How About Internet Counselling?

Please note: For what they are worth, these comments represent Debbie’s opinions and perceptions based upon her own experiences and must be understood as such. Thank you…

So, what is all this telemedicine stuff, anyway?  I get asked this question a lot… So I thought it might be good to share my views on the subject….

Telemedicine (ehealth, internet counseling, distance counseling, remote visits, etc.) is a fairly new way to use electronic systems like computers to have a one-to-one visit with your healthcare provider.

In my case, it is a way for me to have a counseling session with you over the internet.  You can be snug and warm at home in a room where no one can overhear you, and you can log into an internet site with your computer, tablet or smart phone.  I do the same thing, and we can see and hear each other in “real time.”  It is very similar to what you might know as Skyping or Face timing, but it is done through a HIPAA-compliant system so that no one can overhear what you and I are saying to each other.

I have been performing ehealth with clients for several years now and find it to be a useful therapeutic tool. The client does not need to leave home and travel to my office. I do not need to confirm that they are safely driving or not running into other problems along the way.  I find that I can understand what they say and can help them sort out their issues just as if we were face-to-face in my office. And I have discovered that I can use all sorts of methods, including EMDR, EFT, somatic techniques and so on, even though we are far apart.

And guess what?  Health insurance pays for the service just as if we were face to face. How’s that for being in the modern age?

Of course, there are a few hoops you have to jump through. For example, there are special permission slips you must sign, and I must make sure that I am licensed in the state where you are. If you are a Medicare Part B recipient, you must (in most circumstances) be speaking from a building that is certified to accept Medicare (like my office or a hospital or clinic). But aside from that, the process is pretty easy.  Most all the other insurance companies, including Medicare Advantage programs, let you do it from home.

I think this is a development with great potential. For example, if it snows on the day of your appointment, no problem. If you can’t get off work for the travel time and office time to come to an in-person session, you may be able to walk down to the parking lot and use your smartphone from your car. If you live way off in the mountains up a dirt road or down a canyon, you can still get counseling… If you have a bad cold and do not want others to catch it, if your anxiety is so bad that you are afraid to leave home, no problem…. See what I mean?

More and more of us in the counseling business see this as a way to reach out to folks who couldn’t get into our offices before.  Some of my internet clients come to my office on alternate weeks. The opposite weeks we meet on the internet.

So let me know if this is something that might interest you ….dhc

How do you know if you have a good counselor?

Please note: For what they are worth, these comments represent Debbie’s opinions and perceptions based upon her own experiences and must be understood as such. Thank you…

How do you know if you have a good counselor?

What a great question this is!  The most important thing about a counselor is that he/she is a person who you can trust.  This means, to me, anyway….

The person really listens to you and lets you know that they understand your experience.  If they don’t get it, how can they really give you something that will help YOU?

Legitimate counselors have a license to do counseling.  This means that they have had training, supervision and experience in the mental health field. If they have a license that means that there is a State Board that upholds standards of conduct to protect you from unethical practices.

Other things to consider:

  1. Does the counselor accept your health insurance? Sessions can be expensive, and it is important to get some of the cost covered by your insurance (or your EAP) if you can.
  2. Clarify whether the person you are considering can give you what you want. Do you want advice? Or do you want to learn something? Or do you want to have help clarifying the issues so that you can work them out yourself?
  3. Compare your sense of comfort as you interview (in-person or on the phone or even using the internet) several candidates. Which one seems to “get it?” Which one seems to have the patience to chat with you?
  4. Does the therapist have a way to explain their approach? Does it seem to apply to your situation?
  5. Does the counselor use the same approach with everyone? Or can they customize their work to meet your exact needs?
  6. What kind of treatment philosophy does your counselor have? Do they follow a particular school of treatment? Or do they know several? How will they pick the one they use with you? Will you have a chance to make choices about the approach?
  7. How long do they think it will take to address your problem?
  8. Have they had experience with your problem and with the goals you would like to achieve?
  9. Does the therapist seem sensitive to you and your needs? Or do they seem to have another agenda?
  10. Do you feel uneasy or unsafe with them and their office? Is it in a safe environment? Is there enough privacy?
  11. Is the office accessible? Handicap friendly? Is there convenient parking?

These are a few of the things to consider as you make your choice. Remember, legitimate therapists cannot guarantee results; most of them cannot use testimonials or endorsements from ex-clients. (This practice is considered unethical by many licensure boards.) Your best approach is to ask friends or your MD for a recommendation. And then be sure to interview them first, so that you can develop a sense of whether they will fit your needs. …dhc

How Do You Know If You Need Medication?

Please note: For what they are worth, these comments represent Debbie’s opinions and perceptions based upon her own experiences and must be understood as such. Thank you…

How do you know if you need medication ?

Well, this is a controversial topic, isn’t it? Everyone seems to have an opinion on the subject. Here are some principles to think about as you make the choice:

1. Have you used psychotropic meds before? Have they helped you? Made things worse? Or not made much difference?
Depending on your condition, some meds help and some meds make things much worse. Of course, if you start a med and things get worse, you MUST CALL YOUR DOCTOR AT ONCE, and ask about stopping the medication.

2. What is your condition? Is it a condition that is known to have biochemical aspects where a specific medication is recommended? This question implies, of course, that you have gotten a diagnosis from a (licensed) mental health professional who can help you understand your condition and the various treatment methods that are recommended.

3. Are meds the only treatment recommended? Or are there other treatments that should also be considered? There is all kinds of evidence these days that indicates that the mind and body always work together to create or treat any specific condition. There may be some aspects of your condition that need to be addressed through medication, while other aspects can be treated with talk therapy. (For example, schizophrenia most often requires medication to address some of the features, but you probably should have counseling also to help you learn to cope with the everyday problems the condition brings.)

4. Should you consider newer, cutting edge treatments instead? There are several new ideas about how to treat conditions that involve specialized processes. They include Biofeedback, Neurofeedback, Transcranial Magnetic Stimulation (TMS), Acupuncture/Acupressure, Hypnosis, to name but a few. Some of them may work for some people, but often there is little research to determine whether they are effective.

5. Do you have funds or good health insurance to cover the cost? While some medications are inexpensive, many of them are not. It is critical, I think, to know that you have money to pay for the meds before you begin them. Because if you have to stop them abruptly, there can be serious side effects.

6. Do you want to try meds alone? Or do you want to use them in conjunction with talk therapy? Often times meds do not cure a condition, they only stabilize some of your brain function so that you can think more clearly about what needs to be done to solve your problem. So it is often best to use courage to face the issues what are causing the condition in the first place. This is a critical consideration if you are diagnosed with depression, anxiety or PTSD.

Of course, there are many other concerns that can come to mind as you think about all this. Consider your options carefully, research the questions, and if you feel the need, talk with a mental health counselor to address your concerns. …dhc                  1/10/2020