It's easy. Check out their license.

1. First of all, make sure she ~ has ~ a professional license. States require licensure of all professionals so as to protect your rights as a consumer. Bus drivers, undertakers, beauticians, and plumbers need to be licensed. Surely you want someone who is responsible for helping you with your emotional well being, or that of your loved one, to be licensed after proving their skills to an objective state licensing board.Besides, if they mess up, you'll want to be able to call someone, and that would be their licensing board.

2. Find out how much training they've had for doing online therapy or counseling. If they sidestep the question and try to dazzle you with the 10 years of experience they've had workign online or by telephone, be leery. Alcoholics have lots of experience with alcohol, but by state law, they need to prove they have had training in alcoholism treatment before they can deliver alcohol counseling. So you want someone who has had formal classroom training.

3. Go to your state board for their profession, and make sure they are either licensed in your state or registered with your state. If they are not, they most likely are practicing in your state without a license – which is probably a crime. Do you want to work with a lawbreaker? (If they are especially naive, they may not even know or remember that they need a license to work with you, wherever you are, online or offline. Call your state board and get the facts if you are in doubt.

Please post your questions below!

Dr. Marlene

Fraud

When mis-billed, such practice is technically known as insurance fraud, and a serious crime for which your therapist will be held responsible.

Of course, nothing will happen if you don't get caught, much like speeding in your automobile. However, if you are complicit in fraud, and something goes wrong, you may be held responsible to some degree if you knew of the fraud. Make sure you know how your sessions are being billed to your insurance company, and double check to see if your therapist knows what they are doing both technically and with proper billing practices for the professional services they offer you.

Therapists can get a billing guide funded by the federal U.S. government by using the form in the upper right corner of this website: TeleMental Health Institute to get our newsletter. A free gift we give to professionals subscribing to the newsletter is an ebook called, "Telemedicine Reimbursement Handbook" and also available through CTEC.

What Else Can You Do?

Check with your insurance company. Just call them anonymously and ask if they pay for the specific type of technology your therapist is using, be it email, chat, video, telephone or anything else.

TIP:  if your insurance hasn't traditionally paid for telephone based services, they most likely won't pay for Skype or other non-HIPAA-compliant video services online, either.

The next step for you of course, is to send you insurance company a letter and voice your strong objection to their rejection of services that make access to mental health more possible for you. In fact, 12 states mandate payment by insurance companies for telehealth. They just seem to be dragging their feet. Consumer complaints will make all the difference.

~

Marlene M. Maheu, Ph.D. is the Executive Director of the TeleMental Health Institute, Inc., offering a Certificate training program in TeleMental Health for telepsychiatry, telepsychology, telesocial work, and online counseling. Academic books authored by Dr. Maheu and colleagues include eHealth, Telehealth and Telemedicine and The Mental Health Professional & the New Technologies.

Help comes in all shapes and sizes, as do people and their challenges. Similarly, online therapy, online counseling and web therapy are being practiced in many research-based and viable forms by responsible practitioners. The scientific literature supporting "telemental health" and "behavioral telehealth" is over 50 years old, and shows that benefits  often parallel in-person therapy.

Bad News

However, online therapy, online counseling, web therapy, Internet therapy and even Skype therapy are also being offered in random, unmeasured and undisciplined ways, from anonymous chat room sessions for $3.99 a minute to Skype sessions. (Anybody online can claim to be a therapist without actually being one — even your next-door neighbor using a false name.)

Worst yet, many therapists have jumped online without any training whatsoever, and now are offering "professional" services through email, chat rooms, text messaging and videoconferencing — without so much as an undergraduate course in what can go wrong, or how to make sure you are safe. That's like allowing them to drive without a driver's ed course or exam, and just hoping they won't hit anything.They might do just fine, until there's a problem with the road, or traffic, or in an emergency.

The professional mental health associations are working hard to help develop guidelines for therapists wanting to use technology, but they move slowly and simply are not there yet in many ways. Their second step will be professional training.  To see 5 questions Dr. Maheu recommends you ask your online professional, click here.

Having "psych" issues when in the military can quickly lead to being treated as unreliable on the battle field, and other forms of stigmatization. Many military personnel choose to never speak of their internal struggles, thereby rendering themselves more unreliable than if they sought help when they needed it. After all, witnessing the horrors of war is unnatural, and pretending it's business as usual is unnatural. Such deviations from human nature can lead to unpredictable performance and put an entire platoon at risk – but the machismo of the military won't allow such natural reactions to be fully voiced and de-briefed over time.

War veterans then, are often comfortable and at home with gaming-like environments such as Secondlife, and don't feel as threatened by them as they would if they had to go visit a "shrink." Virtual worlds are offering these people a new way of interacting with their medical and mental health practitioners in order to get the help they need as a viable member of their platoon.

