Although therapy has traditionally taken place within the office of a psychologist, or other mental health specialist, online therapy is now gaining traction. There are now a number of published studies demonstrating the efficacy of e-therapy (e.g. Kumar et al., 2017; Ruwaard et al., 2012).
Telepsychology can be especially helpful to those people living in remote areas where health services are less available, and during unique circumstances that pose a challenge to receiving health services. The current pandemic we all face with COVID-19 is one such example. Thankfully, internet-based therapy can now be offered so that our psychological health does not suffer.
A number of best-practices guidelines have been published by both the Order of Psychologists of Quebec (OPQ) and American Psychological Association (APA).
If you are considering this form of therapy, some key highlights organized by topic, reproduced below to help guide your choice.
You can following this link if you would like to learn more about the ABCs of Online and Web-Based Therapy.
Competence Of The Mental Health Specialist
Since internet-based therapy is different than individual face-to-face therapy, it poses different challenges than traditional 'in-the-office' therapy.
Make sure to select a psychologist that is an expert and that you feel comfortable with from their online presence. The following guide on how to find the best online therapist will be of help to you.
Besides their website, you can also look for Reviews and Testimonials in order to learn the experience that other people have had working with the specialist. I am proud to have achieved a 5-star rating on both Google Reviews and RateMDs and am listed as 1 of the 3 best psychologists in Montreal. Thanks for letting me know I was helpful!
Therapeutic Approach
Research studies have evaluated the efficacy of Cognitive Behaviour Therapy (CBT) most often for e-therapy, so it would be ideal to select an expert with this expertise.
CBT approaches are scientifically-based and have been shown to be efficacious through 1000s of studies involving 100000s of subjects (e.g. Butler et al., 1996). These approaches are practical, present-focused and tend to be more short-term in length.
You can find out more about CBT and other ‘third-wave’ psychotherapeutic approaches on this page.
Technology
Make sure that you are comfortable using the internet, a computer and your smart phone since these mediums are used for e-counselling.
Ensure that you have a good reliable internet connection. Make sure to deactivate any apps, notifications, and popup windows on your computer or phone that may appear and distract you from fully benefiting from the session.
Use a secure internet connection that is password-protected, and not a public WiFi connection, to ensure your confidentiality and prevent any possible hacking. Make sure that your Antivirus and Firewall software are up-to-date to prevent any potential hacking.
Ensure that you discuss with your psychologist using a platform that is compliant with the Health Insurance Portability and Accountability Act (HPIAA).
For your information, applications on your smart phone like Facetime and Whatsapp are not HPIAA compliant. Some platforms that do meet the standards of the HPIAAUse are Zoom, Webex and Skype (with certain upgrades).
Physical Space
Do you think you will feel comfortable with e-therapy. If you are unsure, try a few sessions and then decide. Psychotherapy is voluntary so you can withdraw your consent at any moment you decide to.
Choose a quiet location for your sessions and minimize distractions. Make sure the room is quiet. Remove any objects or pictures that may distract you. If there are any objects, glares, etc. that are distracting you in your psychologist's room, mention it to them so they can be removed.
No one else should be present in the room during your sessions. If someone is present, make sure to inform your psychologist as they need to be able to see every person in the room.
Make sure to keep your camera close to your face so you can be seen well. Ensure the lighting is good and that there are no reflections. Also make sure you can hear your psychologist well and that they in turn can hear you well.
Consent And Confidentiality
Here are a few basic points your psychologist or psychotherapist should go over with you during your first session.The specialist should:
1) Discuss informed consent with you and confidentiality as is regularly done when sessions are in-person.
2) Discuss the limits of confidentiality with online therapy and how it is different than in-person therapy.
3) Outline the risks and benefits of therapy and how this could be different with online therapy.
4) Confirm with you that nothing is being taped and that written permission would need to be obtained to do so.
5) Ask that you make sure that your insurance provider will reimburse teletherapy or internet-based therapy.
6) Confirm that you are comfortable and feel secure to do therapy in the location that you are at.
7) What to do in the case that the session was interrupted (e.g. bad connection or the internet stops functioning).
8) Confirm your contact information such as your address, date of birth and phone number where you can be reached.
I hope that you have found these practical guidelines helpful.
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