Revealed: Three actions every therapist needs to take immediately to improve their teletherapy sessions
by Charles Roberts, ED.D, LPCC-S, LICDC-CS
It will be years before we fully understand how the coronavirus pandemic has changed society. But one thing that is certain: teletherapy is here to stay.
Last spring, teletherapy became a lifeline for clients during the lockdown. Almost a year later, therapists and clients are still seeing benefits to this mode of treatment. It’s convenient for clients. It has expanded access for those who have transportation barriers or who face community stigma. And most important, research is finding that symptom reduction and client satisfaction rank about the same for teletherapy as for in-person sessions.
Yet despite the widespread adoption of telehealth tools in the past year, obstacles for therapists are still prevalent. Very little formal training exists that is specific to mental health providers. Telehealth has unique policies and procedures above and beyond in-person visits. Technology issues can derail a session. And there are a host of legal risks to navigate.
Continuous improvement is at the heart of what we do. In the spirit of continually improving how we serve clients, here are three video teletherapy best practices therapists need to incorporate into their teletherapy sessions now.
#1 – Set Your Sights on the Setting
Creating the right ambience is just as important on a video platform as it is for in-person sessions. Dress professionally and be on time. Remove visual clutter and physical distractions from your practice space. And don’t overlook lighting—it should be adequate without being harsh. Always position your camera so that light sources, including windows, are in front, rather than behind, you.
Pro tip: always look at your camera, not your client’s face, to show engagement. Keep in mind that positioning the camera too close to your face can make a client perceive that you are in their space. It may also cut off nonverbal cues, like hand gestures.
#2 – Know Your Technology
You may need to pull double duty as IT support, so make sure you understand how your technology works before diving in. Start by ensuring your internet connection is fast enough to support video conferencing. Test your video and audio connections before every session. And always create a back-up plan with each client during your first session. Even with preparation, technology and internet connectivity can fail without notice. You and your client should both know what to do when this occurs so that their care is not interrupted.
#3 – Protect Patient Privacy
Teletherapy presents a host of risks related to the Healthcare Insurance Portability and Accountability Act (HIPAA) standards. At the most basic level, sessions need to be conducted in spaces that are free from interruption. You will also need to ensure that your device has a lock and is not used by any members of your household.
From a technology standpoint, all text messaging, email applications and videoconferencing platforms must be HIPAA compliant. All emails, text messages, instant messages, chat history and clinical records will need to be preserved and stored in the client’s file.
Compass Point uses HIPAA-compliant video and email platforms, and all Compass Point therapists have access to these tools.
More Best Practices for Teletherapy
Mental health providers have a challenging ethical landscape to navigate. Keeping current with new guidelines can feel overwhelming at times.
Compass Point is offering a one-day webinar called Best Practices in Private Practice (Ethics). The webinar will be available in March, May, September and November as a live webinar. It will be offered in June and August on location in Mason, Ohio.
The course will be worth three CEUs. This training will clarify Ohio Counselor, Social Worker, and Marriage and Family Therapist board and insurance company rules. We’ll also look at best practices for using teletherapy, including avoiding common legal risks. Register for the course today.
Charles Roberts, ED.D, LPCC-S, LICDC-CS
Coping with Covid is a group at Compass Point for Individuals trying to figure out life during the ongoing Pandemic. Please join us as we find meaning, purpose and life satisfaction in this 'new normal.'
This group may be a fit for you if :
- You live in Ohio
- You have a smart phone, tablet or computer with internet connection
- The pandemic has affected your day-to-day life
-Changes have caused you stress, anxiety, etc.
This group will cover different mental health topics including tips, tricks and resources we can use to build awareness, motivation and coping skills.
FACE COVID offers a set of practical steps for responding effectively to the Corona crisis, using the principles of acceptance and commitment therapy (ACT).
F = Focus on what’s in your control
A = Acknowledge your thoughts & feelings
C = Come back into your body
E = Engage in what you’re doing
C = Committed action
O = Opening up
V = Values
I = Identify resources
D = Disinfect & distance
Russ Harris is an internationally acclaimed acceptance and commitment therapy (ACT) trainer and author of the best-selling ACT-based self-help book The Happiness Trap, which has sold more than 600,000 copies and has been published in thirty languages. He is widely renowned for his ability to teach ACT in a way that is simple, clear, and fun—yet extremely practical.
I am very excited that Compass Point is offering groups that will be using mindfulness to reduce stress and improve overall physical and mental health.
