This document discusses using videoconferencing as a therapeutic tool for victims. It proposes providing online counseling via synchronous videoconferencing to rural populations who have experienced domestic violence and sexual assault. Research shows this approach can effectively deliver trauma-focused therapy and reduce PTSD and depression symptoms. The benefits of online counseling include increased access, reduced geographical barriers, and lower costs compared to in-person sessions. Privacy, legal and ethical guidelines must still be considered.

1. Videoconferencing
As A therapeutic
Tool for Victims
Denise De Jesus Spring 2014
Pace University Counseling 2.0

2. Online Counseling
 Online counseling is a new medium making headway
into our society.
 As we try to keep up with a society that is consistently
dependent on technology new forms of services need to
be adequately implemented.
 Asynchronous and synchronous communication are
mediums for which we use to communicate.
 Asynchronous communication does not take place in real
time and is considered email, and text. Synchronous
communication is done in real time and can be done by
the phone, videoconferencing, and Skype.

3. Online Counseling
 Pros
 Targets a greater
population
 Eliminates geographical
barriers
 Increases disinhibition
 Allows for Zone of
Reflection
 Is cost-effective
 Cons
 Lack of visual cues
 Disruptions with
communication
 Security network issues
 Difficult to process crisis
situations
 Most insurances don’t
cover it
 Not very clear ethical
guidelines

4. Populations that would Benefit
 A group that will benefit highly from this form of transaction (online
counseling) are victims of rural domestic violence and sexual assault.
 Domestic violence is defined as physical abuse and includes assaultive
and coercive behaviors, physical attacks, sexual assault, psychological
and emotional attacks and economic coercion.
 About 2 million women in the United States are assaulted each year by
their partners, and takes them about five attempts of leaving an abusive
situation before they are successful.
 Barriers not allowing this population access to services are because of
geographical reasons, transportation difficulties, individual or social
factors, reason regarding anonymity and confidentiality.
 Disparity in provider’s access to evidenced-based treatments, insufficient
time to learn evidenced-based treatments, lack of access to
informational resources and the prohibition of expense of training.
 Unfortunately, those that due receive services are usually done by their
primary care physician and are not allocated the proper services by a
mental health provider.

5. New Wave of Telemedicine
 Telecommunications and information technologies have had an
increased impact and improvement towards the health care system
as a whole. Leading us to the idea of telemedicine—a combination of
innovative and mainstream technologies defined as “the use of
electronic information and communications technologies to provide
and support health care when distance separates the participants
(Field, 1996).”
 As a whole we are constantly using social networks like Facebook,
instagram, LinkedIn, twitter, and etc..
 We build parasocial relationships where we think we know the
person on the other end but in reality they have no idea that we
exist.
 We are all highly dependent on technology for example; how much
time do we spend on out phones?
 Increasing research on providing mental health services via
technological mediums.

6. Practical, Ethical & Legal
Implications
 Licensed clinicians have to
know the regulations of
their state and their
professional associations
in order to not have to
deal with legal risk or
penalties.
 No specific guidelines have
been put into place.
 General guidelines have
been provided by the
American Counseling
Association.
 In order to follow ethical
standards clinicians should
abide by the following;
 Need to be competent
 Keep records secured and
private
 Can’t break confidentiality
 Have the responsibility of
“duty to warn”
 Should not false advertise
credentials
 Provide consent

7. Tech Plan
 To provide synchronous online counseling to rural
populations having been victims of domestic violence and
sexual assault via videoconferencing.
 Group workshops would be held and called “ healthy
relationships” and would help individuals see what are the
differences between healthy behaviors in any relationship
and unhealthy ones.
 Therapy would also be targeted at increasing self-esteem,
and decreasing symptoms of post-traumatic stress disorder,
and depression, as well as any other related disorder.
 Individuals would be coached in how to leave their current
partner if that was a goal and making sure that their safety
was not compromised.
 Resources would be available for continuous support.

8. Hardware / Software
 Encrypted videoconferencing-based technology (Polycom), an integrated
videoconferencing unit that not only allows many individuals to meet at
the same time via audio conductors, but also provides visual information.
 Simple to set up.
 Increases rate of absorption of information, improves retention, is
accessible and can be used in conjunction with other tools, exhibits
higher quality and uses lower bandwidth.
 Can be used with a Windows or a Mac computer/ desktop, and its stable
 Reliable internet connection as well as wireless access, microphones and
web cameras.
 Telephone and facsimile contact (a system that transmits and produces
graphic material through signals sent over telephone lines as back-up.
 Programs like iChat and Skype will also be considered when appropriate.
 A firewall system like Norton Internet Security or ZoneAlarm will be
established through the implementation of a router to monitor client
safety.

