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On May 12th this year, the DirectShifts team had organized a panel discussion on ‘Transforming your in-person practice to a virtual setting’ with Steven Herbst – Psychotherapist & Licensed Clinician at Riverdale Psychology, Sarah Joyner – Founder & CEO at The Social Social Worker, George Anderson – Psychotherapist, Founder & CEO at Anderson Services, and Ori Balaban –Growth & Business Development at BetterHelp as panelists. The online event saw over 100 therapists actively participating and seeking insights from the industry leaders. This article presents the the A-Z of setting up a teletherapy practice to capture the essence of the hour-long discussion in text format for your quick reference.
The COVID-19 pandemic and the global lockdown situation triggered an unprecedented mental health crisis in several countries across the world, including the US. The health concerns, social isolation, loneliness, and loss of livelihood, made several people turn to teletherapy companies like BetterHelp for stress, anxiety, depression, and substance abuse issues. While it was believed earlier that about 25% of the American population suffered from diagnosable mental illnesses, that percentage has roughly risen to 40% through the pandemic.
Mental health professionals have been equally affected by the pandemic, with uncertainties around their health and careers. The tremendous stress on healthcare systems led therapists to adopt teletherapy as a viable solution to make mental health support available to those in need. However, they still had to adapt themselves to the new normal and adjust their working styles to a remote model. Several healthcare professionals are increasingly retiring early or moving away from clinical practice due to burnout. Since mental health professionals have also been treating patients in hospitals through the pandemic, there is a high likelihood that they may develop Post-Traumatic Stress Disorder (PTSD), once the pandemic ends. As a result, they might choose to restrict themselves to online practice after the public health situation normalizes. Such a decision might be economical too, as it helps avoid overhead expenses for therapists.
In short, we have strong reasons to believe that teletherapy is here to stay, either as a standalone or a hybrid model. And therapists must be prepared to advance their careers in the digital space.
Let’s discuss and address some of the common challenges that therapists face with moving their in-person practice to a virtual setting:
Setting up a system that would ensure a steady flow of clients for your virtual practice can be as challenging as getting that first client. “One of the things that has worked well for me for many years is to begin with a niche. You need to identify a niche and master that niche. So, instead of practicing after I got my first degree and my master's degree, I went for post-graduate training, then I started a practice”, says George Anderson who has a flourishing career as a child and adolescent psychotherapist for almost 50 years.
In addition to identifying your leadership niche, establishing a social media presence with your niche as the focus is crucial to building referrals and a pipeline of clients.
People are mostly hands-on with video tools such as FaceTime and Zoom for a variety of reasons ranging from being in touch with family to fixing appointments with patients/clients. Even though patients might feel awkward in a teletherapy consultation initially, they will eventually settle into it. Online therapy is the future of mental health, and walking clients through the process beforehand might put them at ease.
Social media can be a powerful tool to build your teletherapy practice. It gives you greater visibility and allows you to connect with people across the world and have real conversations with them. Another advantage of being on social media is that you can learn about topics that are relevant for your practice, at zero cost. Most healthcare professionals, however, tend to forget to build their brands on social media due to the zillion things that they are juggling. This can be counter-productive if you want to find new clients. Always remember to promote your personal brand.
For therapists who are not comfortable donning the hat of marketers, a quick workaround could be to join hands with teletherapy companies. BetterHelp, for example, provides all the tools that are necessary to run your teletherapy practice. Their platform includes text messaging, video chat, worksheets, tools, and billing. The BetterHelp team spends millions of dollars on client acquisition and unlimited referrals for therapists based on the needs and preferences of the patient and the task at hand.
Also, when it comes to building your practice, it may be worthwhile to think about ancillary services that clinicians can offer, in addition to traditional psychotherapy. For instance, “Road rage is not an issue that needs to be or can successfully be addressed with traditional counseling or psychotherapy. It could be something that one may specialize in doing as a side hustle. The other one would be batterers' intervention, these are mandated clients who come from the court based on the crime of family violence. Another one is parenting, people who abuse their kids are automatically mandated for parenting classes. And substance abuse. The same person who beats his wife or is involved in road rage and so on often uses chemicals to reduce the stress and I think that those are some of the ancillary areas that we may consider adding to our areas of focus or getting patients from”, says George Anderson.
Some patients may feel disconcerted with their therapy sessions on Zoom being recorded. You must have a candid conversation with clients at the very start, explaining to them that you will be unable to provide any feedback if they do not sign a release of confidential information. Being clear in terms of what you can and can't do makes it easier for both you and the patient.
Joining hands with technology companies can be a good decision too. “At BetterHelp, we pay a lot of attention to the security and we have a security team that's responsible to maintain security across the platform. Every interaction is secured and encrypted. We don't record any session, we care a lot about member data. People who work for us cannot even look at what's going on in the platform”, says Ori Balaban.
Also,ensure that you are conscious of your own boundaries as you could be taking on more workload now that technology enables you to accept clients anytime.
Teletherapy can offer a great deal of freedom with your practice. It allows you to try out new things for your patients’ well-being, which may not have been possible in an in-person setting. Steven Herbst shares, “I've had clients who were nursing home patients in long-term intensive residential nursing home. They missed their pets. As they've been quarantined, they're not allowed any visitors, they're not allowed to go to the dining room or a social hall. I have a dog and a parrot here in my home and I've brought the dog in for them to see. One of the clients told me that she loves birds. I brought my parrot in for her to see and just put a smile on her face. When somebody's been quarantined for the better part of a year, stuck in a room with a roommate they can't stand, putting a smile on their face can be a big help. One client from geriatric said she always wanted to visit New York to see the big apple, but she wasn't able to do that anymore. So, I changed the virtual background to have a scene of New York City with the statue of liberty and the skyscrapers and I gave her a little tour of New York.”
The advent of technology has now led us to a turning point in the history of mental health care delivery, where therapeutic support can be accessed easily across geographical barriers.Therapists must therefore rise to the occasion and lead the change by adapting themselves and helping patients adapt to the new normal.
You can watch the full panel discussion here.
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