Mindfulness is a bit of buzzword at the moment. It may have popped up on your social media or at your job. What is mindfulness? Mindfulness is the art of being fully present, fully aware, and fully engaged in this moment without judgment. Mindfulness allows you to reduce the stress hormone cortisol which allows your body to function in a healthier way.
So why would you want to learn how to do that? Mindfulness has been around for thousands of years but it is only in the last 60 years that scientists have really studied it in depth. What they discovered was astonishing and will be taught in the class. In short mindfulness has been researched and found to be helpful with improving:
Please note that Mindfulness does not replace your current medical and mental health treatment but rather enhances it. It gives you the tools to get the most out of your treatment.
We tend to look at the mind and body as separate but Mindfulness is a holistic practice that embraces the interconnected whole. If you struggle with any of the above issues, I expect you have noticed how when you are stressed your health is more difficult to manage and vice versa. If you want to find ways to better manage this cycle this group could be for you.
The group will meet weekly for 9 weeks and include a time of teaching and a time of practicing techniques. There is daily homework that is essential to getting the most out of the group.
Interested in signing up? Please give the front office a call at 513-939-0300 to ask about the next available start date.
What attendees had to say about MBSR
Compass Point is now offering Mental Health Services in Mason, Ohio
Compass Point Counseling Services, a mental health private practice, is partnering with Lee Side Wellness, a psychiatric practice, to bring comprehensive mental health and psychiatric services to a brand new location in Mason.
The new Mason location will open Monday, August 5th in a 1,600-square-foot located conveniently right off of interstate 71 at 3615 Socialville-Foster Rd, Mason, Ohio 45040.
This partnership will allow a “one stop” comprehensive experience to our mutual clients who are looking for quality mental health care In addition to medication management as well as TMS treatment for chronic depression. Both mental health facilities are grounded in the core values that all people matter, are of sacred worth, and warrant the finest in mental health and psychiatric healthcare.
The office will open with 7 clinicians: Chrisha Anderson, Stephanie Baker, Debra Bruemmer, James Canfield, Geralyn Cleary, Mariah Goodwin and Dana Mcdonald. The new location will have 5 individual therapy rooms along with a large group therapy space.
“Good mental health is essential to our overall health and gives us the sense of well-being we need to live fulfilling and satisfying lives," said Founder Charles Roberts.
Compass Point offers comprehensive behavioral health services for all ages, including addictions recovery, adolescents, dialectical behavior therapy, disordered eating, family therapy and a mindfulness-based stress reduction therapy program for those with chronic health conditions.
Lee Side Wellness nurse practitioners, physician assistants, and psychiatrists assess, diagnose, and manage a variety of conditions through psychotropic medication management.
The National Alliance on Mental Illness reports one in five American adults will experience mental illness within a year — with about 60 percent of people not seeking out mental health services.
“This can have devastating consequences, as recent government reports show. For the third year in a row, life expectancy in the United States has fallen, primarily due to drug overdoses and suicides, conditions that are preventable with help from behavioral health specialists,” Roberts said.
Compass Point has locations in West Chester, Fairfield, Anderson Township, Kenwood, Dayton and Western Hills in addition to this new Mason office. The group is currently hiring for independently licensed clinical counselors and social workers.
The Addictions Support group
When: The last Saturday of the Month
Cost: Private Pay $30
This group is open to adults who have been impacted by a friend or family member with addiction. This is an education and support group focused on teaching skills to help family and friends be more effective with their family/friend. Each month we will cover a different topic.
The April 27th group will cover:
Self Care: Caring for ourselves as well as our addicted family member or friend.
The Teen Talks
6:00-7:30pm Mondays in Dayton from June 17-August 5
14-18 (high school age)
4:00-5:30pm Thursdays in Dayton from June 20-August 08
14-18 (high school age)
3:30-5:00pm Tuesdays in Anderson from July 2-August 20
These groups are for teens to discuss common themes such as academic pressure, depression, anxiety, and social stressors.
We will also learn and utilize skills effective in coping with difficult emotions, managing stress, communicating effectively, and practicing relaxation.
To learn more or register for our next start date please call our front office at 513.939.0300
or register online.
In response to those changes, the brain adapts to the presence of alcohol and other drugs, increasing the chances that a person will develop a substance use disorder. Substance use disorders are types of mental health disorders that are more commonly called addiction.
