Distance Psychotherapy Via Electronic Media
Dr. Schwartzburd and Ms. Chelette have been using these modalities to provide service between their offices and people receiving their services for more than 10 years, due primarily to the fact that until three years ago they spent significant amounts of time together in one another’s states, (Georgia and California) as a function of what had been their cross country marriage.
The offering of psychological services such as psychotherapy via the electronic media of tele-video, telephone, instant messaging and email is being increasingly addressed in the research and other professional literature. The research is pretty uniformly to the effect that such services provide positive benefits for the members of the public who receive them, and many people actually prefer service by these media. It is a service of increasing importance for populations in under-served sections of the country. In addition to these services being supported by a growing number of studies and state laws, a number of professional organizations are developing guidelines.
The American Psychological Association is presently formulating guide lines growing out of existing experience and some states, such as California, have law requiring insurance companies to pay for them where the service is appropriate. We feel the most important guide line for a meaningful standard of care is to establish available resources for emergency care in the location of the person using our services. In our experience it is highly unlikely that such resources will need to be used, but a good standard of care should cover all the bases.
We most often work by Skype, the free service anyone with high speed internet and an inexpensive video camera can use, (many good cameras cost less than $50 and many of the more recent computers have a built in camera.)
During the early stages of treatment we always spend at least several sessions of psychotherapy actually together with those we serve in our offices in Berkeley, California. These early in person sessions do not have to be all at once. Of course the best situation is face to face together in the same room, but as the psychotherapy research has shown, working together by these media does a lot of good. Using these media we currently do psychotherapy with people who initially lived relatively close to our offices and have moved away. This allows for continuity of care. There are people who travel a lot for their work and continuity of care is available for them too. There are cases where care is provided internationally. .
We are required by HIPPA, the Federal law governing psychological services, particularly regarding confidentially, to inform the people we work with, (regardless that most already know this,) that absolute security via the internet cannot be guaranteed. We do take our ethical and legal responsibilities connected with confidentially very seriously and utilize available precautions to protect the security of the process and have never experienced having any problems with our security being breached. It may be helpful that the financial incentives to cyber criminals do not exist in the work we do. It is our best understanding that nothing remains on the internet of sessions conducted by tele-video or instant messaging once the session is ended. For people who feel an exceptional need to protect their confidentiality, the telephone is probably most secure.
If you have any questions about services at a distance we will of course discuss them with you.