Online "Counseling" How is it Legal?

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Grenth

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I keep getting ads online for services like betterhelp.com which says it employs 1,500 licensed and accredited therapists and uses anonymous text or voice chat to offer therapy ($35 a week for unlimited sessions) I know these type of websites and apps seem to have been around for a while, but I feel like I've started to see them more and more often and in MA-MFT ethics classes we didn't cover them at all. I know video/Skype-style counseling has some pretty strict parameters and can be useful in some cases, but these anonymous web services seem very different.

How are these legal? It seems potentially unethical, unsafe, and ineffective, but maybe I'm missing something.
Betterhelp offers this http://azy.edu.haifa.ac.il/home/ as their proof of "effectiveness"

Members don't see this ad.
 
The practice of psychology is generally regulated at the state level and overseen by some type of board of regulation of psychologists. Given the relatively new nature of electronically delivered therapy, it's proba ably not directly addressed in a regulation, but may be covered in a board position paper. Here's an example from my state: http://www.mass.gov/ocabr/licensee/...ovision-of-services-via-electronic-means.html

In MA, the therapy is considered to occur where the client is located. As the board states, any legal or ethical complaints regarding services delivered to a client in MA will be heard by the MA board, and thus the clinician will be subject to MA regulations and need to be licensed in the state to legally provide any type of psychological services to someone physically located in MA. I'm guessing other states have similar policies. The MA board of registration of Social Workers and board of registration of Mental Health Counselors have similar policy statements.

Interestingly, the board position statement has comments about concerns for the effectiveness of e-services, with criticisms of the type that "[as the psychologist] loses the kind of direct contact with a patient/client that occurs in an in-person, face-to-face office, the psychologist incrementally loses much of the richness of interaction which, as any psychologist knows, comes with traditional face-to-face contact." I would hope that they have some evidence for that statement. I can provide some direct contradictory evidence- I am a psychologist (legally) in their jurisdiction, and I, in fact, don't "know" that. It was addressed in my training (wasn't an issue back then), and it hasn't come up in my professional development since then. If I were to ever consider providing such services, I would have an ethical obligation to "know" such things, but until then I don't. All the board really knows about what I know is that, at the time I took them, I "knew" the answers to about 75% of the questions on the EPPP and jurisprudence exams. Anything else is supposition and seems a unrelated to the duties of the board. In the linked document, they basically say "we don't like it, but you can do it if you follow the rules."
 
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Members don't see this ad :)
They are probably not legal or on US soil. The link you provided is an Israeli, which means the state boards are going to have limited means of sanctioning him. $35 for unlimited therapy also doesn't sound like a US provider.
 
This thread discussed this briefly if you'd like to take a look: http://forums.studentdoctor.net/threads/text-therapy.1137491/#post-16493366

Also, after seeing that thread months back, I found these couple of articles (blog posts by a psychologist) on forbes talking about talkspace (similar service to betterhelp). I found his critique pretty well thought out and informative. He is not a fan of these services.

http://www.forbes.com/sites/toddess...in-talkspaces-text-only-therapy/#4a060b962089

http://www.forbes.com/sites/toddess...ting-messages-and-clinical-risk/#40b9de0e1981
 
They are probably not legal or on US soil. The link you provided is an Israeli, which means the state boards are going to have limited means of sanctioning him. $35 for unlimited therapy also doesn't sound like a US provider.

Nope- from the their website (betterhelp.com):

Meet our counselors

Counselors in BetterHelp are licensed, trained, experienced, and accredited psychologists (PhD / PsyD), marriage and family therapists (MFT), clinical social workers (LCSW), or licensed professional counselors (LPC). All of them have a Masters Degree or a Doctorate Degree in their field. They have been qualified and certified by their state professional board after successfully completing the necessary education, exams, training and practice. While their experience, expertise and background vary, they all possess at least 3 years and 2,000 hours of hands-on experience.


It's kind of funny- for some of the "counselors" when you click for their info, it give a licensure number- just the number, not the state. For others, it mentioned the state of licensure in their narrative.
 
The Talkspace ads are pretty disconcerting. Both for consumers and "therapists."
ItAfEK7.jpg


Edit: Sorry for the gigantic image, folks.
 
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