It’s possible to have more than one mental health disorder. Substance use disorders often co-occur alongside other mental illnesses. More than half of people with substance use disorders also have a mental illness. Sometimes the mental illness comes first. In other people, substance abuse occurs first. In both situations, each disorder amplifies the symptoms of the other.
“A large number of people with substance use disorders also have some psychiatric disorders which may or may not be major,” Dr. Timothy Huckaby, medical director of Orlando Recovery Center, told DrugRehab.com. “A lot of people have underlying depression or underlying anxiety.”
Other common co-occurring disorders include personality disorders, behavior disorders and psychotic disorders. With comprehensive treatment, individuals can recover from addiction and most co-occurring mental health disorders. But failing to address co-occurring disorders during addiction treatment increases the chances of relapse.
The phrases “mental illness,” “mental health disorder” and “mental health issue” are often used synonymously. In its diagnostics manual, the American Psychiatric Association uses the term mental disorder to define mental illnesses, but the organization also recommends using the term mental health challenge.
The American Psychiatric Association defines a mental disorder as: “a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning.”
Mental disorders are different from developmental disabilities. Developmental disorders, such as autism spectrum disorder and learning disabilities, impair social interaction, mobility, language and self-sufficiency.
Substance use disorders and other mental health disorders can co-occur alongside developmental disorders. But the term co-occurring disorder most commonly refers to substance use disorders and mental disorders.
Dual Diagnosis & Comorbidity
Dual diagnosis is an outdated term for co-occurring disorders. Both of these terms are sometimes confused with comorbid disorders.
Comorbidity is a broad term used to denote the existence of multiple physical or mental diseases or disorders. Co-occurring disorders and dual diagnosis are specific to substance use disorders and other mental health conditions.
Any mental health disorder can co-occur alongside substance use disorders. The most common types of co-occurring disorders include mood, anxiety, psychotic, eating, personality and behavioral disorders. Each category includes numerous types of mental disorders that can range in severity.
Symptoms of personality disorders vary widely based on the type and severity.
Behavioral disorders most commonly occur in children. Many healthy people exhibit behavior problems, such as inattention, defiance and hyperactivity. However, behavioral disorders are characterized by chronic behavior problems that last at least six months.
Common behavioral disorders include:
- Attention-deficit/hyperactivity disorder
- Oppositional defiant disorder
- Conduct disorder
Symptoms of Co-Occurring Disorders
The physical and emotional symptoms of co-occurring disorders vary depending on your life circumstances, the type of substances you use and the type of mental illness you possess.
The symptoms of mental health disorders are similar to the side effects of addiction. Thus, it can be difficult to determine whether a mental illness is caused by substance abuse or vice versa. Reputable addiction treatment centers screen patients for mental illnesses and develop plans for treating co-occurring disorders simultaneously.
Manage your anxiety and depression holistically
Compass Point is Partnering with Trio Natural Oils and Wellness using doTerra oils to teach you ways to manage your mental health symptoms. Learn how oils work with your body to improve a variety of symptoms such as: anxiety, depression, headaches, focus.
This class is open to CPCS clients, therapists and the public.
Why am I telling you about EMDR?
I was trained by Dr. Stephen Dansiger, a certified EMDR therapist from the Institute of Creative Mindfulness. I experienced a life changing shift when he himself demonstrated the 8 phases of treatment on me. Keep reading and I will tell you more about these 8 phases later. During my experience I felt a relief, something years of talk therapy had not been able to process for a long time. As a clinician, I feel passionate about giving as many people the opportunity to learn about and benefit from this treatment as possible.
But what is EMDR therapy?
EMDR stands for Eye Movement Desensitization and Reprocessing. Don’t worry, it is way less complicated than it sounds. It is a non-drug, non-hypnosis, psychotherapy that combines many positive elements of numerous therapies along with left/right brain stimulation (known as bilateral stimulation), developed by Dr. Francine Shapiro in the 1980’s. EMDR therapy involves a trained therapist waving their fingers from left to right (some therapists use a light bar to achieve this part of the therapy), in a windshield wiper motion, which will trigger the brain to bring up the painful memories in an effort to process them and speed up the healing process. All of this is done in a safe environment with you and your therapist present. You are not alone in the processing of your memories. The therapist will also work to reprocess negative beliefs, images, and feelings and replace them with more positive ones. The outcome is the feeling of resolution and a more peaceful state overall. EMDR therapy has successfully treated millions of people of all ages, has gained notability with veterans of war as a primary treatment modality for Posttraumatic Stress Disorder, but also many types of other traumatic stress and negative symptoms that come along with different experiences.
