Just finished a free consult with a colleague wrestling with a "telehealth client from Hell". Got me thinking more about what I really think about the telehealth option in our profession and the social convenience of telehealth:
- I don't like it.
- I think it's way over-utilized, and abused by some clients and some counselors.
- And, I think face-to-face should always be the primary option.
My Telehealth Disclaimer
So you know, I offer telehealth as an option but I don't utilize it for marriage counseling, or kids. It just doesn't work. Most of the time I require that at least the first session be done in-person in order to get a complete read on a new client. If I could completely eliminate telehealth as an option I'd do it, but it does have a place, in increasingly rare instances.
The Social Convenience of Telehealth and Why Clients Shouldn't Be Calling The Shots
We're in the HEALTH CARE profession. People come to us daily with all manner of mental issues looking to us for guidance. We need to remember that this is first and foremost about health care, and "client convenience" should never, ever, be the #1 determiner of the mental health care delivery venue. Ever. What's best for the client's mental health outcome, should be.
I dare anyone to make the case that the telehealth option would ever allow us to deliver a better standard of care than in-person therapy does. You can't do it.
If Your Cardiologist Did This?
What would you think if you needed a triple-bypass and your cardiologist would only meet with you online? All of your pre-surgery care is done online, and then he wanted to direct your surgery from another state via ZOOM, with some med-school interns actually doing the procedure?
You'd have a melt-down fit and so would I. So why do we so often default to online sessions?
Going With the Flow Got Us Where We Are
We let the Covid event mainstream the virtual option and now we won't let it go for three reasons:
- The population has been trained to use it over the past several years,
- Some of us, selfishly, won't let go of the convenience factor, and...
- The rest of us don't have the backbone to call the shots with our clients.
There, I said it. We need to take back control of the counseling environment.
But What About the Rural Communities?
Yes, telehealth is a viable, last resort option for the underserved rural communities. It's better than nothing for sure. But even our Board, by its actions, believes that in-person would be better.
Almost a year ago the Board passed a rule allowing Associates to run their own practice purportedly so "we could better serve the rural communities" by encouraging associates to move there and set up shop. (I've checked the numbers so far and there's no mass migration in progress. If the counseling community was really so worried about the mental health of the rural communities then we'd be moving there en masse, where the opportunity is, but that's not happening. We're staying where the money is.)
Part of providing therapy to people is about delivering it in a manner that WE think will best help the client in the long run. There is a place virtual counseling but face-to-face is always going to be best choice.
We've got to take back full control of the healthcare environment not only to best serve Joe Citizen, but to protect our own backsides (I didn't even get into that!).
What's your telehealth policy look like? Comment below.
Plan Smart. Be Safe. Serve Others.
Kathleen Mills, LPC-S, CEAP
Got An Opinion?
These posts are my beliefs based on my a) 32 years of practice as a mental health provider and b) my own research. Whether you agree or disagree, please feel free to leave your civil, constructive comments below. I try very hard to back up my liberty-based statements with my own experience and/or verifiable facts and I would ask you to do the same. You do not need to be logged in to leave a comment.
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