Counseling Services

Practicing Outside The Box: Psychotherapy On The Client's Couch

Michigan therapist finds niche providing in-home psychotherapy services

Would you travel to a client's home to provide therapy? After witnessing the high no-show rates while working at community mental health centers Michigan, therapist Tomanika Witherspoon, LMSW, CEO of Growing Counseling Services, decided to do just that.

She created an "outside of the box" specialty practice by focusing on providing in-home therapy.

In Witherspoon's experience, individuals who discontinued traditional therapy cited transportation, time and family responsibilities as the biggest barriers for receiving treatment. By providing in-home therapy, Witherspoon saves her clients travel time, travel expenses and time spent in an office waiting room.

What about her own travel time and expenses? Witherspon said that she does not bill for her travel time. However, to minimize the unpaid travel time and expenses, she only sees clients within a 20-mile radius of her location.

What about safety issues? "I typically do a phone-screening to gather the client's demographic information, insurance info, and the assurance that we will have somewhere to meet privately," Witherspoon says. "Safety is generally not a concern, but if it ever becomes one, I would meet in a colleague's office."

Providing in-home therapy services is not for everyone, but Ms. Witherspoon makes it work for her and her clients.

Visit GrowingCounseling.com to find out more about Tomanika Witherspoon, LMSW's "outside the box" practice.

Have you found a creative niche, a unique office space, use non-traditional interventions, or have something that sets you apart from other private practice clinicians?  I want to hear about it! Email me with "outside the box" in the subject line.

(c) Can Stock Photo

Who's Afraid Of Online Counseling?

Eleven years ago I ventured briefly into the world of providing online counseling services. It was short-lived because there was not enough interest from potential clients in online counseling. At the time, there was a sense that online interventions would revolutionize counseling, and that it might even become a preferred method of treatment for many. While online counseling, also known as telemental health, and e-therapy, hasn't "taken over" the field of therapy in the past decade, electronic delivery methods have steadily grown.

According to APA’s Center for Workforce Studies, the use of videoconferencing jumped from 2 to 10 percent between the years 2000 - 2008, and the use of email for service delivery tripled during that same time frame.

The ethical concerns and uncertainties surrounding online counseling haven't changed much in the past decade. Is it really confidential? What problems are appropriate to treat online? Can you treat clients across state lines? What ages are appropriate to treat?

Professional guidelines and state laws still don't clearly outline what's appropriate and what's not when it comes to working with clients online which brings up a lot of anxiety for therapists, including me.

In spite of the questions that linger, my clinic is venturing into the world of online therapy this month. There is enough evidence of it's effectiveness, new secure delivery platforms, and enough client interest to offer online services.

Here's how my colleagues and I are managing our own anxiety about offering online counseling:

1) Pre-screening clients for appropriateness of online counseling prior to initial session.

2) Online counseling training for my therapists who are interested in offering online counseling.

3) Signed consent form by client acknowledging risks and benefits of online service delivery.

4) Working online with clients in our state.

5) Selecting a secure, easy-to-use online counseling platform. (We decided to go with CounSol)

If you're afraid of online counseling, here are a few resources that might help you get the courage to try offering services online:

Do you provide online counseling services? Why are why not? I want to hear about your experiences!

Online Therapy...Naked? Heading To 2012 SXSW Fully Clothed

SXSW Interactive 2012

South By Southwest Festival is legendary in the music, film, and technology worlds. I've always wanted to go, but this year I'm actually going to make the trek to Austin, TX to present on an interactive health panel! PsychCentral's CEO and founder Dr. John Grohol, a pioneer in online counseling, invited me to participate on a panel called "Online Therapy...Naked?"

Yes, you read that right...n a k e d. An unlicensed NY woman (with a BS in Psychology) and founder of "Naked Therapy" who claims to be providing "therapy" online to "patients" while getting naked (and aroused) will be on the panel. Also, weighing in on the discussion will be LICENSED professional counselor Audrey Jung, LPC who provides legitimate online counseling services.

Our discussion kicks off the SXSW interactive health track on Saturday morning at 9:30 a.m. Here's the panel description from the official SXSW site:

Professionals have been offering psychotherapy online since 1995. While the earlier services focused on offering therapy through email, this has changed in recent years. With the popularity of video conferencing, it was inevitable that someone would invent a form of therapy called "naked therapy."

This intriguing panel will discuss how Internet and mobile technologies enable therapeutic interactions between professionals and individuals. Experts will discuss e-therapy, how it's changed over the years, and how technology is disrupting traditional professional relationships -- enabling therapeutic modalities not possible a decade ago... Even the possibility of "naked therapy." It should make for an interesting, heated discussion between practitioners of traditional forms of online therapy and the founder of  "naked therapy."

So, why was I invited to be on this panel? 

While I do use online therapy as an adjunct to face-to-face clients (always fully clothed) I primarily use the web for mental health education and promotion through Ask The Therapist Q & A's, blogging on JulieHanks.com, WasatchFamilyTherapy.com , and through social media channels Twitter, Facebook, Pinterest, YouTube, and others. In addition to giving a social media and mental health perspective, I'll also be commenting as a working, credentialed clinician for 17 years on the idea of a "new kind" of therapy "Naked Therapy." Frankly, it doesn't sound new at all. It sounds like a lot like one of the world's oldest professions.

Follow My SXSW Tweets

I'll be tweeting SXSW updates throughout the weekend through Twitter @Julie_Hanks. Also follow Twitter hashtags #SXSWH (for tech & health topics) & #NakedTX for interesting info on this specific panel. Feel free to tweet me your thoughts on online therapy issues, "naked therapy", or mental health & social media topics.

If you're a going to SXSW Interactive check out the great health track presentations here.

Curious to know what you licensed therapists think of someone using the word "therapist" in their business when they have no training or supervision in talk therapy?