You’re probably wondering how simple “finger wipers” do all that? Interestingly enough the “finger waving” is key to the therapy. It engages something called bilateral stimulation (right to left eye movement), which repeatedly activates the opposite sides of the brain. This releases emotional experiences that are "trapped" in the nervous system. When this happens it assists the neurophysiological system, the basis of the mind-body connection, to free itself of blockages and begin to heal. In a basic sense, when a person experiences an adverse event, or trauma, the brain cannot process the event as it does normally. The brain instead takes this event and stores it, sort of like “I’ll get to this later”. Unfortunately, the “I’ll get to this later” never quite happens and essentially these adverse feelings, memories, and thoughts become “stuck” in an isolated memory network. They can easily become re-triggered by sound, smell, feelings, and environments that were activated during the traumatic event. EMDR therapy is able to guide the person in a safe, contained environment to “unstick” the memories, reprocess them, and replace them with more positive images. Once this happens,the person can begin to move forward with healing.
Who is the best candidate for EMDR?
EMDR therapy is for children, adolescents, and adults. If you or a loved one has ever experienced panic attacks, complicated grief, dissociative disorders, pain disorders, anxiety, performance anxiety, depression, addictions, phobias, sexual and/or physical abuse, body dysmorphic disorder, and personality disorders.
**It is important to note that a consultation with a EMDR trained therapist is the best way to determine if EMDR is right for you.
EMDR therapy has been designated by the American Psychiatric Association, U.S. Department of Defense, and the International Society for Traumatic Stress Studies, as a highly effective and empirically supported treatment modality for the treatment of Posttraumatic Stress Disorder (PTSD).
What happens in EMDR Therapy sessions?
EMDR therapy has a standardized set of protocols that a therapist will follow. There are 8 phases to the treatment, that are moved through at a varying pace depending on your readiness for the next stage. An EMDR therapist is trained to know appropriate pacing but you can determine whether to continue or stop at anytime. The therapist is there as a guide to help you get the most out of the experience, and at times may gently aide in pushing you through painful moments.
Why bring up painful memories? Isn’t it best to forget them and move on?
By avoiding the painful memory you might continue to experience the lasting effects of the event, through nightmares, stress, anxiety, and panic attacks. By holding onto these memories you stop yourself from moving on. The problem with avoidance, or ignoring these memories, is that it is a temporary relief. For a brief moment it allows you to feel better and put aside the pain, but it doesn’t remove it, and worse, it allows it to keep its power over you and your joy. Often, this painful memory rears its ugly head at times when we are not prepared and leaves us crippled by its effects. EMDR therapy is not just bringing up painful memories, its moving through them in a safe, contained way. It alleviates suffering, and replaces it with positivity.
What happens when I’m done with all 8 phases?
After the 8 phases you will likely continue to process the material for days, weeks, or perhaps even months. You might have new insights, vivid dreams, feel angry or numb with no real answer why. This is because your are finally processing the unpleasant memories you were holding onto for so long. Your therapist will guide you through this process and advise best practices for moving forward. Some people feel a slight buzzing all over their body, similar to the feeling of when they stand up too fast. Don’t worry, this will soon fade. Your right and left hemisphere are stimulated by the finger waving motion and it is only natural that you will feel something afterwards. Often times, after a person has processed one of their target issues they will notice that some of the other target issues, are no longer are troubling them. This is because our memory networks are linked in ways we aren't consciously aware of. Its normal to cry, feel tired, need time to be alone, or feel a little “off” because your body is starting the healing process. Allow it to heal.
So this all sounds like something I might want to try. What do I do now?
I would be more than happy to help you in your journey to healing! You can call our main office at 513.939.0300 and ask the office staff to schedule an appointment with Jennifer Burns for an EMDR session. I am currently taking new clients and would love to meet you.
I am an empathic, non-judgmental therapist that is here to listen, support, and laugh with you. I believe humor is therapy and have built my life around my passions, laughing and healing. In addition to being a Licensed Professional Counselor, I have substantial training in improv comedy and enjoy bringing this to my sessions. Humor has the power to make you feel in control of a situation, making it more manageable and helping you to release fear, anger, and stress. Life is not always how we imagined it, and sometimes pain makes it difficult to see the joy.
EMDR International Association
The Institute for Creative Mindfulness
U.S. Department of Veterans Affairs: National Center for PTSD
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