Posts Tagged ‘mental health’

Thursday, September 9th!

Join Kate Anthony, DeeAnna Merz Nagel and John Wilson as they host a VIRTUAL TOWN HALL MEETING ABOUT THE IMPACT OF TECHNOLOGY AND MENTAL HEALTH AND ALL THAT IS ONLINE THERAPY!

We will discuss efforts of three of the leading organizations representing online mental health and we will offer information about upcoming conferences, continuing education opportunities and publications. This is a great opportunity for a brief introduction followed by a Q&A session.

You can join us in Second Life at the Online Therapy Institute Conference Centre, alternatively you can view this event from the OnlinEvents website and you will be able to communicate with us using the chat room on our Live Video page.

There is no charge for this event!

Check out the time of the event in your time zone:

San Francisco: 12:00 PM – 1:00 PM
New York: 3:00 PM – 4:00 PM
London: 8:00 PM – 9:00 PM
Sydney: 5:00 AM – 6:00 AM

For more information visit www.onlinevents.co.uk

On Tuesday, May 11th I had the pleasure of attending the screening of Life 2.0, a documentary about Second Life, at ICF Theatre’s  Stranger Than Fiction. Director Jason Spingarn-Koff follows people for a period of over a year or more as they maneuver life lived in a mixed reality.

The scenarios include two people, each married to someone else,  involved in a cyberaffair, complete with hook-ups in Second Life to using webcam technology for face-to-face encounters. Their love affair takes them out of cyberspace for several in-person encounters. Emotions are high and limerence, that state of intense romantic desire for another person, is clearly evident. This is an affair of great proportions~ emotional, cerebral and physical~ filled with the excitement and consequences of infidelity.

An intimate look  into the lives of several people who are brave enough to share their stories continues. Another young adult who is engaged to be married logs into Second Life and soon he has created an alter~ an 11 year-old girl who he describes is a part of himself. This story line is rich and psychodynamic offering a glimpse into the impact of virtual worlds on the lives of people who have experienced childhood trauma. The vulnerabilities of the adult male, his alter child female, his “real life” fiance and other avatars the child befriends in Second Life are all laid out across the screen in a disturbing yet expected fashion.

A woman searching for meaning in her vocation  discovers that she can merge her love of gaming with her talent for design. She also explains that she has been dealing with several health issues so working from home is a plus for her. She starts a business creating a line of clothing and accessories as well as designer homes and landscapes. She manages to turn her hobby into a profitable enterprise. As with any entrepreneur, she applies focused concentration and long hours.

It is the stuff of life that therapists have been dealing with for years, or is it?

Enter the ability to create an alternate digital reality and these life struggles become magnified. Online disinhibition means that people do and say things in cyberspace they might not be able or willing to do or say in their “real life.”  Quotations are purposeful here because the underlying message is that these cyber experiences ARE real- as real as what I had for breakfast this morning.

So what does this documentary offer those of us in the helping professions? How about a new chapter in multiculturalism? Cyberculture is rich, full, real and impactful. Our clients don’t just go to soccer games, or movies or to Paris or Walt Disney. They don’t just have clandestine affairs at work or deal with historical issues of abuse in the therapist’s consultation room. They go to Second Life, another destination rendering the thrill of decadent and clandestine meetings, corporate enterprise, vocational fulfillment and the ability to create a new beginning, reconstruct a past event or extend parts of oneself into another reality.

If you have the opportunity to view Life 2.0, don’t miss it.  Your understanding of cyberspace will grow beyond measure.

Stay tuned for more about Life 2.0. We will regularly post notes of interest to our readers.

DeeAnna

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Our colleague, David P. Diana has authored a new book just out!  Marketing for the Mental Health Professional: An Innovative Guide for Practitioners is a book about success within all areas of the profession, offering practical and powerful strategies that lead to growth and opportunity you may never have imagined possible.

Diana has teamed up with Online Therapy Institute and several others to offer unique resources and discounts for people who purchase his book.  OTI is offering a 50% discount on our Get Verified program.

