Clinical Principles & Treatment Modalities<br />4 Hours<br />
Review the different modalities and most common usages in counseling<br />Identify potential clinical and ethical issues<b...
Review Online Counseling: A Handbook for Mental Health Professionals<br />http://www.netlingo.com/<br />Text Reading<br />
Tweets<br />Emails<br />Blogs<br />Secure Forms<br />Forums<br />IM<br />Video Chat<br />Second Life<br />Good ole telepho...
This is a great way to push out positive thoughts for the day.<br />I have used this for morning focus meditations and eve...
Technical<br />Use a secure service.<br />If you are not using a secure service, then make sure your email address does no...
 Drawbacks<br />Can miss a lot when you do not see the rate of responding (increase in rate or errors in typing etc)<br />...
Provide information to people<br />Not secure or HIPAA compliant unless you make them that way<br />Excellent activity to ...
Secure Blog Formats<br />Video Blog: <br />Can be used for daily check-ins for clients—excellent for addictions, eating di...
Forums are a good place to ask a question to a group and let them provide answers<br />Group members can see each others r...
Useful to get information quickly such as intakes, client’s week in review and CBT or DBT worksheets<br />Can be created a...
Mainstream communication for the younger generation<br />Can be done via mobile devices<br />Not secure/HIPAA unless you m...
Next best thing to face-to-face<br />Can connect patients and clinicians worldwide<br />Must be done on a secure connectio...
Appealing due to avatars<br />Does not meet HIPAA security standards<br />Has had incidents of being hacked and losing use...
Most people are comfortable talking on the phone<br />It requires a high amount of concentration on your part<br />Traditi...
Above All Do No Harm<br />Evaluating appropriateness (diagnosis, crisis, age, comfort with computer technologies)<br />Dev...
Evaluating appropriateness<br />Can you and the patient type?<br />If no, look into video or phone counseling<br />Is the ...
General<br />All CAPS= YELLING<br />Don’t overuse exclamation points!!!!!!!!!!!!!<br />Use italics, different colors, font...
Chat Rooms<br />No Lurking<br />Say hello and Goodbye<br />If you step away, say BRB as appropriate<br />Use private messa...
Options<br />Email/IM/Phone/Video Only<br />Email/IM/Phone/Video + weekly or monthly F2F<br />Email/IM/Phone + weekly/mont...
Have people review their emails or chat logs for patterns or improvements<br />Use information documented in email and cha...
Have clients research<br />3 famous people who have encountered similar situations<br />About depression, temperament, CBT...
Online Counseling and etherapy make it possible for patients to access services<br />Easier<br />With Greater Confidential...
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Online Counseling | Etherapy Clinical principles & treatment modalities 1

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Overview of basic principles of etherapy. Part of a powerpoint series on online counseling for the Florida Certification Board's certificate in Etherapy

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Online Counseling | Etherapy Clinical principles & treatment modalities 1

