I became curious about the possibility of doing online therapy years ago but it wasn’t until the summer of 2016 that I really began to seriously study the issue. I took courses, looked for individuals who were offering the service who were willing to share their experience and knowledge, and began to explore all the issues that were involved in the practice.   I won’t get into all of those issues here. I will share a few of the concerns I had and the solutions I found that eased them.   By sharing them I hope to ease your mind about entering online therapy.

I’ve always been rigid about people’s right to confidentiality. One of the things that still bothers me when individuals come to see me in my office is that they have to wait in a waiting room and interact with the office staff. For most people, it isn’t an issue, but for some it is. So, I had many concerns about privacy. Add to that the issue of security and technology and my head started spinning. You would have to be living under a rock the past year to not understand how much trouble a simple email can get you into. What software would I need in order to hold sessions online? Was the cost as high as it had been years ago when telehealth first started? Many dismissed that concern and said, “Just use skype.”   Was it truly secure? Was the technology good enough to allow for a seamless transmission of image and sound? And what about those emails? What could I do to offer people a secure way to send them? I was persistent and found great resources that solved those issues. First is a user-friendly service for sessions that does not require people to have to sign up or download software. The second is a service called Hushmail that allows encryption of email communication between myself and clients.

I then turned my attention to the issue of relationship. Is it possible to really connect with someone over a real time video session? Would I be able to pick up on the subtle nonverbal cues that are part of every conversation? Again, research and my colleagues eased my mind quickly.   In fact, there is research that indicates it is easier for people to open up and honestly share their struggles using online therapy. I learned that there are several things that can help make the online experience successful.

  • Computer or Laptop – It really doesn’t have to be a fancy set up but a computer or a laptop is needed. Using a smartphone just doesn’t allow for a big enough screen for you to see me clearly enough.
  • Before starting a session it is important to close out ALL programs. We have many things running in the background that we often don’t think about (i.e. Dropbox).  
  • Secure Internet Connection – A good, secure internet connection is critical. That means that it not a good idea to go to your local coffee house and connect to public Wi-Fi for your sessions.
  • Quiet Private Room – Finding a quiet private room to go to for your session is important. Somewhere that is going to allow you to have a block of time without interruption.
  • Background – Having a background behind you will help eliminate distraction and improve the quality of the image of your face.
  • Lighting – You need a space that has enough light but does not have bright light directly behind you.
  • Headphone and Microphone – Not a must but helpful. Sometimes you can hear yourself from the other person’s computer and it can be distracting. Having a headset quickly resolves that issue. They can be found inexpensively online or at your local box store.

The additional long list of issues that needed to be explored and address are part of the background of any practice. Some things I prefer to keep “old school.” For example, I like to keep paper files that are locked and secure in my possession. But the ability to offer people online therapy is an exciting one that I think provides a great deal of value and convenience.   I hope that you think so too and will give it a try.