Virtual Backgrounds for Therapists
In the years since the pandemic, telehealth has become an increasingly common format for therapy, with many therapy private practice telehealth providers offering mostly (or even exclusively) virtual sessions.
And, it’s for a good reason—telehealth is flexible, accessible, and it can be a win for both the clinician and the client.
That being said, if you’re new to the world of telehealth, incorporating it into your practice can bring up a lot of questions.
What regulations apply to seeing clients virtually?
And what steps do you need to take to stay compliant?
How do telehealth sessions differ from in-person ones?
And how can you provide the best care to a client in a different location?
Finally, how do you get the word out about your private practice telehealth services and take your virtual practice to the next level?
Let’s take a dive into all things telehealth, including tips for starting a telehealth private practice, how to conduct sessions, and how to market and grow your virtual practice.
Plus, download a free telehealth guide and checklist to ensure you’re prepared for your telemedicine private practice sessions.
Getting started with telehealth
If you’re thinking about launching and/or growing your telehealth practice, the good news is that there isn’t a huge barrier to entry.
“Telehealth is an excellent way to launch [and/or grow] your private practice—it keeps overhead low and set up simple,” says Rena Freedman, LPC Associate, a Dallas-based therapist who specializes in treating anxiety, OCD, and mood-related disorders. “In most cases, all you really need to get started is a laptop, an EHR platform, and malpractice insurance.”
That being said, there are definitely things to consider and keep in mind as you’re getting started, including:
Understand the rules
Before you even think about seeing your first telehealth client, it’s important to do your research and understand the laws, rules, and regulations you’ll need to follow in your virtual practice.
Understanding the legal side of things from the get-go can help you stay compliant as you build your practice—and help you avoid serious consequences.
HIPAA compliance
Therapists are subject to HIPAA regulations, which are designed to protect client privacy and protected health information (PHI)—and that includes when offering virtual therapy sessions.
And, in order to comply with HIPAA, you’ll need to choose a platform to host virtual sessions and communicate with your clients.
"Therapists are responsible for making sure that the video platform they're using is HIPAA compliant as well as making sure clients' PHI is also protected," says Sara Hiebsch, MA, LPC, a licensed professional counselor at Hope River Counseling, PLLC.
But not all video conferencing or communication platforms are created equal; many mainstream and popular platforms (like Zoom, Skype, or Gmail) are not HIPAA compliant—and, as such, using them to conduct private practice telehealth sessions or have sensitive conversations with clients is a definite no.
Instead, it’s important to look for a platform that offers all the features and functionality you need to effectively launch, grow, and manage your telemedicine private practice in a HIPAA-compliant way.
SimplePractice is 100% HIPAA compliant and offers a variety of features that support telehealth, including secure video conferencing, notes, and a secure client communication platform, allowing you to protect your client’s privacy and protected health information.
Licensing
It’s also important to understand licensing issues in telehealth.
Generally speaking, if you’re going to start seeing someone for telehealth sessions, "the client must be located in a state in which you are licensed to practice," says Hiebsch. So, if you’re licensed in Oregon, your client needs to physically be in the state of Oregon during your telehealth sessions.
Note: There are exceptions to that rule. For example, interstate compacts like the Psychology Interjurisdictional Compact (PSYPACT) or the Counseling Compact allow licensed clinicians to practice in not only the state they’re licensed, but other participating states in the compact.
Insurance
Insurance can add another layer of complexity to private practice telehealth.
But, the good news is that telehealth has become so mainstream over the past several years that most major insurance providers now cover telehealth services—often at the same rate as in-person sessions.
That being said, coverage and requirements vary between carriers, so before you start seeing clients, it’s important to verify coverage with any insurers you work with in your practice and make sure you understand their specific requirements for telehealth billing and documentation.
Be realistic with your case load
Another thing to consider as you’re getting started with telehealth is your case load and how many clients you’re going to see in a given day or week.
Many therapists assume that an ideal caseload for in-person sessions and telehealth sessions is the same, but that’s not necessarily true.