For more information on the book and corresponding offers, check out Diana’s recent blog post announcing the book launch and partners!

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Some of you who are thinking about delivering therapy online are wondering what might be the best way to get started.  Some practitioners opt to deliver services straight from their own websites tapping into platforms such as Skype and Hushmail. Skype offers encrypted voice, web and chat services. Hushmail offers encrypted email and chat. Skype and Hushmail are but two examples of available services. Now many companies are offering encrypted communication platforms. Currently I use Skype and Hushmail because these services are free and user friendly for clients.

Others may opt to join an “E-Clinic” which is an easy way to describe a platform or portal that allows providers of services and potential clients to conduct therapy. There are some nuances across the E-Clinic menus but in a nutshell, it is a one-stop shop for the client and therapist. I have previously joined E-Clinics in the past and I am still listed on a few.  It might be interesting to note that I have been listed for several (a decade in some cases) years on some e-clinic sites and I rarely if ever receive an inquiry from a potential client. I’ll get back to that in a minute.  E-Clinics are convenient and easy. Some E-Clinics offer appointment setting, billing capability, credit card processing and an extensive listing. Conceivably, one could create a listing on such a site and use the listing as a website. Some E-Clinics offer customized or “branded” services so that you can integrate the platform into a custom website of your own.  And most E-Clinics conduct some variation of credentialing so that license and certification numbers as well as malpractice insurance information is verified.

So it sounds hassle-free. So, why not? Well, there are a few reasons why not.  One is cost. Some of these sites charge monthly fees. That’s great but if you also have a website of your own then you might be paying twice, so to speak. Remember I said previously that I rarely if ever receive client inquiries from these sites so just because they have a glossy “store front” and offer a suite of products to the therapist, it does not mean that the site is marketed well. If you want to know, do an internet search using keywords like online therapy, online counseling, online counselling, or etherapy. What comes up? Is the E-Clinic listed on the first page of results? That is but one way to find out how “popular” the service is.  The other way is to check press or media tabs on the websites. Has anyone interviewed the company? Is there any information about advertising campaigns, past, present or future?  Remember, you can create a listing anywhere on the World Wide Web. That does not mean people can find you. In the case of E-Clinics, make sure your money is working for you.

Another concern is security. Is the site encrypted? Is the information held on the company’s server? I often joke that we need to be careful about setting up our services using encrypted platforms that are hosted on Joe’s server located in Joe’s garage somewhere in an urban neighborhood across the country or the world. But seriously, the security and encryption of the site should meet very high standards. Does the E-Clinic serve via contract, any major government or insurance entities? That is one reasonable and simple way to know if the E-Clinic has “clout” so to speak. But even so, do your own security tests. Take the E-Clinic for a spin. Use their web, messaging or chat services with a colleague. When you are logged on, send the URL (which should begin with https://) via your regular email or chat (yahoo or gmail for instance). Can the person on the other end open the the URL? If so, the site is not secure. Why is this important? If you do this same test with sites like Amazon, Ebay or your bank once you have logged in, the other person will not be able to see your information and will most likely be sent to a login page for that site. The same process should occur for E-Clinic sites.

If you think you have found an E-Clinic you want to use, be sure to check out their Terms of Use, Privacy Policy and other Terms and Conditions.  You should be concerned with what you are agreeing to as the provider of services and what the consumer agrees to as the recipient of services. Does it match your legal and ethical responsibilities? Do you have the ability to upload your own informed consent documents to your clients? And if you take client referrals from these sites using their platform, what intake information do you receive? Does the site conduct any screening? Is the site set up to provide crisis intervention? If the site clearly states that online therapy is not for people in crisis, then consider whether you want to make yourself available immediately. Many of the E-Clinic sites offer instant sessions as a way to lure consumers into using the site. Some would say these E-Clinics are offering a viable service to people who are in immediate need. So I ask, is the immediate need a crisis or just needing to have a personal issue addressed right away, representing the immediacy of our culture? Be careful not to compromise standards of care. For instance, if you make yourself available immediately, what client information do you have on hand during this initial contact? Is the client allowed to remain anonymous? If so, what happens if the client is genuinely in crisis?  I recommend that if you are going to utilize the option of immediate availability that you use this option as an initial consultation- and treat that time much like you would if a client called on the phone inquiring about services.  Why? Well, consider your ethical responsibility to properly screen your client and to know the identity of your client. If you are providing crisis intervention then the site should clearly state that services are for people in crisis with the proper terms and conditions in place.  Counseling and psychotherapy services that occur within a contracted relationship are very different than crisis intervention services.

