How to become a therapist online

therapistonline, onlineteletherapy

How to become a therapist online? It’s a question more therapists were asking themselves as the people seeking out telehealth services grew exponentially throughout the COVID-19 pandemic. This growth created the need for more therapists to provide online counseling services. As a clinician, learning more about online services can help you decide if you want to offer telehealth services in your practice and become a therapist online.

What is an online therapist?

An online therapist provides behavioral health services using technology or electronic communication. During online therapy, the treatment occurs while the therapist and client are in two different places. Other terms for online therapy include telehealth, teletherapy, telemental health, e-therapy, e-counseling, cyber-counseling, and video counseling.

Therapists provide many different services via telehealth including:
  • Video therapy sessions
  • Telephone therapy sessions
  • Email communications and support
  • Text messaging communications and support
  • Instant messaging
  • Online chat
  • Online messages

Some services may occur live or in real-time such as a video or telephone session. Others may have delayed response times such as email or other forms of messaging.

How does an online therapist differ from a traditional therapist?

Counseling services should not change whether the therapist meets with a client virtually or face-to-face in a traditional setting. The difference is how the therapist chooses to interact with clients in their practice. To become a therapist online, a provider must meet the same education, licensure, and credentialing criteria whether providing online counseling services or traditional services.

Some therapists choose a hybrid model. In a hybrid model, therapists see some clients in a traditional office setting and also see clients using telehealth technology.

What are the requirements to become a therapist online?

Currently, when providing online counseling services, therapists must meet the licensing requirements for their state as well as the state in which the client is located during the session. Current policy and law dictate that, in a telehealth session, the treatment occurs in the location of the client.

For example, if the therapist is located in Apple City and the client is located in Orange City, the treatment occurred in Orange City. For this reason, therapists must determine the location of the client before providing services at every session.

Checking on the following agencies is suggested if you’d like to become a therapist online.
  • State licensing board of your state as well as the state where the client is located to understand and abide by the state-specific requirements. 

  • Professional liability carriers to ensure you have coverage for telehealth services. Some policies may automatically cover telehealth and some plans may require additional coverage.

  • Insurance plans accepted in the practice regarding qualifications to provide telehealth sessions. Each plan differs in its criteria regarding any specific annual training, billing codes, and other criteria.



Tools for providing telehealth services

As a telehealth therapist, you will need some extra tools and support outside of your therapy toolbox. Some minimal tools for your online counseling toolbox include:

Computer: While most therapists have a computer, if you are providing online counseling services you will need a computer that can support a video conferencing platform.

Webcam: If your computer does not have a webcam then you can purchase an external one that you can attach to your computer.

Video conferencing platform: The video conferencing platform hosts your video telehealth sessions and must be HIPAA compliant. You have a variety of options from which you can choose and most electronic health records (EHR) providers offer a telehealth monthly subscription. For example, TheraPlatform offers HIPAA-compliant video conferencing along with practice management software. 

Confidential and private location: Online counseling sessions require the same privacy and confidentiality as in-office sessions. When you set up your office space, make sure that you have a private location. You cannot hold a session at your kitchen table while your family wanders around the house. If you work from your home, you need a location with a door that closes and some type of signage to indicate to anyone else in the home that you should not be disturbed during your sessions.

Secured internet access: You should have access to a secure internet connection. You do not want to log into a public network for your online counseling sessions.


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As you grow more comfortable and expand your online counseling services, you may add other tools such as:
  • Microphone
  • Headphones, headset, earbuds
  • External webcam
  • Lighting
  • Larger or extra monitor

Does an online therapist require special training?

Training requirements to become a therapist online vary by state, licensure boards, and insurance carriers. Before providing telehealth services, check with your state’s regulations, your licensure board, your malpractice carrier, and any insurance companies that you accept.

Therapists should always provide services within the scope of their abilities and practice. This ethical obligation includes having a solid understanding of best practices when providing telehealth services.

It is important to seek out trainings to provide guidance and education in areas such as:
  • Maintaining confidentiality during a telehealth session
  • Additional paperwork such as an informed consent
  • Risk management issues with telehealth
  • What to do regarding suicidal clients during a telehealth session
  • HIPAA and telehealth
  • What to do if technology fails before or during a call
  • How to best conduct a session
  • Any contraindications for using telehealth (populations, diagnoses, or symptoms that might not be appropriate for online counseling)?
  • How to stay up to date on regulations and laws regarding telehealth

How to become a therapist online

Starting an online therapy practice can occur as you build your practice or you can choose to add this service to an already existing practice. You can start your telehealth practice by incorporating it into your marketing plan, informing any insurance providers you use, and discussing it with clients.

Before you become a therapist online, create a plan to make sure that you carefully address the areas discussed in this article before you begin seeing clients:
  • Learn about state-specific requirements
  • Consult with your liability insurance
  • Set up the appropriate office space
  • Select and learn how to use a video conferencing platform
  • Identified necessary information from any insurance providers you accept
  • Obtained appropriate training regarding telehealth


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During the COVID-19 pandemic, many rules and regulations changed regarding providing telehealth services. Some changes may remain permanent and some will be revised as the pandemic state is declared over. If you decide to become a therapist online at any level, it is essential that you remain up to date on rules and regulations within your state, nationally, and with any insurance plans that you accept.

If you decide to become a therapist online, tools like TheraPlatform provide HIPAA compliant software and the ability to schedule appointments, document and bill clients from a single portal. They also offer a 30-day free trial. No credit card required. Cancel anytime.

Sources

Camper, A. and Felton, E. “Telemental Health: Legal Considerations for Social Workers.” National Association of Social Workers, March 2020. Accessed November 28, 2022.

More resources:

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