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Online Counseling


Online counseling is also known as telehealth, telecounseling, teletherapy, video counseling, or Skype counseling. It is counseling that is made accessible to individuals in their home, office, or other location rather than in a counseling office. Online counseling is a professional relationship that is invested in your counseling goals and providing relief.

Benefits of Online Counseling:

  • Location – Counseling is now accessible to anyone who is normally limited by distance and location
  • Schedule – Counseling can more easily be scheduled into your day
  • Travel time – No travel time needed
  • Relevance – Counseling can use the technology means that you are already familiar with
  • Health & Illness – No need to cancel your appointment due to cold and flu season or other complicating health reasons
  • Travel – You can still make your counseling appointment if you’re out-of-town (check with your counselor on restrictions for out-of-state travel)
  • Accessible – Easily available to anyone who has internet access and a web cam via your electronic device
  • Privacy – Increased privacy for those who don’t want to physically go to a counseling office
  • Specialists – Ability to find a counselor who best specializes in addressing your needs/goals
  • Ease – There are fewer barriers that impact your ability to access treatment with a counselor

Getting Started with Online Counseling:

Schedule an appointment with a counselor

  • Contact Lacamas Counseling if you would like a referral or recommendation
  • If possible, attend your first session in person to familiarize yourself and create more context for the counselor you are working with

You will need a computer, laptop, tablet, or phone with a camera, speaker, and internet speed of at least 10 mbps

  • Computers connected to a wired ethernet cord will have the least amount of internet disruption and lagtime
  • Test your internet speed online (Search “Internet Speed Test”)
  • Internet Connection Pre-Call Test:
    • Tests internet speed
    • Camera quality
    • Sound quality

What to Expect:

Create a comfortable, quiet, and private environment to have the session

Limit your disruptions:

  • Consider a “Do not disturb” sign on your door
  • If needed, get childcare
  • Separate noisy animals in another room
  • Tell family, friends, or housemates that you will be unavailable
  • Alert your counselor to any privacy disruptions or changes in environment
Prepare your device:
  • Internet Connection Pre-Call Test:
  • Restart your computer every couple of days
  • Close any extra programs or screens
  • If using a smartphone, download the app “Telehealth by SimplePractice”
  • Position your device so the camera is at eye level and there is not too much bright light behind you

Prepare yourself:

  • Set yourself up in your room 5-10 minutes early
  • Write down any notes/thoughts/questions that you want to cover in session
  • Take some deep breathes to help yourself focus
  • Get your necessities: water, tea, tissues, cough drops, notebook and pen
  • Take care of your body needs: bathroom break, snack
Connect to the online session:

Join through your computer or laptop

  • Appointment reminder email will be sent 10 minutes prior to your appointment
  • Select the appointment link to open your online counseling session

Join through your smartphone

  • Download the app “Telehealth by SimplePractice” before the appointment
  • Appointment reminder email or text will be sent 10 minutes prior to your appointment
  • Select the appointment link to open your online counseling session

After the session

  • Write any notes, phrases, or tasks that you want to remember from the session
  • Challenge yourself to incorporate the tasks identified in session
  • Keep track of your attempts, successes, and challenges

Frequently Asked Questions

Will my sessions be recorded?

No, there are no permanent records of the sessions.

Is online counseling private?

Yes, your privacy will be protected through HIPAA compliant technology. When using this HIPAA compliant technology you are able to speak confidentially with your counselor

Are there any safety issues that I should be aware of?

Yes; be aware of your surroundings, alert the counselor if your setting is no longer private, delete your texts and emails frequently, password protect your phone, and provide your address at the start of the session.

What if there is an emergency?

Always call 911 if there is an emergency or immediate risk of harm. Inform your counselor of your current address at the time of session in case emergencies arise during the online counseling appointment.

What if the technology fails during the session?

You can attempt to reconnect with your counselor in the online counseling session or call your counselor directly by phone. It is recommended that you do an internet connection pre-call test to test your audio, video, and connection. Also consider using a computer with an ethernet cord, restarting your computer every couple of days, and closing additional programs that are not being used during the session. You can consult with your counselor and create a plan to prepare for potential interruptions to your online counseling session.

What hours are sessions available?

Online counseling sessions are conducted during business hours. Ask your counselor about their specific hours of availability.

Can I email and text my counselor?

Email and text cannot be guaranteed full confidentiality and cannot be the means of your online counseling session. However, you can authorize email and text to be used as another means of communication. Text and email can be used to coordinate appointments, share documents and resources, and provide small updates. We request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies. An immediate response cannot be guaranteed.

Is online counseling effective?

Yes, online counseling has been found to be as effective as face-to-face counseling for a wide range of problems. Some clients even report greater satisfaction with online counseling due to the confidentiality, convenience, and ease of maintaining a rhythm of counseling appointments.

Are there certain issues that are not appropriate for online counseling?

Yes, some client concerns are not appropriate for online counseling and need more intensive care, such as active suicidal ideation (intent to harm self), homicidal ideation (intent to harm another person), hallucinations (experience of stimuli that others do not experience), delusions (beliefs that differ from reality), and active addictions. If you regularly experience or anticipate emergencies that involve your counselor then it is recommended that you pursue in-person counseling.

Can I use online counseling only occasionally?

Yes, when scheduling your appointment, you can coordinate if you want the appointment to occur in the office or online. Occasional online counseling can be a beneficial option when you have medical or health concerns that would normally impact your appointments, inclement or hazardous weather, higher symptom severity, or out-of-town travel.

Do I need to live in the same state?

You need to be in a state in which your counselor is licensed to practice; this is due to many reasons of malpractice, liability, and knowledge of state laws. Consult with each individual counselor about their state licensees.

Can this work for me?

In order for this to be effective, you need to feel comfortable using technology and patient through possible technology disruptions.