941-462-4807 meg@megyounglcsw.com

online therapy For those of us in any critical care giver role – police, firefighter, EMT, 911 dispatcher, therapist, counselor, doctor, nurse, probation/parole officer, corrections officer – PTSD is real. Unfortunately many people still see it as a weakness. We are supposed to be the strong ones; the ones the community comes to when they are in crisis and need to lean on someone’s strength. If we develop PTSD, there’s something wrong with us. At least this is still an all to common belief. Suicide among our first responders is higher than deaths from those in the military overseas this year, and it continues to rise, not fall.
 
Unfortunately, when we try to show a strong front to the world, we often fail to see the symptoms ourselves. We block it out or pretend it isn’t real. We make excuses for the symptoms we feel. We refuse to believe there is anything going on and refuse to get help.
 
The downsides to this are many, all the way to suicide. But there are many downsides prior to getting to a feeling of suicidality. We have self defeating feelings and thoughts about ourselves, we have behavior changes such as drinking, gambling, or other impulsive or reckless behaviors. We may have appetite and sleep changes. We may start withdrawing from others.
 
Not only does ignoring the symptoms affect us emotionally and behaviorally, we start to see changes in others around us. Our children’s behavior changes, our spouse’s behavior changes. Our friends and family may confront us a few times about how we are feeling or acting, but then they start to act different around us.
 
“Jessica” is a licensed therapist who works with children. She has been in the field for 14 years at this point and recently had a youth, 11 years old, come to her with her mom. The youth had been brutally attacked and was struggling to get back to normalcy. Jessica had her own 12 year old daughter. After meeting with this client several times, Jessica started becoming more protective of her own daughter and started feeling more anxious, even paranoid, about the outside world.
 
Her anxieties affected her sleep, her activity choices, what she allowed her daughter to get involved in, and so much more. She strongly believed she was being a good mother and protecting her daughter. There is no doubt Jessica was being a good mother, but were her actions and feelings necessary to the extreme she felt them and acted on them?
 
Without you having all of the details of Jessica’s struggles, it is impossible for you to answer that question. But I wonder if you can relate to Jessica and her change in attitude and behavior due to experiences she had at work.
 
We often make excuses for our behaviors. Excuses aren’t necessarily good or bad. They are just reasons. Take the judgement out of the equation and you may be able to relate. Jessica’s experiences at work made her feel justified in her over-protectiveness with her daughter. Again, right or wrong is not the debate here.
 
However, when our experiences at work change our feelings and behaviors at home and in our own lives, it can lead to a great deal of extra stress. Not only are we worried about our clients and work, but now we are also worried about our own lives and loved ones.
 
Eventually you wind up in a place of helplessness and overwhelm. Things seem to spiral out of control faster and faster and you feel less and less in control of yourself and your world. You may even wonder how it came to this – poor health habits, more anxiety, less happiness in life.
 
You are not alone. Many of our first responders, therapists, doctors and nurses have been where you are, currently are where you are, and/or will be where you are. The reality is, PTSD from our job is real and is normal. Secondary trauma is just as traumatic as first hand trauma in many (not all) ways. The Diagnostic and Statistical Manual (DSM) which therapists use to help guide diagnoses has even changed the criteria of PTSD to include secondary trauma: “Indirect exposure to aversive details of the trauma, usually in the course of professional duties.”
 
I know that you are struggling with admitting to yourself that your behavior and attitude has changed to the point where it’s affected your life and I know you strongly believe that you are justified in how you feel and act. I do not necessarily believe you are NOT justified in those feelings and actions. But when those feelings and actions have caused you to wind up in a place of helplessness and overwhelm, it is time to take a look at online therapy. Online counseling, also called telehealth or telemental health, is a legal, ethical, and effective way to get your life back on track in a quick way from the comfort of your own home. When you fully understand online or video counseling, it is entirely possible to overcome your biases about coming to therapy and reobtain the life you want and deserve.
 