Remember that E-Clinics cater to many disciplines so be sure that you can follow your legal and ethical codes and that you remain within your scope of practice.  If you live in a geographic area that does not regulate your profession and you have no real code of ethics to fall back on for reference, then consider using best practice standards set forth by the Online Therapy Institute’s Ethical Frameworks for Mental Health Practitioners and Career and School Guidance.

Hoping this has been a helpful post~ perhaps this will generate a healthy discussion of the topic.

DeeAnna

Lyle Labardee offers a great overview of where the field of online counseling is today. This article was published in the Summer issue of EAP Digest.  The full article is available here:

Online Counseling Crosses the Chasm

Kate and DeeAnna were interviewed for the article as well as several of our colleagues.  The Online Therapy Institute’s Ethical Framework for the Use of Technology in Mental Health is summarized as well.

Lyle, thanks for a great article! It is a wonderful contribution to the literature!

The proposed U.S. health care bill would enact a Telehealth Advisory Committee.  While I am not writing to debate the current merits of the health care bill in general, I find this particular component potentially valuable in promoting online therapy. The committee would consist of physicians and non-physician health care professionals so we need someone representing mental health and counselor efforts on that committee! This would also seem the perfect forum to discuss license portability or national licensure.

I have excerpted the information from the bill below which can be found on page 379.

If you want to see the entire 1017 pages go here
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf

Happy reading!!

