​What is E-Counseling?

E-counseling, sometimes referred to Telehealth, allows the client and counselor to meet through audio and video over the internet.  I utilize a secure, HIPAA compliant, web-based technology (similar to Skype, but easier to use) in conjunction with webcams to provide two-way, interactive video counseling sessions over the internet.  Clients can see and interact with me (and I with them) in real time, as if we were in the same room.  This provides a similar experience to in-person counseling in that the client and counselor can interact with and respond to each other without losing all of the nonverbal pieces of communication (both visual and auditory) that account for the bulk of relational interactions.  At this time, I can only provide E-Counseling services to individuals physically present in the State of Ohio.

E-Counseling helps to address several hurdles to engaging in mental health services.

Finding the time for an in-office therapy appointment is becoming more and more of a challenge in our fast-paced lives, especially when many people’s mental health takes a backseat in their list of priorities due to time-constraints and other life difficulties.  E-counseling allows more accessibility and flexibility and can provide people with greater freedom and choice, providing help to many who would not otherwise receive it. 

Accessibility:

• Many Americans live in an area with limited access to healthcare.  This means that people who are having difficulties either have to travel some ways to receive help or simply don’t have access at all.  If there are counselors in these areas, there are usually only a handful of them.  It may be possible that the counselors in question know family or friends of their clients, which could create a conflict of interest.  E-Counseling can play an important role in these communities by increasing accessibility. 

• People who are home-bound due to physical limitations or have social difficulties such as being shy, anxious and/or introverted may have difficulty making it out of their homes to see a face-to-face therapist.  

• E-Counseling is also advantageous to individuals who lack transportation or anyone seeking help who is reluctant to see a counselor in person.  Until now, those who live far away with no public transportation were unable to get to counseling unless they found a way to get to their counselor’s office. Those without transportation just had no way to get there and went without therapy.

Convenience: 

• E-Counseling may be more convenient for some clients and can provide a better client experience.  While E-Counseling takes place in real time and does depend on making an appointment, traveling and related formalities do not present obstacles.  There is great convenience in scheduling and it can also have savings in cost due to the lack of travel.

  • Access counseling anywhere from the ease of your desktop or mobile device as long as there is a secure wireless internet connection.

  • Sessions can be done at flexible times of the day in the complete privacy and comfort of your own home or office.

  • With no waiting or travel time, you won’t have to take time off work or away from other priorities.

  • E-Counseling can save money when compared with traditional approaches to providing care.  For clients, this often means lower co-pays, transportation costs, less time missed from work, and less money spent on child care expenses. 

Safety and Assertiveness:

• E-Counseling may increase clients’ sense of safety, for they are able to receive help from within their own environment. This may help clients open up and express themselves more fully than they would be in a traditional counseling setting. 

Social Stigma:

• There is an unfortunate stigma associated with counseling. Many people report feeling embarrassed for having to use counseling services to help them work through life’s issues rather than being able to handle them on their own. While taking advantage of the life-altering benefits of receiving counseling is becoming more mainstream, we as a society still have a long way to go before some individuals become more fully comfortable letting their network of friends know they are seeing a therapist without fear of being judged. Until that day comes, E-Counseling services allow patients to receive counseling with greater discretion than in-person therapy since it can be done in a quiet room at home or at the office during lunch break.

Effectiveness and Potential Limitations

Effectiveness varies by individual. However, research has shown that E-Counseling can be as effective as face-to-face counseling for countless mental health disorders, including but not limited to stress, depression, and anxiety.  On the other hand, more severe and complex circumstances, such as suicidal feelings or psychotic behavior, would be better aided by traditional counseling, though even with this, more research is required.  E-Counseling can be very beneficial for clients, but it may not be the best fit for some situations.  The considerations listed below will be helpful in determining whether E-Counseling services are appropriate for you at this time.  (Hilty, Ferrer, Parish, Johnston, Callahan & Yellowlees. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine Journal and e-Health, 19, 444–454).   

• Clients need to be intellectually, emotionally, physically, linguistically and functionally capable of using the E-Counseling application and corresponding technology.  E-Counseling is less ideal than in-person counseling for some counseling goals.  For example, with couple’s counseling it can be challenging for more than one client (i.e., the couple) to share the same webcam.  There also might be some individual counseling issues for which physical proximity to the counselor is important for the client, and thus E-Counseling would be less ideal in those situations.

• E-counseling is not suitable for individuals who are actively making attempts to take their own life (i.e., are actively suicidal).  Note that there is a difference between someone feeling down, not wishing to be in pain, and even wishing they “weren’t here anymore” and someone who is actively planning out and taking steps toward trying to take their own life.  People can experience the former without ever seriously considering, or trying, to take their own life.

Setting up your first session:

Call my office at 614-333-9957 to inquire about my services and/or to set up an appointment.  Text messages are welcome.  You may also email me at Info@NicholasBoltonCounseling.com.  More information about my services, counseling approach and training can be found at www.NicholasBoltonCounseling.com.

During the intake process and the first session we will discuss the appropriateness of E-Counseling methods and resources and services that you might be interested to explore instead.  I am available to answer any questions or concerns and assist you in reaching a determination about the appropriateness of this service delivery format for your needs and your specific goals for counseling at this time.

Client Responsibilities and Hardware Requirements:

Computer with internet connection (with adequate speed):  In order to have online video sessions you will need a computer or device with an internet connection.  It is the responsibility of the client to ensure that they have access to a secure and private computer or device with certain capabilities that allow for smooth and interrupted services such as a strong and secure internet connection.  You also need to be at least somewhat comfortable with using technology (e.g., logging into a website, interacting via webcam, etc.).  Most of the time you will not need to download any software in order to engage in the E-counseling process.

 

Ohio Counselor, Social Worker, & Marriage & Family Therapist Board

http://www.cswmft.ohio.gov/

 

License Verification:

http://cswmft.ohio.gov/Online-License-Verification

 

Counseling Codes

http://codes.ohio.gov/oac/4757-5

​

Please reach out if you have any questions, curiosities or concerns.  I look forward to hearing from you!