Over the last week, many mental health practitioners have been forced to transition to telemental health as all of us implement social distancing. This is abrupt and perhaps anxiety-producing for those who have never treated clients through videoconferencing—and perhaps never wanted to. But there is no shying away from it. During such an uncertain time, clients need continuity of care. They need your support to keep working toward their goals.
When I decided to move part of my psychotherapy practice to a virtual platform a few months ago, I feared I might not be able to offer my clients my best self. Would my services be less effective through a screen? Would I be less present? And would my clients be less focused or forthcoming? I knew I wasn’t going to overcome these fears by ruminating over them. I had to take the same advice I would give to a client in my situation: exposure therapy. And this is what clinicians are doing now.
After a brief adjustment period with the videoconferencing format, I have found that I am more present than ever. I feel more attuned to my clients as I engage with them face-to-face—and only face-to-face. I can pick up on the smallest nuances of my clients’ verbal and nonverbal responses. The screen is unflinching.
Research on videoconferencing has been relatively consistent with my experience. A study by Barbara J. Kocsis and Peter Yellowlees (2018) out of the University of California, Davis examined the advantages to the psychotherapeutic relationship when psychotherapy is carried out over videoconferencing. They concluded that “Telepspychotherapy offers a novel way to reach and form strong psychotherapeutic relationships with many different types of patients, and it may foster therapeutic intimacy in ways that in-person psychotherapy cannot.”
Here are some tips to make your transition to telemental health smoother.
1. Education. It is necessary to familiarize yourself with the legal, ethical, and clinical aspects of telemental health before practicing. I use the Telehealth Certification Institute platform, which offers free webinars as well as a certification.
2. Boundaries. You must create the same private and confidential environment at home that you have in your office. Both you and your clients should set boundaries with the other occupants of your homes. Think ahead and let your family members or roommates know that you will be closing your door between specific times of the day. You can also buy a sound machine.
3. Screen size. While clinicians can conduct these videoconferences via phone, tablet, laptop, or desktop computer, I prefer a desktop computer screen. If you have the means, you might find that a desktop enhances your focus since you can’t walk around as you can with a phone or tablet. Thus, this option allows for the most transparency between clinician and client.
4. Video platform. I use Zoom and Doxy.me. Since my clients tend to prefer Zoom and its free sessions only last 40 minutes, I pay for a subscription. Both Doxy and Zoom are HIPPA compliant.
5. Payment. Payment must be HIPPA compliant, and many of the apps out there are not. I use Square, for which I have to pay a small interest fee, but it allows me to easily enter a credit card number and is HIPPA compliant.