Online Counseling (web-based, app-based, messaging-based counseling, video-conferencing, etc.), as opposed to in-office sessions, is increasing in popularity and has a number of benefits. These benefits overcome many traditional barriers to accessing counseling sessions including transportation issues, scheduling conflicts, finding childcare services, coordinating times as a family or couple to meet together for a session, or even locating a counselor who is both local and a good fit for the challenges and goals a client is facing. Additionally, an online counselor is often able to adjust communication methods to fit with a client’s needs. Yet, not every counselor offers online counseling, and for those who do provide it, how can the individual consumer know if the provider is competent in offering these services? Some counselors, for example, might jump into online counseling because their clients have asked for it but before they are truly prepared or competent in offering it.
Healthcare clinicians have legal and ethical responsibilities to both evaluate and then ensure their own competency before providing services of any kind. Mental health providers cannot adequately assess their own competency if they have not been exposed to the essential aspects of online counseling. Counselors invest a lot of time preparing to provide on-site services in their office by completing a graduate program and years of clinical supervision. However, most graduate programs and clinical supervision programs do not cover the competent use of technology in practice.
Standards of practice are in place for the benefit and protection of clients. Some of the standards of online counseling are: adhering to federal and state laws and codes of ethics; verifying identity and location; establishing emergency management plans; protecting the privacy and security of patient information; using professional communication skills when using video, phone, or messaging; adequately preparing the client for sessions; providing clear and adequate consent forms; assessing whether or not the app actually does what it claims to do.
Prior to providing online counseling, counselors ought to complete a comprehensive training program that covers all of the essential competencies discussed in this article. After completing a comprehensive training program they will then be able to assess their own competency and receive any needed further training or supervision to become competent before practicing distance counseling. The Telehealth Certification Institute LLC provides the Telemental Health Training Certificate program which covers all of the essential competencies of online counseling, including:
- defining the benefits and risks of online counseling,
- determining how to practice legally and ethically,
- identifying privacy laws in the United States,
- preventing risks to privacy and confidentiality,
- choosing proper communication technology and business agreements,
- establishing an emergency plan,
- properly identifying the client receiving counseling and ensuring they are a good fit for online sessions,
- preparing the client and skillfully providing online sessions,
- and many others…
The Telehealth Certification Institute provides consultations to counselors and a provider workbook to assist them in practicing competently. They also have a Telehealth Provider Directory on their website where individuals can identify clinicians who have completed a comprehensive training program by using the search filters.
The best way to discover if a counselor is competent in online counseling is by holding them up to the same standards of care you would expect when receiving in-office services. Some questions to ask:
- Are they licensed to provide services in the state in which you are currently located?
- Do they provide a consent form?
- How do they verify your identity and location?
- Can the counselor explain how the technology or apps they use with you protect your privacy and security?
- Do they share a back-up plan for emergencies and technology failures?
- Do they refrain from communicating with you through non-secure means such as standard email or texting?
- Do they prepare you in using technology for successful and effective sessions?
If the answer is “Yes” to these questions, there is a very good chance your counselor has been trained to competently provide virtual or online services. You might initially feel that asking these questions is disrespectful to the counselor. This is because we assume that a clinician would only practice in areas where they are competent. However, clinicians sometimes fall into the trap of thinking that they are competent in the use of technology, when they really are not ready to use it in their practice. With a little effort you will now be able to find a competent distance counselor who fits your specific needs.