And avatar-based therapy isn't just for war veterans. It is useful for anyone who needs relaxation, stress management, anxiety reduction, depression relief and many other types of useful self-help information. It's our job to deliver services in whichever format the consumer will use.

Stay tuned — virtual worlds have a lot to offer, and their therapeutic uses have only just begun to be realized.

Therapists (like teachers, other health care practitioners, and public servants) are "mandated reporters," that is, they have to inform the authorities (and the intended victim in some circumstances) if a client reveals that they:

a) plan to murder someone

b) plan to suicide or

c) have hurt a child, elderly person and in some cases, a spouse.

These mandated reporting laws were put into effect after decades and thousands of consumer protection issues were considered by our legal and professional systems. As you can imagine, victims of people getting reported are often more than relieved to have their abuser stopped by the "system." Furthermore, people who get reported are often relieved to have been stopped, once they get the help they need.

If an online therapist isn't following these mandated reporting rules but offers you professional services, they may very well be practicing illegally and unethically. Do you really want to be working with some who takes such issues so lightly? What else are they not doing properly?

You can find all kinds of help online. There's no need to seek out professionals who aren't following some of the most basic rules of our entire health care system.

That's my opinion. What's yours?

He said: I have heard depression described as pain and anger and trauma turned inward (against yourself) and in my own experience, I've found that often to be true.  It sounds like you are physically acting that out and YOU DO NOT DESERVE TO BE TREATED THAT WAY BY ANYONE, INCLUDING YOURSELF!!!!!!!

Here's how:

1. Your therapist needs to get secure technology. SKYPE is not yet secure, but if they pay a little money, they can get what's known as "HIPAA-compliant technology." If they have any questions about doing that, ask them to get the audio recording available at the bottom of this page about the risks associated with SKYPE.

2. They need to get approved to practice where you live. That's pretty easy. All they need to do is contact the licensing board for the discipline they practice "Psychology, psychiatry, counseling, social work) and ask permission. Most states and countries will grant it, but it has to be approved on a case-by-case basis. This is for YOUR protection, so don't short change yourself. Make sure they get it. I'm offering a webinar on this topic this coming Monday, July 11, for free. They can download it and listen to it later if they can't make the live call.

3. They need to get trained to meet ethical requirement for proficiency and competence in new areas of practice. Using technology is a big new area of practice. If they want training, it is available at the TeleMental Health Institute, which is the Institute I founded with colleagues.

Your insurance company may not like it, but in 11 states, the law says they need to pay for remote care. Ask them before you ask your therapist, just to be sure.

Gotta love technology!

Dr. Maheu

Some mis-informed therapists think that simply telling you they are using an unsecured platform lets them off the hook to jump on Skype. Asking for your permission doesn't let anyone off the hook. There are many other bases that need to be covered. We will be discussing them here in this blog.

That's my opinion. What's yours?

Marlene M. Maheu, Ph.D. is the Founder and Editor-in-Chief of SelfhelpMagazine. She is also the Executive Director of the TeleMental Health Institute, Inc., offering a Certificate training program in TeleMental Health for telepsychiatry, telepsychology, telesocial work, and online counseling.  Academic books authored by Dr. Maheu and colleagues include eHealth, Telehealth and Telemedicine and The Mental Health Professional & the New Technologies.

1. Is it ok for me to ask my therapist to text me rather than call and leave messages? or have a Skype session with me online? or let me send them an email describing how I feel about a certain topic?

2. If my therapist agrees to work with me using some technology, what does that mean about their professionalism?

3. If my therapist doesn't agree, what does that mean about their professionalism?

4. What else should I know about using technology for psychotherapy or counseling?

5. Should my therapist get special training to do online therapy or online counseling with me?

You can expect that I have strong opinions, since I've been doing research, writing and lecturing on this topic for the past 17 years. You don't need to agree with me, but you might find what I have to say thought-provoking. I invite you to comment and discuss the issues with me, as many therapists do every day. I founded an Institute designed to help professionals learn how to work remotely, using a variety of technologies.

Regardless of my background with this topic, I sincerely look forward to learning from you. I hope you share your views with me.

I think what you're describing is too much pressure – I know the feeling all too well.  I've learned to do 1 thing at a time, and if my mind starts wandering over to another, to call it back and say, "No! I decided I'm doing this now, and that's all I'm doing." Period. Have a good time with your man and forget it until Sunday. Then on Sunday, ask him to go away and focus on getting that application tip-top shape.  I found that a lot of my anxiety was because I didn't trust that I would keep my promises to myself, I'd let myself down, get pulled into this or that by someone else because I couldn't say no.
It's hard to make it stick, especially when other people get involved and want me to do things. I want to be included, yada, yada, yada. Once I learned how to make my promises to myself stick, the anxiety lessened dramatically. I hope this helps!