Karen Weiman Counseling

TELEHEALTH TIPS

TECHNOLOGY HOW-TO

I use HIPAA-compliant telehealth videoconferencing software to conduct our online therapy sessions.  It is typically simple to use if you have the proper equipment. Most people who can successfully stream Netflix without it pausing to “load”, and who have video and audio (speaker and mic) on their device, find it works well. Most smartphones, laptops, and tablets have both video and audio capability. Desktops vary. We will discuss your ability to handle online sessions at our consult call.  

Most patients opt in to receive electronic invitations to sessions during the intake process.  If this is the case for you, prior to our meeting, you will receive an appointment reminder with a link to log in to the waiting room at our appointment time.  If you have any troubles getting to the waiting room, feel free to text, email, or call me so that we can troubleshoot together.

I encourage patients to do a test log in prior to our appointment to make sure everything is working well on their side and to help ensure our initial session does not get shortened as a result of technical issues.  You can check that your mic, speakers, and video are working this way.  You can also ask to test things out during our initial consult call.

• Please be sure to EXIT out of any programs that steal bandwidth prior to our sessions. You may want to close all other Tabs just to be safe.

• QUIT (don’t just minimize) Skype, Carbonite, Google Drive back up, or any other cloud backup service. 

• Please ensure that no one in your home is streaming video or playing graphic heavy online video games as this will decrease our internet connection.

• Some patients find it easier to connect their device directly into the internet modem rather than use Wi-Fi. That is what I do on my end.

• Ensure that your internet browser is not “blocking” camera or microphone access.  You will need to “allow” it to use camera and microphone in order to use these during our sessions.

Tech issues can happen, but they are rare and usually very easy to solve. Turning things off and back on again typically fixes most issues.  If we are not able to resolve any technology or connection difficulties, either party can discontinue the telehealth consult/visit.   

ADDITIONAL PRO-TIPS FOR ONLINE THERAPY

It is important to maintain a setting that is similar to being in an office together as possible. In order to have effective online sessions, please review the following guidelines. 

• Connect. Research says that the connection between therapist and patient is the primary determinant of therapeutic change.  I want to make sure that we connect well over video, so in our first session:

  • When we talk, I’ll share some tricks to make sure that we can look at each other, rather than the camera. If it looks off to you, please let me know.  Eye contact matters.  It helps to have my eyes on your screen nearest to your camera and I will do the same.

  • Please be sure to have efficient lighting so that I can best communicate with you. 

  • Some patients choose to where headphones with a speaker (such as ear pods) for privacy and better audio.  I highly recommend this and will likely be using them too in order to prevent feedback.

  • If we get disconnected, I will call you and we can try to resolve the issue. Please also be available by phone.

• Steady Surface. Please have your device on a steady surface and not in your hand. If it must be held in your hand, please hold it as steady as possible. You should be in a set location and not moving about. 

• Bring tissues.  If you were in my office, I’d provide them for you.

• Private. Ensure that you have adequate privacy prior to session.  This may mean adjusting the volume, using headphones, and closing your door. Psychotherapy is serious work. You do not want to be interrupted. A quiet space with no background noise is best.  I am not able to conduct online therapy if there are others in the room that I am not aware are present.  Please inform me if there is anyone in the room with you, or who you believe may overhear the session.  If you want anyone to join the session, let’s discuss it first. 

• Prevent interruptions, minimize distractions. Turn off notifications on your computer and phone once we are connected and turn off background noises like TVs and music or other sounds.  Again, closing the door can also help with background noise. Please do not play games on a device, be on social media or working on other things while in therapy. Make sure pets, children, household members, and roommates will not be distractions from treatment. Babies are usually fine to be present, though the less distractions in these cases, the more you will get out of therapy.

• Be Ready. You may be extra cozy because you are somewhere familiar to you and you may feel more casual because the work is online. Remind yourself prior to session that you are here to do the meaningful work of positive change.  

• Be fully present. It is important for you to be fully present during therapy sessions.  Please refrain from driving while participating in online therapy and please do no consume any recreational drugs or alcohol prior to or during therapy. If these occur, you will be asked to reschedule and the late/24-hour cancellation policy applies.

• Dress appropriately.  No underclothes permitted. No provocative postures or gestures will be tolerated.  

STRENGTHS AND LIMITS OF ONLINE THERAPY

Telephone, chat, and video sessions have some advantages over in-person psychotherapy.  Many of my patients share with me that it is more convenient (no commute, takes less time out of the day) and more comfortable (in their own space).  Some patients share that they feel more able to share “deep” things because it is online rather than in person. 

Online therapy is not for everyone.  Online therapy is not a good fit for a patient in crisis, where their safety or that of others could be a concern. In-person treatment may be the most appropriate treatment choice for these situations.  If a patient has a poor internet connection, lack of appropriate equipment, a lack of privacy, or otherwise would simply be more comfortable meeting in person, it is better to connect with a provider who offers in-person services.  We will discuss if any of these situations apply at the first session and determine if online therapy is appropriate for you.

SERVICES AND LOCATIONS 

I provide services to adults over age 18 throughout the States of Ohio and Michigan.  By law, you will need to be in the state of Ohio during the therapy session, even during vacation and otherwise. If you are not in the State of Ohio during any session, the therapy session will be terminated for that day and all subsequent sessions while not in the State of Ohio.

TELEHEALTH PRE-SCREENING QUESTIONS

Due to being in a separate location than your therapist, there are extra measures telehealth clinicians need to make to ensure your safety and privacy. Please be prepared to answer the following questions at the beginning of each session (or confirm there have been no changes since last session):

-          Current location address and phone number to reach you:

-          Local hospital:

-          Who can I call if I am worried about you?

-          Have you taken appropriate measures to prevent interruptions?

-          Are you in a private space?

-          Is there anyone else in the room, not pre-approved, who could hear sessions.

-          Is there anything in the environment I should know about?

-          Are there any safety concerns today?  

-          Do you feel capable continuing to use telehealth services? Is this modality working for you?

See you soon!

Karen