Online counseling offers tremendous accessibility, flexibility, and convenience — both for therapists and their clients. It undoubtedly creates more opportunities for dynamic mental health care.
With that in mind, it’s important to understand the concept, benefits, and risks associated with this type of treatment. Let’s get into what you need to know!
While telehealth isn’t particularly new, the demand for online counseling has surged since the beginning of the COVID-19 pandemic. While some professionals have returned to their traditional offices, many clinicians have opted for an entirely virtual practice. And pandemic or not, it appears this popular online trend isn’t going anywhere.In this guide
- What is online counseling?
- Online counseling job overview
- Benefits of online counseling
- Drawbacks to online counseling
- Outlook for online counselors
- How to get started
What is online counseling?
Online counseling (also known as telehealth, teletherapy, e-therapy, distance therapy, or video therapy) refers to providing mental health services electronically. As a clinician, this may mean corresponding with clients via email, videoconferencing, or through other secure messaging systems.
Online counseling typically follows the same format as conventional counseling. You and your clients will work together to establish rapport and create effective treatment goals. It’s common to meet with clients once per week for about 45-60 minutes. You are still responsible for completing all necessary paperwork and client notes.
But unlike in conventional face-to-face therapy, your clients can meet for their sessions anywhere with a reliable Internet connection. As a provider, you will usually work in a designated, confidential office, although this office can be in your own home!
What does the job structure look like for online counselors?
Some online counselors work for agencies as either employees or contractors. As an employee, you typically receive standard pay and benefits along with a fixed schedule. In addition, your employer will withhold federal taxes.
As a contractor, you set your own schedule and can usually charge your own rates. However, you’re responsible for tracking your deductions and paying your own taxes.
Many online counselors also work for popular online telehealth platforms. These platforms usually offer low-cost services to clients, and they typically offer monthly subscriptions to their users. As a provider, you cannot set your own fees, but you can often choose how many hours you wish to work.
Furthermore, some clinicians choose to offer a hybrid approach. For example, they may work in-person with some clients and online with others.
What are the benefits of online counseling?
Online counseling offers impressive accessibility and flexibility for clients. Here are some benefits to consider as a provider.
More and more research now shows the benefits of telehealth. Although studies are still relatively limited (when comparing online counseling to face-to-face counseling), the data looks promising.
For example, research shows that veterans receiving PTSD interventions online yielded the same benefits as veterans receiving face-to-face interventions. Other reviews have shown similar results for CBT treatments for depression, anxiety disorders, and adjustment disorders.
Of course, further research is needed. The COVID-19 pandemic has shifted how we give and receive services in nearly all sectors. Future studies will likely need to examine the benefits of online crisis care and the efficacy of popular online counseling platforms.
Many clinicians find online counseling incredibly convenient. To start your session, you just need to log in a moment before. This convenience allows for you to be location-independent, which may allow for more flexibility for other tasks.
If you work from home, you do not need to worry about commuting to and from an office. If a client no-shows (doesn’t attend their appointment), you aren’t stuck waiting at work for the next client.
Many clients also prefer the convenient features associated with online counseling. They may be less likely to miss an appointment or show up late- after all, they don’t need to worry about traffic or commuting, either!
Cost-effective (very little vverhead)
Operating a private practice can be expensive once you factor in office rent, marketing costs, liability insurance, and other miscellaneous items. That said, an online counseling practice may be cheaper to run, especially if you opt to work from home.
In addition, some platforms or agencies will cover all the costs for you. When you opt to work for them, you aren’t responsible for any office-related or marketing needs.
Finding and securing adequate treatment poses a significant barrier for numerous clients. But as an online counselor, you can provide services for:
- Clients with certain disabilities.
- Clients who lack safe or reliable transportation.
- Clients who live too far to commute to a therapist.
- Clients with erratic or overly busy schedules.
You may also enjoy a greater reach of clients when providing online counseling. As long as you are licensed in the state your client lives in, you can provide services. This means you aren’t limited to a small radius around your home or practice.
If you offer a specific specialty, you may have more clients who can benefit from your services. This is especially true if you live in a more rural area.
Flexible with other jobs or responsibilities
You may wish to work part-time while working in another job or managing other important responsibilities. If you have your own practice, you have complete control over the number of clients you see and how many hours you choose to work.
What are the drawbacks and risks of online counseling?
Online counseling may not be appropriate for all therapists or clients. Here are some potential drawbacks to consider.
Difficulties with treating severe mental illness
Generally speaking, online counseling may not be advised for people struggling with severe or acute crisis issues. This may apply to people with chronic suicidal thoughts, psychosis, substance use, or eating disorders.
These issues may warrant a higher level of care, especially if the client needs medical stabilization. Many professionals will recommend more monitoring or structured support before transitioning into online services.
Sometimes, these serious problems are not apparent during the initial intake process. As a clinician, you may not be aware of them until you really start working together. That’s why it’s essential to have referrals and resources available should you need to take immediate action.
