Tips for Therapists Conducting Teletherapy in Response to COVID-19 Recommendations

By Gwendolyn S. Gaumond, MS, MA, LPC 

Many therapists and agencies have started to offer teletherapy for people they are providing mental health services to. These tips apply to video therapy – where therapist and client participate in the session using a video platform.  

General guidelines to keep in mind planning teletherapy delivery: 

1. Do not ever provide teletherapy using a smartphone. 

2. All agency or governing body HIPAA regulations are being followed. 

3. Agencies and independent providers need to ensure that they are using a HIPAA compliant teletherapy platform. 

4. When doing new client intakes for clients that you have not met, you should require identification such as a driver’s license to verify identity.  

5. All new client intake procedures and rules apply – anything you would do in a normal initial session has to also be done for initial meetings with teletherapy clients. Plan accordingly – ensure that clients have mandatory disclosures and forms prior to the session so that they can be reviewed. For agency therapists ensure that all agency forms are filled out and reviewed. Consider adding and reviewing (during initial teletherapy session) the following client guidelines for teletherapy: 

  • No therapy sessions while either party is driving. 
  • No drinking alcohol or using substances during or just before teletherapy. 
  • Clients are not permitted to record teletherapy sessions without the therapists’ permission. 
  • Client’s need to be in a location where they will not be interrupted and that is private enough to ensure confidentiality. 
  • Client’s may not take part in teletherapy when they are in a different state – unless the therapist is also licensed in that state. 

Just before every session:

6. Turn off email and any other application that is running in the background. Consider silencing anything that can be a distraction and make sure you, as a therapist, are in a room or location that is secure from other people (adults or children) interrupting. 

7. Verify and document your client’s current address/location in case a crisis is disclosed and you need to respond by getting client help from emergency responders. 

8.Verify that the client is in a secure location where confidentiality can be maintained and that there are no other children or adults in the room (unless they are part of the therapy session in some way such as couples counseling or planned parent consultations). 

9. Verify your client’s state. (client must be in the state where you are licensed when receiving therapy).  If your client has traveled outside the state and reaches out to you the following are acceptable actions: 

  • Federal Agencies can provide support over state lines – for agency therapists contact your compliance department to see if this applies to you. 
  • Individual therapists can do a brief follow up with clients who have travelled to a different state to assess for crisis and encourage clients to get care in that state. If a crisis exists (client is a danger to themselves or others), therapists should request a wellness check from the local law enforcement agency.  

For therapists who begin to do this regularly there are now several accredited CEU providers of telemental health certification. While it is not yet mandated it is a good idea to obtain this certification if you commonly provide teletherapy sessions. APA is offering a free training in response the COVID-19 recommendations – click here to access

A heartfelt thanks from the National Mental Health Innovation Center to all clinicians who are responding to the COVID-19 social distancing recommendations by creatively continuing to meet client needs with technologies like teletherapy. Please check the following links for practice guidelines by governing body: 

NASW 

ACA 

APA 

CMS guidelines during COVID-19 pandemic 

Teletherapy training guidelines by state 

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