SelfhelpMagazine Blog

17 Reasons for Verifying That Your Online Counselor Is Licensed in YOUR State of Residence & Just Theirs

Posted on 10. Oct, 2009 by Dr. Maheu.

Consumers often ask me how they can tell when an online counselor or online therapist is legitimate. First, don't fall for the e-therapy trap of having some hack offer you services anonymously. That's dangerous and if you sufddentl find yourself overhwlemed with feelings, don't count on anyone being there to help you. More about that in another post, but for now, here one of my strongest suggestions for getting reasonable and responsible treatment online.

One of the easiest things you can do is make sure you pick someone who's licensed in your state of residence. This residency requirement is one that's often confused, both by consumers as well as professionals.

This applies to all health care practitioners of all disciplines. States are very clear about this so that you have legal recourse if you have a complaint against any treating professional. Trying to file charges against someone in a different state is often expensive, complicated and unsuccessful.

Of course, any wise consumer will choose a licensed professional of any type over an unlicensed professional. If you think about it would you take your child to Dr. who claims to be proficient when he or she cannot show you a license to practice? I'd encourage you to hold the same standard for any type of professional, be they a healthcare, financial, legal, or even a hairdresser. If you do not insist on licensure for anybody working with you, you're selling yourself short and not taking appropriate care of yourself.

Answering questions over recent journalist writing an article on this topic for US News & World Report, I came up with these questions for consumers to ask themselves when they hire an online counsel or online therapist.  Unfortunately, there wasn't room in the article for all of them to get published, so I'm post the rest of them here for those of you who want the full story:

1. Is this professional licensed in my state of residence so that if I have a problem with them, I will know which licensing board to send my complaint?

2. Are they telling me everything I'm suppose to know regarding confidentiality? For example, aren't they suppose to report me if I do something against the law? What are those things? Do they tell me ahead of time in a written agreement?   What will they write in my file and where does that file go? Do I get the chance to see or correct my file like what happens between us? Who else sees that file? What other things am I suppose to know ahead of time?

3. What proof have they offered that they have successfully completed specialized training to work with people who contact them from the Internet?

4. What backup systems do they have in place to help me if I get emotional when we start talking? What happens if we get disconnected at those times, do they call my house or just forget about me? How do they know where to send me in my local community, or will they just tell me to "go to the emergency room" or "use the Internet to find someone locally" when I'm too upset?

5. What will happen if the counselor decides at any point that you are not of legal age or of sound enough mind to continue the online counseling?

6. What happens with mandated reporting situations:

• • • elder abuse
    • child abuse
    • spouse abuse
    • homicide and in some cases
    • suicide

For example above, what will happen to your medical record or to you if , at any point in the future, you feel like killing someone? yourself? Shouldn't someone have kept a record of these things? Reported you earlier? Done something to help while you were emotionally open to talking about it?

7. What should you do if you feel like you need to contact a counselor you met online and he or she isn't available, or ever available again?

8. What should you do if the counselor you get is unprofessional or imappropriate? Is it ok for the counselor to give you their personal contact information?

9. Who gets to see your contact information? Staff? Programmers? Have they signed confidentiality agreements? What should you do if you suddenly get put on spam lists or get contacted by someone else at that referring company for other offers? Who has access to their computers? What's to stop them from misusing your info?

11. What happens if that counselor sends you an email and your spouse/child/parent/friend intercepts that email? How much personal information should be in any email you are sent? Should such private conversations occur exclusively in encrypted email or an encrypted website? isn't there a law called HIPAA that required such encrypted and confidential information exchanges? Given that most email and chat rooms are not HIPAA complaint in terms of encryption, what can you do to make sure your information is safe?

12. If you sue the counselor, how much of the private information you gave them during your conversations going to get revealed to the public court?

13. What are your rights if you are involved in a court proceeding at a later date and want to have your record used  to support a claim you may have about a situation you discussed with your online counselor?

14. Did your counselor discuss a law called HIPAA with you? Just like any physician you see, it it a licensed mental health care practitioner's duty to inform you of these protections prior to your care if they transfer information about you to other professionals, and in some cases, including the police. This information should be available to you somehow.

15.What will happen if the chat room, email or telephone system you use to communicate gets hacked; or if the file about your account gets tampered.

16. If your record is shared with other parties, such as law enforcement, the court, or other governmental agencies, are you going to be informed? By law (HIPAA), you have aright to a full accounting of who has requested to see your records, where and when they were sent.

17.  If no records are kept of your contacts, that too is unprofessional and can harm you in situations where you want to know what happened between you and a professional, especially if you make life changes are based on that discussion.

One last thing for you to think about…what do you make  of these small e-therapy websites  don't use medical records, offer anonymous counseling through SKYPE and other systems without encrypted protections for you on one hand, and then  see the big companies like Google setting up services that are in line with "Telehealth" requirements and using HIPAA-compliant medical records? Which group do you think the well-trained and most competent therapists are going to follow?

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Depression: How to Think about it & What to Do

Posted on 19. Jun, 2008 by SHM Staff.

Dini wrote this in response to someone who looked like she was depressed, but not identifying it in herself:

Hi K…

We "spoke" a few messages ago. I read your post about your classes and work situation and my immediate thought was pretty much the same as Jimmy's; the word depression popped into my head. I've had a major one and lack of caring about things we normally care about, not taking care of ourselves, etc., are some of the symptoms. I've done pretty much what you are describing (except the thesis part). Let us know what you think if you follow Jimmy's suggestion and "google" depression. There is a sort of standard list of symptoms that I'm sure you could find on numerous sites (including this one).

If you are experiencing depression the good news is that it can be treated and managed. I've found therapy and appropriate meds took me from a place of insane, and at times suicidal, depression to much more solid ground (well, at least what passes for solid ground under my feet anyway). And I continue therapy to avoid those places and learn about "triggers" and dealing with them before I start spiraling downward. Insanity is a fascinating place, I'm glad I know where it is (for me), but I'd rather not spend a lot of time visiting. (Don't take that the wrong way; I am not saying you are insane – I was and now have the knowledge that I am perfectly capable of being insane, even did a "walk on" for a short hospital stint of my own volition in a particularly bad patch – while I didn't enjoy the experience of insanity very much, it is handy knowledge to have in hand). I'm also a sober alky which is another form of insanity (the drinking part).

Let us know your thoughts and feelings about it. There are plenty of folks around here who have been through depression – you certainly would not be alone. It's a lot more common than most folks like to let on.

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