  1. 1. Clinical Principles & Treatment Modalities<br />4 Hours<br />
  2. 2. Review the different modalities and most common usages in counseling<br />Identify potential clinical and ethical issues<br />Learn about at least 3 unique ideas for doing online counseling<br />Define Treatment Structure<br />Objectives<br />
  3. 3. Review Online Counseling: A Handbook for Mental Health Professionals<br />http://www.netlingo.com/<br />Text Reading<br />
  4. 4. Tweets<br />Emails<br />Blogs<br />Secure Forms<br />Forums<br />IM<br />Video Chat<br />Second Life<br />Good ole telephone<br />Modalities<br />
  5. 5. This is a great way to push out positive thoughts for the day.<br />I have used this for morning focus meditations and evening roundup meditations.<br />It is NOT secure, so no PHI here. This includes graduation announcements or congrats.<br />Good way to get the word out about you and your approach.<br />This is not a therapy approach.<br />Tweets<br />
  6. 6. Technical<br />Use a secure service.<br />If you are not using a secure service, then make sure your email address does not give away who you are.<br />Services offering Secure Email: Hushmail, ZixMail, Websites4Counselors<br />Are considered part of the clinical record and can be subponeaed just like progress notes.<br />Provide clients with a response time frame<br />Benefits<br />Can provide a running “diary” of progress<br />Are excellent for people who like to write and ponder. (Introverts and Reflective learners)<br />Emails<br />
  7. 7. Drawbacks<br />Can miss a lot when you do not see the rate of responding (increase in rate or errors in typing etc)<br />Gives patients time to go back and edit which may remove some of the underlying meanings<br />Not appropriate for patients in crisis<br />Formats<br />Diary—freeform<br />Diary—Structured<br />Worksheet completion (i.e. CBT, relapse prevention)<br />Questions to ponder—(i.e. Miracle Question)<br />Email Cont…<br />
  8. 8. Provide information to people<br />Not secure or HIPAA compliant unless you make them that way<br />Excellent activity to inform patients about conditions, new treatments and new programs<br />Excellent for patients who have something to say to the world—Awareness/Advocacy Campaigns<br />Blogs<br />
  9. 9. Secure Blog Formats<br />Video Blog: <br />Can be used for daily check-ins for clients—excellent for addictions, eating disorders and major depression<br />Blog with pictures<br />Can be used to as a means of creative and therapeutic expression for some clients<br />Can also be created like an online scrap-book with pages for: What means the most to me, My Goals, My accomplishments, About Me (Best with teens)<br />Text Blog<br />Can be used as a running diary <br />Blogs cont…<br />
  10. 10. Forums are a good place to ask a question to a group and let them provide answers<br />Group members can see each others responses and comment and/or learn<br />More than some other modalities, it is imperative to be clear about appropriate behavior in the forums.<br />If you do not have something nice or constructive to say, don’t say anything at all<br />This is not a place for Borderline behavior<br />Forums<br />
  11. 11. Useful to get information quickly such as intakes, client’s week in review and CBT or DBT worksheets<br />Can be created as fillable PDFs and securely emailed to you.<br />Used as an adjunct to therapy for people who like using workbooks etc.<br />Secure Forms & Worksheets<br />
  12. 12. Mainstream communication for the younger generation<br />Can be done via mobile devices<br />Not secure/HIPAA unless you make it that way<br />Provides real-time text-based interaction<br />Nonverbals include <br />Color, font, size of text<br />Speed of response and error rate<br />You must set boundaries<br />You must know the lingo (see below)<br />Instant Messaging (IM)<br />
  13. 13. Next best thing to face-to-face<br />Can connect patients and clinicians worldwide<br />Must be done on a secure connection (Skype)<br />Provided internet connection is adequate, provides nonverbals<br />Drawbacks—You must have a backup plan for:<br />Internet issues<br />Software issues<br />Firewall issues<br />Power issues<br />Video Chat<br />
  14. 14. Appealing due to avatars<br />Does not meet HIPAA security standards<br />Has had incidents of being hacked and losing user data<br />Does not provide subtle nonverbals<br />May reinforce a fantasy persona in those with an unfavorable or unstable sense of self<br />Second Life<br />
  15. 15. Most people are comfortable talking on the phone<br />It requires a high amount of concentration on your part<br />Traditional nonverbals are not available<br />Format<br />VoIP<br />VoIP sometimes goes out. Skype seems pretty reliable<br />Must make sure it is a secure connection<br />Cell Phone<br />Data is minimally available when it hits cell towers<br />Low risk of being “hacked” or “breeched”<br />Land Line<br />Excellent as a backup in the event of a power or internet outage<br />Phone<br />
  16. 16. Above All Do No Harm<br />Evaluating appropriateness (diagnosis, crisis, age, comfort with computer technologies)<br />Developing a safety plan<br />Making appropriate referrals<br />Netiquette<br />Mastering the lingo<br />Clinical Principles<br />
  17. 17. Evaluating appropriateness<br />Can you and the patient type?<br />If no, look into video or phone counseling<br />Is the condition appropriate for that level of treatment?<br />Developing a safety plan<br />Making appropriate referrals<br />Above All Do No Harm<br />
  18. 18. General<br />All CAPS= YELLING<br />Don’t overuse exclamation points!!!!!!!!!!!!!<br />Use italics, different colors, fonts and font weight to emphasize ideas<br />This is awful! I am totally over it.<br />This is awful! I am TOTALLY over it.<br />Paraphrase and check your understanding B4 U get offended<br />Email<br />Return emails in a timely fashion<br />Add responses within the persons email to you<br />Netiquette<br />
  19. 19. Chat Rooms<br />No Lurking<br />Say hello and Goodbye<br />If you step away, say BRB as appropriate<br />Use private messaging for “side” conversations if allowed<br />IM<br />Never have multiple private chats going at the same time<br />Respond quickly <br />If you have to step away from a crisis, tell the client BRB<br />Netiquette cont…<br />
  20. 20. Options<br />Email/IM/Phone/Video Only<br />Email/IM/Phone/Video + weekly or monthly F2F<br />Email/IM/Phone + weekly/monthly Video<br />Considerations<br />Cost<br />Time effectiveness<br />Patient preference<br />Acute issues: Crisis, medication changes, impending triggers<br />Treatment Structure<br />
  21. 21. Have people review their emails or chat logs for patterns or improvements<br />Use information documented in email and chat logs as “evidence” when confronting a client<br />Have a client do a video tribute to someone who has passed away<br />Have someone do a blog in the words of someone they have lost…What Mom would have said<br />Have clients tweet commitments and/or statuses <br />Neat Techniques and Tricks<br />
  22. 22. Have clients research<br />3 famous people who have encountered similar situations<br />About depression, temperament, CBT etc.<br />Resources for coping with _____<br />How nutrition and/or exercise can help them<br />Different hobbies<br />Local clubs and social groups<br />And the list goes on….<br />Tips and Tricks cont…<br />
  23. 23. Online Counseling and etherapy make it possible for patients to access services<br />Easier<br />With Greater Confidentiality<br />With Experts Worldwide<br />It appeals to the younger generation and those who are very visual.<br />Just like any other new modality, etherapy has its own techniques, language and netiquette.<br />It will be important for etherapists to stay in tune to the evolving regulations regarding online services<br />Summary<br />

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