Keep reading for everything you need to know about online/video counseling so you can start feeling more in control of your mind and your life today.
 
WHAT EXACTLY IS TELEHEALTH OR ONLINE COUNSELING?
 
Telehealth is defined a bit differently in each state, making policies around telehealth, especially across state lines, more difficult. In general, telehealth is broadly defined as the use of technology to provide healthcare services. These technologies include texting, phone calls, emails, or video counseling.
 
For the purpose of this blog, I am going to explain the benefits of video counseling. Video counseling is where the therapist is at their computer in one location while the client is at their computer at a different location. Both parties sign onto a HIPAA compliant web platform which includes video and audio capabilities (it is important to ask your therapist whether they are using a HIPAA compliant web platform for the security of your session) to conduct the session. This means the therapist is meeting with the client in real time. The therapist can see the client on their screen and the client can see the therapist on their screen and both parties talk as normal as the computer’s microphone will pick up the voice and transmit it to the other party.
 
Video counseling is a legal and ethical method of seeing a counselor. In fact, many insurance companies are starting to reimburse therapists for use of video counseling. With my clients, I noticed that often they feel more comfortable in their own homes and thus feel more free to work on and be honest about what is going on for them. This allows for more work to be done in less time, which is a win-win.
 
Research shows that there is a growing desire for the use of telehealth and the benefits of it are tremendous. There are studies citing clients improving faster thus costing the state less money, less overhead costs, and the ability to reach more clients. Several factors can get in the way of getting to a therapists office – childcare/eldercare concerns, weather concerns, transportation concerns, living in a rural area and thus not having access to a therapist, some mental health conditions such as severe anxiety or agoraphobia, and more. When these barriers to treatment are eliminated, the client is able to get the care they need and thus return to a healthy level of functioning including returning to work as appropriate.
 
HOW DOES ONLINE COUNSELING WORK?
 
When my client and I use video counseling, we start by signing an additional informed consent. Telehealth has risks that coming to a therapist’s office does not (for example a spouse coming home from work and walking into your session). The client and I then discuss the platform I use, how to get onto it, how it works, and even do a practice run to ensure the client understands the platform. Each session starts with a set regimen including review of safety and concerns or questions regarding technology from last session before getting into each session. We periodically review how the online sessions are working for the client and if there is anything that they would like to see different with our sessions.
 
There are several HIPAA compliant web platforms therapists can choose from. You want to make sure your therapist uses a HIPAA compliant platform to minimize the risk of data breeches. Not all video platforms are HIPAA compliant and telephones generally are not HIPAA compliant either.
 
With the platform I use, there is nothing for you to download if you use your computer. There is an app to download if you use your phone for sessions. I will send you a link to your session which will be your link for our sessions. Nobody else will have the same link.
 
When I use video counseling with my clients regularly, I tend to see a shift in their behaviors and attitudes relatively quickly. As stated above, I believe this is due to them feeling more comfortable in their homes thus they are able to open up and be more honest thus facilitating change quicker. My clients start to feel calm, safe and secure and start to enjoy the online sessions. Many of them report they like our online sessions better than in person sessions.
 
WHO IS ONLINE COUNSELING FOR?
 
Online counseling works well for people who are ready, willing, and able to do the work needed to get better. It works well with people struggling from PTSD, which is my specialty, as well as those struggling with depression, anxiety, substance use, parenting, stage of life changes, and more. It is good for people who are looking for confidentiality such as police officers who do not want to be seen going in and out of a therapist’s office.
 
The reason it works so well is because the client is able to immediately put into practice what they did in session. They do not have to wait the 30 minute drive home where some of what they did in session is now in the back of their mind. The client, who is ready, willing, and able to make changes tends to put those skills to use immediately after they get off the computer. Because they do the skills immediately, results are seen faster.
 
My blog last week about maintaining motivation mentions motivation follows action. When my clients get off the computer and immediately take action, instead of having to drive home first, the cycle of action/motivation begins right away decreasing the time needed to spend in therapy.
 
