefer communicating through technology. As a therapist, it is your responsibility to make sure that you comply with all of the relevant professional guidelines as well as state and federal laws. With enough research and the right platform, you can set yourself up for teletherapy success.