When a client reaches out for online counseling, I schedule a phone or video session with him/her. This gives me a chance to see the client in person or hear his/her voice. As we would in a more traditional counseling environment. In addition, my Code of Ethics (NASW) now suggests obtaining photo ID on all online clients. This is to further verify identity and make arranging emergency services a bit easier if needed in the future.
Beyond asking what brought the client to online counseling, I will ask why he/she is choosing online versus a traditional in-person option. I also remind the client that I am always happy to make a referral to an in-person therapist at any time in our work if they would prefer.
As we become more comfortable in the conversation, I will inquire about:
- past experiences with counseling
- goals for online counseling
- history of trauma
- history of suicidal ideation or self-harm.
If the client is actively experiencing suicidal thoughts or has a recent history of this, then I will make a more immediate referral to an in-person or emergency option.
I also always ask the client some technology-related questions as well including:
- Are you comfortable with the idea of online counseling?
- Are there any questions or concerns that you would like to discuss about online counseling before moving forward?
- Do you have the technical knowledge to utilize email, phone, and video mediums comfortably and confidently?
- Do you have adequate internet bandwidth (primarily for video sessions) and/or consistent internet access?
At the conclusion of this conversation, I discuss with the client the appropriateness of online counseling for their needs. If this is not the right fit, I share in-person counseling referrals with the client.
In a solo or group practice setting, it is important to document the steps and screening tools. As well as specific questions that you want your clinicians to ask potential online clients. Document the responses in the client’s file, so you can verify that this assessment happened and why the client was approved to move forward with online counseling or not. By creating these systems and protocols in your practice, you can ensure consistency and accuracy across different therapists while protecting your clients.
With these steps in place, you can assist clients in obtaining counseling that is the best fit for their unique needs. And increase their likelihood of success in therapy.
Wendy Galyen, LCSW and BC-TMH, is the founder of Thrive for Life Online Counseling, solely private pay and entirely online private practice in Indiana. She has degrees from the University of Indianapolis and Indiana University where has also served as an adjunct faculty member. Wendy has over 16 years of experience working with individuals, couples, families, and children. She also has extensive social work research experience. And has published and presented this research in textbooks, journals, online periodicals, magazines and at national conferences. In addition to her work with clients via online counseling mediums, Wendy also provides consultation services to other counselors who are looking to add online counseling as a component of their practices.
