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Online Counseling
Dr. Dawn-Elise Snipes Ph.D., LMHC, LPC-MHSP
Charles Snipes IT Director &
~ History of Online Counseling
~ Reasons for Online Counseling
~ Methods of Online Counseling
~ Ethics of Online Counseling
~ The Business Aspects
– Choosing a Virtual Office
– Possible Features
– How much to charge
– Marketing: Making a Place in Cyberspace
~ 1970s several hospitals linked via video feed to provide doctor-to-doctor consultation
~ 2000 the first independent practitioners started making a name for themselves
~ 21st Century people have begun communicating more by text/IM
~ 2006 several states passed laws indicating that telehealth must be compensated at the same rate as face2face
~ 2010
– The majority of insurers are compensating for telehealth services
– Florida created a state-certification for e-therapy.

~ Access experts on a particular problem worldwide (must be licensed in the state of practice and the state where the client resides)
~ Often more cost effective for the practitioner and the patient
~ Provides a degree of anonymity making many people feel more at ease
~ Enduring record
~ Many of the youth of today prefer etherapy…You lived on the phone as a teen, they live on their iphone or text.
~ An adjunct to traditional therapy
Methods /Ethics / Cultural Appropriateness
~ Phone
– Benefits
– Drawbacks
~ Text/IM
– Benefits
– Drawbacks
~ Video
– Benefits
– Drawbacks
~ Email
– Benefits
– Drawbacks
~ Who and Where
~ Verifying identity
~ Assessment
~ Treatment Issues
– Addictions
– Anxiety
– Depression
– Bipolar
Ethics- Informed Consent
~ Verifying Identity
~ Who will have access to the information
~ How to handle power or internet outtages
~ How to handle mental health emergencies
~ How to schedule and reschedule
~ Payment policies
– Fees
– What shows up on credit card
– Alternate payment methods (checks / money orders)
~ Releases of information
~ Information Security and Risks
~ Methods for protecting privacy (clearing cache / deleting recent history, etc.)
~ Handling disinhibition
– Suicidal threats
– Flaming
– Repeated calls/texts/emails
~ Information about expected response time for
– Text
– Email
The Business Aspects
~ Choosing a Virtual Office
– Virtual office vs. a web presence
– Partnering with someone else vs. Independent Office
 Advertising/Marketing
 Commissions
 Payment

Business Aspects cont…
~ Possible Features
– Web presence
– Interactive online appointment book
– Fillable assessment and intake forms
– Secure IM/Text chat (imbedded or downloadable)
– Secure email
– Secure video chat (imbedded or downloadable)
– Instant services

Business Aspects
~ How much to charge
~ Marketing: Making a Place in Cyberspace
– SEO optimization
– HTML vs. Blog or CMS
– Designing your website (colors, usability)
– Finding a niche

Online Therapists and Social Networks
~ Keep your personal social networks separate from your clinical / practice network
~ Add clients only to your clinical network if you have one
~ Know whatever you say / put out there can possibly be seen and interpreted personally by a client
~ Online therapy is becoming increasingly mainstream
~ There are many advantages such as convenience, cost effectiveness and accessibility
~ Things to consider when choosing an office are your particular skill set, your target population, how tech savvy you are and how much you want to spend
~ Building an online practice is no faster than a face-to-face one, but there are things you can do to speed up the process.