9. Research
 One particular study set out to demonstrate the effectiveness and
feasibility of providing evidence-based, trauma focused treatment
via videoconferencing to rural survivors of domestic violence and
sexual assault. The results when regarding the Post-Traumatic
Stress Disorder index, The Center for Epidemiological Studies
Depression Scale and the Wyoming Telehealth Trauma Clinic Client
Satisfaction Scale, exhibited large reductions in PTSD and
depressive symptoms and very high levels of satisfaction for
psychological services administered via videoconferencing (Hassija
& Gray, 2011).
 Another interesting study that focused on enforcing a telepsychiatry
program for rural victims of domestic violence displayed a
substantial amount of evidence on how telepsychiatry provided the
opportunity to address specific problems in care delivery as an
integral part of the mental health system, as the use of
teleconference facilitated the patients comfort and alliance as it
allowed for control and distance, while also decreasing the use of
emergency and inpatient psychiatric care.

10. Research Cont.
 Further, another study examined the effectiveness of
cognitive behavioral therapy (psychotherapy)
administered via videoconference for post-traumatic
stress disorder and the results showed a significant
decline in frequency and severity of symptoms with an
increased improvement in overall functioning (Germain
et al., 2009).

11. Interview with Dr. Joseph Franco
 1. What are your current feelings about online counseling?
 I think that it is critical for our profession to use all appropriate technological
resources for clients so that they can reach us with ease and so that we can
be available to a wider audience.
2. Do you have any knowledge about online counseling?
 Yes, I have used Skype and other forms of technology to counsel clients on a
professional level. I do so only with clients that I have personally conducted
an intake and bio psychosocial, to be sure that I have clear insight as to their
clinical issues.
4. Plans to use online counseling.
 I will continue to use on-line counseling for sure and want to explore improved
delivery systems for clients so that video and audio are clearer than they are
now. Any glitches tend to impact clinical sessions in major ways.

12. Interview Cont.

5. Feelings towards privacy and confidentiality when using online counseling?
 I do believe that clinicians need to be familiar with these issues as well as their
ability to provide clinical services across state lines. In fact, I plan to complete the
Distance Learning Credential (DCC) offered by the National Board of Certified
Counselors (NBCC) so that I can be well-versed on these issues.
6. Where do you see online counseling in 20 years.
 While I do believe that on-line counseling modalities will definitely increase, it seems
to me that we will always have the option of face-to-face counseling depending the
client's ability to physically see that the therapist based on transportation and
geographic challenges. I also believe that online counseling in 20 years will allow us
to reach clients on a national and international level who may not otherwise have the
opportunity to do so.
7. How will you compare it to the face to face module.
 I still enjoy face-to face sessions much more, but once more technological options
become available that are more desirable, I will further enjoy the flexibility that
online counseling allows. It also low cost to counseling clients online rather than
face-to-face.

13. Conclusion
 In the next few years online counseling will become
something that will have more substance as more
research will be conducted and clinicians as well as
clients will be less hesitant to participate in it.
 More individuals will receive mental health services
 Decrease in mental health problems not be addressed as
services will be much more widely used.

14. References
 Field, M. J. (Ed.). (1996). Telemedicine: A guide to assessing
telecommunications for health care. National Academies Press.

 Germain, V., Marchand, A., Bouchard, S., Drouin, M. S., & Guay, S. (2009).
Effectiveness of cognitive behavioural therapy administered by
videoconference for posttraumatic stress disorder. Cognitive Behaviour
Therapy, 38(1), 42-53.

 Kenoyer, M., Malloy, C., Vanderwilt, P., & Wakefield, S. (1999). U.S. Patent No.
5,900,907. Washington, DC: U.S. Patent and Trademark Office.

 Kraus, R., Stricker, G., & Speyer, C. (Eds.). (2010). Online counseling: A
handbook for mental health professionals. Academic Press.

 Hassija, C., & Gray, M.J. (2011). The effectiveness and feasibility of
videoconferencing technology to prove evidence-based treatment to rural
violence and sexual assault populations, Telemedicine ans e-Health, 17(4),
309-315.

15. References Cont.
 Thomas, C. R., Miller, G., Hartshorn, J. C., Speck, N. C., & Walker, G.
(2005). Telepsychiatry program for rural victims of domestic
violence. Telemedicine Journal & E-Health, 11(5), 567-573.

 Mattson, S., Shearer, N., & Long, C. (2002). Exploring telehealth
opportunities in domestic violence shelters. Journal of the American
Academy of Nurse Practitioners, 14(10), 465-470.

 Richardson, L. K., Christopher Frueh, B., Grubaugh, A. L., Egede, L.,
& Elhai, J. D. (2009). Current directions in videoconferencing
tele‐mental health research. Clinical Psychology: Science and
Practice, 16(3), 323-338.

 Schwenn, U. (2005). Status of Videoconferencing standard.
presented on 5th IAEA-TM on Control, Data Acquisition, and Remote
Participation for Fusion Research.

16. Future Recommendations
 Target a greater populations and not only victims of
domestic violence
 Implementation in schools so children learn at an early
age the ramifications of domestic violence and how to
avoid it. (As a learning tool)
 Finding different modes to provide therapeutic services
to these victims for example asynchronous counseling.
 Coach these same victims to be group facilitators by
building self-esteem and self-worth.