5 Questions to Ask Your Psychologist Before Doing Online Therapy

With more people working from home than ever before in recent history, health service psychologists are attempting to revolutionize psychotherapy and other therapeutic care.

Now, providers want to meet you, where you are—wherever that may be.

Telehealth services such as video-conferencing (e.g., like a FaceTime chat or Skype call with a friend) your psychologist, emailing materials, and/or scheduling sessions over text messages are all possible. Today, providers and clients can have entire sessions online, at a distance, and from the comfort of one’s own home. It’s often convenient, accessible, and similar in effectiveness to in-person care.

However, as we transition to using more technology, there are some important things to take into consideration. Here are five questions you should be asking your provider before starting online therapy:

1. What technology do I need to have to “meet” online with my psychologist?

Generally, sessions held online will need a reliable Internet connection. Popular teleconferencing software, Zoom, suggests you have about a 2 Mbps connection for any device you use. High-speed Internet tends to be far faster than that minimum requirement, and allows users to meet over smartphones such as iPhones and Androids; tablets; desktop computers with cameras; and, laptops.

Importantly, if you share your Internet connection with others (e.g., someone else is streaming movies from Netflix), this might impact the quality of your calls. Additionally, in more rural parts of America, bandwidth may vary or make it more difficult to have a telehealth session. Asking your psychologist about what they recommend, what technology they’re using, and common places to find out more resources is an important next step.

2. How private and secure is telehealth technology?

When we use the Internet, there’s a tendency for us to leave breadcrumbs—little bits of data—about what we’re doing, searching, clicking, sending, and sharing. For instance, sometimes when I look for watches on Amazon.com, I find an ad for watches on the retailer’s website popping up from website to website. This tracking technology is just one small example of our digital data having a lasting footprint online.

Ask your provider to explain how they’ll keep your data safe, private, and secure. Similarly, check in with your psychologist about how data will be handled, if they are using a HIPAA (Health Insurance Portability and Accountability Act)-compliant service, and whether your other communications (e.g., emails) will be documented in your chart/medical record. Psychologists have an ethical and legal obligation to keep your information private and confidential—whether you’re sitting in their offices or using online therapy.

3. Can I travel away from home or can we continue to meet outside of the state?

Laws vary greatly regarding this question of online therapy across state borders, as each jurisdiction has their own regulations. For instance, some states allow clients to temporarily cross state lines for therapy, but not forever. Some states have flexible policies or change them regularly in an effort to adapt to the times. And others have signed onto a new agreement called the Psychology Interjurisdictional Compact (PSYPACT) to try to better care if you cross state lines.

For your safety and welfare, it’s essential for you to talk openly with your psychologist about any plans you might have to do so. Should you like to begin online therapy, and know you will need to travel away from home, collaborate with your provider about what options might exist. They can help you coordinate care, find times, and ensure the safety and security is maintained—even at further distances.

4. Where can I find more information about the expectations for online therapy and services used?

As psychologists, we are expected to provide informed consent to those of legal age (informed assent to minors). This process includes the sharing of expectations, benefits, cons/considerations, fees, and more. Oftentimes, informed consent is both a conversation and a document you sign.

Online therapy presents challenges to the process, as you might not meet face-to-face in the first session. By asking where to find more information, psychologists can help you understand how they will bill online, the privacy policies/terms of the software employed, and limitations/losses associated with telehealth. Similarly, look for providers who offer informed consent documents online for your review.

5. How can I prepare my physical space for a session?

By moving therapy outside the physical office setting, many more variables get entered into the mix. A friend, your partner, or any other number of people might be in your home right now. Moreover, your pet might want you to go for a walk. Or the delivery person might be about to knock on your door. All of these possibilities exist when we break out of the traditional therapy space.

Talk with your psychologist about preparing your physical space. First, are there times you coordinate with others in your household to have some alone time? Second, are there spaces that are more private and quiet than others? Third, are there headphones you can use to isolate the sound of the session? By teaming up with your provider, you might be more free to talk—especially about distressing concerns.

Your care is important. Telehealth services are more accessible than ever before, and providers are eager to make it possible. By asking these questions and collaborating with your psychologist about online therapy, you can be better prepared and ready for a great session at your fingertips.

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Samuel Lustgarten, PhD

Samuel Lustgarten, PhD, is an assistant clinical professor in counseling psychology and assistant director of the Counseling Psychology Training Clinic at the University of Wisconsin-Madison. His work has centered on technology in psychology, specifically examining the ethical and legal considerations. Dr. Lustgarten’s research has been published in American Psychologist, Professional Psychology: Research and Practice, and Clinical Psychology: Science and Practice. Additionally, he serves as a consultant and educator for providers interested in utilizing technology in their service delivery.