Telemedicine Tips for Therapists: Effective Online Counseling Techniques

Oct 7, 2020, 08:30 AM

Woman smiling during telemedicine therapist appointmentMoving your practice online is often a necessity of the current climate, but how can one transition safely and effectively? We’re going to answer your questions on how to move your therapy practice online.

How is online counseling done?

Transitioning from being an in-person, licensed therapist to an online therapist is relatively easy once you familiarize yourself with the tech, laws and techniques specific to the platform.

To become an online therapist, you’ll want to do the following:

  1. Set up a distraction-free, at-home workspace.
  2. Check the legal information, especially the information that’s specific to your state.
  3. Step yourself up on a HIPAA-compliant platform, like or VSee.
  4. Talk to clients about their comfort with the platform.
  5. Use teletherapy mental health techniques.
  6. Keep a reasonable schedule and give yourself distance.

HIPAA-Compliant Platforms

  • me: This is a completely free, HIPAA-compliant platform that’s very easy to use.
  • VSee: This platform offers VSee Messenger and VSee Clinic. At one point, the platform offered free services but has begun charging for their HIPAA-compliant BAA.
  • Google Meet: After signing up for G Suite, this platform offers both a safe email and a safe platform for meeting online.
  • Zoom: A HIPAA-safe version of Zoom for therapists is used by many people with careers within the world of behavioral health.

For therapists who are used to taking checks in person, you’ll also want to find a HIPAA-compliant method of online payment like Square or SimplePractice.

Lastly, your email and calendar needs to (and already should be) secure as well.

Does online therapy work?

To answer that, let’s look at the science. Studies have shown that online mental health therapy (specifically using CBT techniques) has been as effective in treating many kinds of mental disorders. In a comparison of online therapy vs. group therapy for people with depression symptoms, the Internet-based treatment was actually preferable in the long run. A similar study for patients with panic disorders found “no statistically significant differences” between the two treatment conditions. There was even a recent pilot of a text-messaging program for those with schizophrenia that achieved some success. Across 12 different studies with differing results, it was made clear that Internet-based treatments hold some promise and are a safe alternative.

Will it work well for my patients?

Of course, that doesn’t necessarily answer the question, “Is online therapy effective for my patient?” Obviously, some level of discussion of comfort is required along with other considerations. For instance, is online therapy safe for those with psychosis, suicidal intent or who are in the middle of a crisis? Dropped calls and technical difficulties can be a huge upset to some patients, and many online companies don’t have guidelines for handling those high-risk situations.

What are some key differences?

There is a lot of pros to why so many people are choosing this platform, besides the need due to the pandemic. It’s helpful for individuals in remote places, with accessibility issues, and those who are nervous about meeting in person. But is online therapy good, all the time? Obviously, there are some drawbacks:

  • You’re not going to be able to see your client’s body language.
  • Certain therapy techniques like EMDR will be difficult to do online.
  • Sometimes, individuals have trouble with insurance coverage.
  • It’s a poor platform for handling high-risk situations.
  • It’s difficult to treat and help those with serious addictions or psychosis this way.

What are some important teletherapy tips?

Here are some of the most important online therapy tips for therapists:

  • Ensure your email, calendar and meeting space are HIPAA-compliant and secure. Every stage of the process, from scheduling to payment, needs to be HIPAA-compliant. There can’t be any shortcuts.
  • Create a distraction-free space. Be sure to turn off notifications. Also, try to keep pets, children and loved ones out of the space and relatively quiet, as this sort of interruption can create a lot of awkwardness in difficult conversations.
  • Test out your camera and microphone before making calls. Make you’re completely comfortable with this platform by testing it out with friends and family first – accidentally hanging up on a client, for example, can happen.
  • Double-check state laws. Many states don’t allow for out-of-state providers, for instance.
  • Connect with your malpractice insurance company for guidelines. Each company will have their own guidelines and recommendations. Malpractice insurance will often change when you bring your practice online.
  • Be sure to get a consent form that includes an electronic signature. Consent forms can help protect you and the client.
  • Add “95” or “GT” to your codes for health insurance. Billing is usually done by typically using the GT modifier (“via interactive audio and video telecommunications systems”) or the 95 modifier (“synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system”).
  • Check with your internet provider to see if you’re getting the quality service you need. You may even want to consider upgrading your account for more bandwidth.

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