Psychotherapists are starting to ‘see’ their patients online

The event reminder on Melissa Weinblatt’s iPhone buzzed: 15 minutes till her shrink appointment.

She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Weinblatt, a 30-year-old high school teacher in Oregon, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer..!”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype, and encrypted digital software through third-party sites like, have made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly…

Still, opportunities for exploitation, especially by those with sketchy credentials, are rife. Solo providers who hang out virtual shingles are a growing phenomenon…

Other questions abound. How should insurance reimburse online therapy? Is the therapist complying with licensing laws that govern practice in different states? Are videoconferencing sessions recorded? Hack-proof?

Another draw and danger of online therapy: anonymity. Many people avoid treatment for reasons of shame or privacy. Some online therapists do not require patients to fully identify themselves. What if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient? “A lot of patients start therapy and feel worse before they feel better,” noted Marlene M. Maheu, founder of the TeleMental Health Institute, which trains providers and who has served on task forces to address these questions. “It’s more complex than people imagine. A provider’s Web site may say, ‘I won’t deal with patients who are feeling suicidal.’ But it’s our job to assess patients, not to ask them to self-diagnose.” She practices online therapy, but advocates consumer protections and rigorous training of therapists.

RTFA. Some of it is hilarious. Yes, I realize we’re discussing mostly legitimate needs and mostly legitimate practices designed to sort them.

I have a clear picture of the range of phonies and hustlers practicing therapeutic crafts — and how most states are easy as pie to tippy-toe around what passes for regulation and oversight. Cripes, I live in Santa Fe. I know people who channel stock tips!

Aside from the seriously disturbed, oftimes those with chemical and biological factors affecting their ability to function in society at all – a great deal of what people really need is conversation with someone who cares about listening. Maybe provide a tad of redirection towards solving problems on their own.

If I didn’t have so much fun blogging I might wander into the shrink-wrapped Skype therapy trade. Though I’d hate the record-keeping required to keep the IRS and insurance companies happy. 🙂

One thought on “Psychotherapists are starting to ‘see’ their patients online

  1. moss says:

    People in American society are fragile from beng crapped on by politicians, incompetent bureaucrats, ego-smitten bosses and endless authority figures – so tired of being lied to by hustlers like Beck and Limbaugh, Dr. Zen and Nancy Grace.

    With the corruption that abounds, you probably would do nothng but good, Eid, just by giving individual attention and dialogue to folks tired of being hushed by clowns who should be listening instead of talking.

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