Risk for ;oneliness
Private practice therapists often work alone- in traditional offices, they spend most of their days meeting with clients and occasionally run into a colleague while entering or leaving the office. That said, online counselors may have an aggravated risk for loneliness. If you work from home, there are no immediate colleagues to lean on for support.
That’s why it’s so important to build professional connections with others. Therapists can and should regularly consult with other therapists. Doing so helps maintain your efficacy and can mitigate the risk of burnout.
Challenges with certain theoretical orientations or specialties
Some clinicians prefer meeting with clients face-to-face because they value the nonverbal communication associated with an in-person connection. However, technology glitches or a poor Internet connection can create problems when discussing sensitive therapeutic material.
Certain interventions may not translate as well online, such as:
- Creative art expression.
- Play therapy with children.
- Equine or other animal-assisted therapies.
- Eye movement desensitization and reprocessing (EMDR).
- Body-based work.
Likewise, some clients simply prefer meeting in person. They may value the sacred space associated with meeting in a specified therapy office. They might also find it easier to open up to someone when they’re face-to-face with them.
What does the future of online counseling look like for mental health professionals?
Online counseling will likely continue to gain traction in the coming years. Even the American Psychological Association (APA) has gone on record indicating that virtual treatment is here to stay.
First, it’s important to note that therapy, in general, is becoming more popular and favorable. Although mental health services do still carry some stigma, research shows that 42 percent of Americans have met with a therapist at some point in their lives, and another third report being open to it. In addition, the anticipated job outlook for therapists over the next decade is expected to increase by 22 percent (much faster than the average career).
With this information in mind, it’s reasonable to assume that more platforms and companies will streamline online services. Unfortunately, some of their techniques may undercut clinicians by offering extremely cheap services to clients.
While low-cost treatment undoubtedly benefits the consumer, it can be harmful to a qualified provider wanting to earn a decent living. Similarly, making money may be contingent on working excessive hours, increasing the risk of burnout.
No matter which path you pursue, it’s important to be meticulous and informative when starting your job search. Vet each company carefully and, if possible, ask other clinicians about their experiences working there. If a job opportunity sounds too good to be true, it probably is.
How do you get started with online counseling?
If you work for an agency, they will likely provide you with the tools and training to start your practice. But if you opt to work for yourself, you are responsible for ensuring you establish your work correctly.
Understand your state laws
Setting up an online counseling practice starts with understanding your state laws. Each state has its own rules and regulations for providing online counseling, and these limits may change over time. It is your responsibility to remain current with this information.
For instance, you may need to be licensed to start rendering services. If you’re not licensed, you will need ongoing supervision under a licensed professional. Subsequently, some states require that your supervisor also work in the same agency or setting where you work.
Consider your niche
Standing out online can be challenging, especially if you work in a saturated area full of eager clinicians. Therefore, it may be beneficial to develop a specific niche or targeted population you wish to work with.
For example, you may prefer helping postpartum mothers transition back to work. Or, you might enjoy providing therapy for families where one member struggles with addiction.
Niches don’t have to be overly restrictive or an all-or-nothing decision. However, it’s generally unrealistic to expect that you can sufficiently work with every population struggling with every issue. Knowing your strengths (and preferences) allows you to focus your marketing and clinical efforts on finding the ideal clients for your practice.
Maintain HIPAA compliance
HIPAA ensures a quality standard of care for confidentiality, protection, and safety of electronic client records. All clinicians are legally and ethically required to adhere to HIPAA requirements in their practice.
You will need to make sure that you are using the following HIPPA-compliant tools:
- Video conferencing software.
- Electronic forms and paperwork.
- Payment systems and payment processing.
Many electronic health record companies offer bundled services for their online counseling providers. However, you will need to make sure you use them properly to ensure your client’s well-being.
There are numerous ways to advertise your services to potential clients. How you choose to market your practice depends on your current caseload, practice goals, budget, and targeted client demographic.
Many clinicians use multiple marketing approaches, such as:
- Setting up a website and using SEO or PPC campaigns to drive traffic.
- Listing their practice on well-known therapist directories.
- Networking with other like-minded professionals.
- Attending conferences or workshops.
- Using traditional, paper marketing sources like brochures or business cards.
- Trying paid ads on social media or other websites.
Marketing efforts require time and money. As a result, some clinicians opt to do their marketing themselves, and others choose to outsource this task to another professional.
Stay connected & practice self-care
As mentioned, isolation can become detrimental for mental health professionals. Therefore, it’s crucial that you build meaningful relationships with other colleagues- even if those relationships are entirely virtual!
Make sure that you also carve out adequate time for rest and relaxation. Burnout can be a serious problem in the mental health field. Preventing it early can make a tremendous difference before it unravels into a more significant issue.
Online counseling offers immense benefits for clients and clinicians. As a mental health provider, you can likely reach more clients and enjoy more flexibility by turning online.
That said, you don’t have to choose one method or another. It might be worth seeing a few clients online to determine if it’s the right fit for you.