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3 Tips for Online Counseling

Stephanie Cook, LCSW, has more than a decade of clinical experience in the mental health field. With a two-year clinical fellowship at Emory University following her Master in Social Work degree (where she was awarded ‘Student of the Year’ at the University of Georgia MSW program!), she has definitely mastered the field of Social Work and counseling. She is a psychotherapist in Atlanta, GA and something she is passionate about is offering counseling online! She provides trainings for therapists in Georgia on the subject of online counseling and is developing e-courses and relationship courses!

“Stephanie, what led you into the business you are in now?”

After working in non-profits following college, she witnessed so many children in and out of foster care. She realized her love of working with families and individuals, and decided she needed to go back to graduate school for training. Clinical Social Work was a great fit for Stephanie, since she knew how much she loved playing the ‘therapist’ role. After she graduated, she worked at a psychiatric hospital in Atlanta, and did her fellowship at Emory University in the student counseling center this further solidified her longing to go into private practice.

“What is the best advice you have ever received that relates to building a business or becoming an entrepreneur?”

Throughout her schooling, Stephanie had a lot of mentors. She was so focused on having to have to have a niche, but these mentors reassured her: “Yes, that will help you, but don't feel so much pressure to figure it out right now. You’re just now starting out, and you’ve had good training. The rest will come. Be open to figuring it out as time goes.”

Stephanie’s 3 Tips for Online Counseling:

Tip #1: Know your jurisdiction’s laws

  • The laws are rapidly evolving all over the nation as it relates to use of technology and mental health. It is a therapist’s responsibility to know them.

  • Ignorance is no excuse. Stay updated - make sure you’re aware of the laws, rules and ethical codes.

Ethics for Online Counseling

  • When it is related to technology for clinicians, Stephanie likes to think of the “ethical ceiling” and the “ethical floor”. -Ethical ceiling = what we want to strive for in our ideal -Ethical floor = the absolute minimum – what can get you into trouble if you don’t comply -So, know the best practices. Keep above the ethical floor and go above and beyond the ethical ceiling.

Who is Right for Online Counseling?

  • There are definitely lots of considerations! -Severity level is of the highest importance. Understand the client’s risk for suicide, or how much stability they have. Have a structure in place to support high risk presentation. -The second consideration would be age. Confirm their identity and age to make sure they are able to consent to treatment. -Third, make sure the client is savvy with technology or able to learn the technology in order to successfully have the video session. -Last, make sure it is the best fit in terms of preferences and personality.

Tip #2: Make sure that you have a Business Associate's Agreement with any technology platform that you use.

  • Any technology you use that might, in any way, hold private, confidential and privileged client information – you need a Business Associate's Agreement with that company.

  • It's a written document between you and the company, saying that we are up to date with the current practice is (a.k.a. HIPAA).

  • Could a hacker in theory breach that? Yes. But are they meeting the best standards and are saying, we will take responsibility if a breach does ever occur.

  • Question: Is it the therapist’s job, or the company’s job to ask for a B.A.A.? -It is in the therapist’s responsibility. -Side note: You can find a great example of a B.A.A. on the government HIPAA website. Also, has great comparisons of different software’s, and are pretty up to date of who will or won’t sign one.

Tip #3: Have a set of ever evolving policies and procedures with your informed consent

  • Yes, informed consent is what you sign at the beginning, but it is an ongoing verbal informed consent with clients. This is a living, changing document, and you have to be the one to bring that up to your clients.

  • Stephanie uses ‘CounSol’ – an electronic health record, as well as video record. If you have problems, then you may have to have backup software. She also suggested or

  • At The Private Practice Startup we have are comprehensive consent and in addition to that we have a Phone and Video Consent.  Any clinician can purchase it.  Remember all our paperwork is Attorney Approved.  CLICK HERE to check out our paperwork.  We offer packages and a la carte options.  

“What is something you want to leave with our listeners today?”

Stephanie expressed how she senses so much anxiety among clinicians around technology and the laws. She sees the fear of noncompliance or the fear of being prosecuted or losing licensure. Do the best that you can to become aware, get training, and to continue to learn. She ended with, “I hope more and more clinicians will consider integrating this into their practice”.

Check out the show notes page to see the awesome resources that Stephanie recommended!

Her giveaway is 25% off of any of the future online therapy e-courses Stephanie hosts. Just mention that you come from this from The Private Practice Startup and you’ll receive it!

CLICK HERE to listen to Stephanie’s podcast, and be sure to check out her recommendations! Assure you subscribe so you can stay in the loop of ALL the podcasts we release. The Private Practice Startup would also be super grateful if you could rate and review our podcasts.  Thanks again for allowing us to Inspire YOU from Startup to Mastery!



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