Subtitle F—Medicare Rural Access
9 Protections
10 SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.
11 (a) ADDITIONAL TELEHEALTH SITE.—
12 (1) IN GENERAL.—Paragraph (4)(C)(ii) of sec13
tion 1834(m) of the Social Security Act (42 U.S.C.
14 1395m(m)) is amended by adding at the end the fol15
lowing new subclause:
16 ‘‘(IX) A renal dialysis facility.’’
17 (2) EFFECTIVE DATE.—The amendment made
18 by paragraph (1) shall apply to services furnished on
19 or after January 1, 2011.
20 (b) TELEHEALTH ADVISORY COMMITTEE.—
21 (1) ESTABLISHMENT.—Section 1868 of the So22
cial Security Act (42 U.S.C. 1395ee) is amended—
23 (A) in the heading, by adding at the end
24 the following: ‘‘TELEHEALTH ADVISORY COM25
MITTEE’’; and
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380
•HR 3200 IH
1 (B) by adding at the end the following new
2 subsection:
3 ‘‘(c) TELEHEALTH ADVISORY COMMITTEE.—
4 ‘‘(1) IN GENERAL.—The Secretary shall appoint
5 a Telehealth Advisory Committee (in this subsection
6 referred to as the ‘Advisory Committee’) to make
7 recommendations to the Secretary on policies of the
8 Centers for Medicare & Medicaid Services regarding
9 telehealth services as established under section
10 1834(m), including the appropriate addition or dele11
tion of services (and HCPCS codes) to those speci12
fied in paragraphs (4)(F)(i) and (4)(F)(ii) of such
13 section and for authorized payment under paragraph
14 (1) of such section.
15 ‘‘(2) MEMBERSHIP; TERMS.—
16 ‘‘(A) MEMBERSHIP.—
17 ‘‘(i) IN GENERAL.—The Advisory
18 Committee shall be composed of 9 mem19
bers, to be appointed by the Secretary, of
20 whom—
21 ‘‘(I) 5 shall be practicing physi22
cians;
23 ‘‘(II) 2 shall be practicing non24
physician health care practitioners;
25 and
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381
•HR 3200 IH
1 ‘‘(III) 2 shall be administrators
2 of telehealth programs.
3 ‘‘(ii) REQUIREMENTS FOR APPOINT4
ING MEMBERS.—In appointing members of
5 the Advisory Committee, the Secretary
6 shall—
7 ‘‘(I) ensure that each member
8 has prior experience with the practice
9 of telemedicine or telehealth;
10 ‘‘(II) give preference to individ11
uals who are currently providing tele12
medicine or telehealth services or who
13 are involved in telemedicine or tele14
health programs;
15 ‘‘(III) ensure that the member16
ship of the Advisory Committee rep17
resents a balance of specialties and
18 geographic regions; and
19 ‘‘(IV) take into account the rec20
ommendations of stakeholders.
21 ‘‘(B) TERMS.—The members of the Advi22
sory Committee shall serve for such term as the
23 Secretary may specify.
24 ‘‘(C) CONFLICTS OF INTEREST.—An advi25
sory committee member may not participate
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382
•HR 3200 IH
1 with respect to a particular matter considered
2 in an advisory committee meeting if such mem3
ber (or an immediate family member of such
4 member) has a financial interest that could be
5 affected by the advice given to the Secretary
6 with respect to such matter.
7 ‘‘(3) MEETINGS.—The Advisory Committee
8 shall meet twice each calendar year and at such
9 other times as the Secretary may provide.
10 ‘‘(4) PERMANENT COMMITTEE.—Section 14 of
11 the Federal Advisory Committee Act (5 U.S.C.
12 App.) shall not apply to the Advisory Committee.’’
13 (2) FOLLOWING RECOMMENDATIONS.—Section
14 1834(m)(4)(F) of such Act (42 U.S.C.
15 1395m(m)(4)(F)) is amended by adding at the end
16 the following new clause:
17 ‘‘(iii) RECOMMENDATIONS OF THE
18 TELEHEALTH ADVISORY COMMITTEE.—In
19 making determinations under clauses (i)
20 and (ii), the Secretary shall take into ac21
count the recommendations of the Tele22
health Advisory Committee (established
23 under section 1868(c)) when adding or de24
leting services (and HCPCS codes) and in
25 establishing policies of the Centers for
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383
•HR 3200 IH
1 Medicare & Medicaid Services regarding
2 the delivery of telehealth services. If the
3 Secretary does not implement such a rec4
ommendation, the Secretary shall publish
5 in the Federal Register a statement re6
garding the reason such recommendation
7 was not implemented.’’
8 (3) WAIVER OF ADMINISTRATIVE LIMITA9
TION.—The Secretary of Health and Human Serv10
ices shall establish the Telehealth Advisory Com11
mittee under the amendment made by paragraph (1)
12 notwithstanding any limitation that may apply to
13 the number of advisory committees that may be es14
tablished (within the Department of Health and
15 Human Services or otherwise).
16 SEC. 1192. EXTENSION OF OUTPATIENT HOL

I am honored to have been a part of the Mid-Atlantic Consortium for Human Services.  The 2009 Annual Conference was held at Brookdale Community College in Lincroft, NJ. I am adjunt faculty at the college teaching Introduction to Psychology.  The focus of the conference: Improving the Health and Wellness of Human Services Receipients and Providers: Thinking Globally and Acting Locally.

Yesterday I presented a 90-minute workshop entitled The Impact of Technology on Mental Health.  The presentation offered an overview of the impact of technology on mental health ranging from online counseling, self-help websites, wikis, podasts and blogs, gaming, virtual worlds, social networks and other related information.  We had a lively discussion ranging from ethics to internet addiction! I offered a handout of various links that embodied the available resources and interventions online. 