These type of motivated clients often see results like improved sleep, improved ability to handle stressors at home and at work, improved relationships with their loved ones, decreased racing thoughts, improved ability to stay on task, increased happiness and an increased sense of control.
 
WHO ISN’T A GOOD FIT FOR ONLINE COUNSELING?
 
Online counseling doesn’t work well for people who are actively or frequently suicidal, people who are currently in an abusive relationship, people who do not have a reliable internet connection, people who have psychosis, children, people who do not have privacy in their homes (can’t get into a quiet location where they will not be interrupted), and possibly others as well. If you are considering telehealth with a therapist, the therapist will discuss with you your needs and circumstances and together will make a determination of online counseling is appropriate for you.
 
Not everyone is right for online counseling. That does not mean there is something wrong with you or your circumstances. There is a lot of additional risk that needs to be taken into account for both the therapist and you. Picture this: You are talking about something very serious and upsetting and because you have poor internet connectivity, your connection drops. You don’t realize immediately that the connection dropped on your end and you start to wonder what happened. Did the therapist hang up on you? Did you say something wrong? Even when you realize that the connection dropped on your end, you still have residual feelings because you were talking about something upsetting and were interrupted causing more bad feelings and questions. If this happens semi-regularly, it can become very frustrating to both you and the therapist.
 
When a prospective client and I talk and decide that online counseling is not appropriate, I will talk with the client about seeing me in person, or referring out, depending on the client’s needs and location. Just because someone isn’t a good fit today doesn’t mean they won’t be a good fit for online counseling in the future. This is an important point to keep in mind.
 
WHAT CAN YOU EXPECT FROM ONLINE COUNSELING?
 
When you participate in video counseling, you can expect the same professionalism as you would from a therapist you see in the office. There are several things I do at the start of each session to ensure we have a positive and professional session that will help you meet your goals. This starts with a reminder to make sure you are in a quiet location with where you will not be interrupted and turning off your phone as if you were in my office. I do the same on my end to ensure both confidentiality and making sure I am giving you 100% of my attention just like you are in my office.
 
Also, you will expect to see results. Telemental health is often a better way to do therapy for my clients because they know they are in a confidential location and won’t be seen coming in and out of a therapist’s office, thus reducing their anxiety about coming to therapy to begin with. As they are more comfortable in the sessions, they are also able to do more and better work in less time.
 
In addition, you can expect pros and cons just like in an office. One thing that we talk about each session is technology doesn’t always work. What if the sound stops working? What if the internet drops? We discuss these issues at the beginning of each session to ensure we have a plan of action in case something does go awry with technology.
 
WHAT ARE YOUR NEXT STEPS?
 
Going forward, you can learn more about online counseling in a variety of places. One place with a wealth of information is www.telehealth.org. This is a website that provides a lot of resources including links to state specific information. You can find online clients on the website as well who have been through their intensive online counseling courses to learn the safety and best practices for an online therapy business. You can also find information about online therapy at my website: https://megyounglcsw.com.
 
The best thing to do if you are interested in online counseling, however, is to schedule a session with me. We will discuss everything we need to even before going online. The best way to learn is to experience something first hand.
 
WHAT YOU CAN EXPECT ABOUT ONLINE COUNSELING AFTER LEARNING ABOUT IT
 
Although you struggle with skepticism and worry at this time, you have the potential to really get your life back to where you want it with minimal time. Now that you know everything there is to know about video based counseling, there is a possibility for you to also find the therapy experience enjoyable. You have the opportunity to make changes in your life right from your own home and obtain the freedom and control you so desire to get back in your life.
 
Achieving freedom and control can be a positive experience. You absolutely can get a lot of work done in minimal time through use of telehealth. Meg Young, LCSW can help because I work with you to achieve your goals online, providing you with a successful online counseling experience.
 
Call me today 942-462-4807 today to schedule an appointment.

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