Here is a sample of some of the website links I offered:

Self-Help and Information

www.psychcentral.com   www.mentalhelp.net  

www.queendom.com

Self-Help Support Groups and Peer Support

www.dailystrength.org   www.addictiontribe.com  

www.mymobileguru.co.uk

Podcasts

http://www.softconference.com/dbsa/slist.asp?C=1382  

www.thejoveinstitute.org

Wikis

www.wikipedia.org   www.onlinetherapy.wikispaces.org   

www.wikimentalhealth.co.uk

Blogs

www.mentalhealthonthewebblog.com   www.onlinetherapyinstituteblog.com  

www.graceuncensored.blogspot.org

Social Networks

www.ning.com   www.social.realmentalhealth.com  

www.onlinetherapyinstitute.ning.com

Online Therapy

www.helphorizons.com   www.deeannamerznagel.com  

www.audreyjung.com

Therapist Directories

www.psychologytoday.com   www.goodtherapy.org  

http://etherapyweb.com

Twitter

www.twitter.com   http://wefollow.com  

www.twitter.com/therapyonline     @therapyonline    @kateanthony

Delicious

www.delicious.com   www.delicious.com/onlinetherapyinstitute

Hotlines

www.befrienders.org   www.deeannamerznagel.com/id65.html

Virtual Worlds

www.secondlife.com   www.clubpenguin.com

I hope everyone is enjoying this lovely spring day!  DeeAnna

The Online Therapy Institute offers an Ethical Framework for the Use of Technology in Mental Health that incorporates the major points of existing codes and guidelines offering practitioners a way to ensure that thier therpeutic work via technology covers best practice. 

The framework’s audience is global and as new technologies and ethical issues arise, the framework will be revised and updated.  Practitioners who practice according to the framework can know that they are implementing the best standard of care available to their clients.

The framework is posted on the OTI website and is also offered as a PDF download.  Members of OTI who offer therapy delivered via technology will be listed in the OTI Web Directory provided their practice follows the framework.  Anyone may join the Institute. but the directory will be reserved for practitioners and organizations who have implemented the framework into their practice.

We are excited about offering this framework to all mental health practitioners!

Best,

DeeAnna and Kate

 

MACHS

 

Mid-Atlantic Consortium for Human Services

 

2009 Annual Conference

 

Improving the Health and Wellness of Human Services

Recipients and Providers: Thinking Globally and Acting Locally

 

April 17-19, 2009

Brookdale Community College

Lincroft, NJ

Keynote: Wellness: A Model for Personal and Professional Practice.

Peggy Swarbrick, PhD., OT, CPRP 

Human service professionals are dedicated to help service recipients attain and achieve a sense of well being through access to resources, supports and skills. Service recipients encounter complex challenges to health, wellness, and longevity. This presentation will review how a wellness model can guide human service practice. Learn about the 8 dimensions of wellness, wellness principles and practical strategies to empower service recipients and fellow professionals. Participants will be challenged to apply wellness principles personally and professionally to prevent burnout and effectively deliver services that foster health, wellness, and improved quality of life.  

Sample of Workshops to be offered:  

“Mental Health and the Impact of Technology” – DeeAnna Merz Nagel, LPC

“Learned Optimism”

“The Privileges of Being in the Visible Majority”

“Introduction to Psychiatric Rehabilitation: A distinct field of human services”  

 

Registration Deadline: March 13th MACHS 2009 Annual Conference Registration   Name: __________________________________________ College/Organization _____________________________________________________   Email: __________________________________________ Address: ___________________________________________________________________       [] Students $75        [] Faculty/Administrator $110        [] Practitioner $110       [] Saturday attendance ONLY $45   Please Note: If you are a person with a documented disability and require special accommodations, you must contact Disability Services at 732-224-2730 or the conference coordinator (David Stout) at 732-224-2340 by the registration deadline (March 13, 2009).

Make checks payable to Brookdale Community College (Write MACHS in the memo line).

 Return checks and registration forms to:

David Stout

Brookdale Community College

765 Newman Springs Rd.

Lincroft, NJ 07738

Want to keep up with the latest posts, blog, news and information about mental health and technology?  We can’t track it all but we make every effort to bookmark new and interesting information related to the Online Therapy Institute and news related to cyberpsychology, online counseling, avatar therapy and other related topics.  Check out our bookmarks at http://delicious.com/OnlineTherapyInstitute.  Do you know of a bookmark we should add?  Let us know!

DeeAnna