“If you’re coming from an in-person practice, you might find that your capacity or scheduling preferences have shifted [when moving to telehealth],” says Freedman. For example, “maybe six in-person sessions felt totally fine, but six hours of screen time leaves you feeling wiped.”
Before you start scheduling patients, be real with yourself on what feels doable—and then use that information to build a telemedicine private practice that works for you.
For example, are you a person that hates staring at a screen all day? If so, seeing six clients back-to-back probably isn’t sustainable—and instead you might start with three or four clients.
Then, as you start seeing clients, “pay attention to how you feel and adjust as needed,” says Freedman.
Being realistic about your capacity for private practice telehealth sessions can help you start your practice off on the right foot—and help you avoid burnout down the road.
What to do before a session
Once you’ve tackled all of your getting started to-do’s, next up on the list is preparing for your telehealth sessions.
Things you’ll want to do before a telehealth session include:
Prepare your technology
Telehealth sessions rely on technology—and before you host a session, you’ll want to make sure that all of that technology is up, running, and functioning properly. This includes:
Setting up your tech. Before your session, take a few minutes to get your technology setup. Restart your computer, close any unnecessary background programs (which can cause system slowdowns), set up your webcam (aim for eye level), and test your audio, speakers, and camera. Confirming that everything is functioning how it should before your session can prevent unnecessary tech issues during your session.
Testing your internet. “Always run an internet speed test before sessions,” says Freedman. “There’s nothing more frustrating than a glitchy connection.” You can test your internet speed by Googling “internet speed test” and choosing from one of the available options. Keep in mind that, for an optimal video experience, you’ll want at least 10 Mbps download speed.
Mastering your platform. Before you host a session, it’s also important to get comfortable navigating your telehealth platform. “Before a session, you should know how everything will operate and have some idea of how to troubleshoot,” says Thomas. “With the platforms that you are utilizing, it is recommended to review FAQs and to have them handily pulled up in a browser just in case you need to refer to it during session.”
Prepare your environment and your self
Just as important as preparing your technology? Preparing your environment—and yourself—for the session.
Before you start your session, make sure that you:
Choose the right space… Where you choose to host your telehealth sessions is hugely important. Choose a private space where you won’t be heard, interrupted, or distracted. If there are other people in the space with you (for example, if you share office space with a colleague or you’re in your home with your children or spouse), let them know that you’re heading into a session and are not to be disturbed—and then take extra steps to ensure they can’t hear the session. (“White noise machines can be great [for this],” says Pennsylvania-based psychotherapist Kayla Meyer, LPC. )
…and optimize that space for the session. How you set up your telehealth space is also extremely important. Make sure the area has good lighting, that the space is clean and free of clutter, and that there’s nothing within the camera frame that could be potentially distracting, offensive, or that you don’t want your client to see (for example, personal effects).
Get yourself ready. Once your environment is ready, it’s time to get yourself ready. Dress professionally, do what you need to do to get comfortable for the session (for example, adjusting your chair or getting a glass of water), and take a few minutes to settle in and mentally prepare for the session.
Prepare your client and get consent
If your client is new to telehealth—or new to telehealth with you—they may not know the ropes. And, as the clinician, it’s your job to prepare them—both for the session and for the telehealth experience as a whole.
Things you’ll want to connect with your client about before your first session include:
Location. Just like you need a private space for therapy, your client needs the same. So, before your first session, “make sure the client has a private space where they can talk, without fear of others hearing them,” says Meyer.
Telehealth process. Most people today are familiar with video calls—but that doesn’t mean they understand your telehealth platform. Prior to the session, make sure to send your client any information they need to successfully access and navigate the telehealth platform and log on for their session, including tech requirements, setup instructions, and a direct link to access their video session.
Informed consent. While regulations vary by location, most states require that clinicians obtain “informed consent” from clients, which includes educating them on the different facets of telehealth—and you’ll want to get that consent before your first session. “You should have a telehealth consent prepared, separate from your consent to treatment form,” says Meyer. “The telehealth consent should summarize the risks and benefits of telehealth services. For example, telehealth provides increased access to services, but is also vulnerable to disruption due to technical issues.”
Conducting a telehealth session
Once you’ve got all the prep work out of the way and you’re ready to see clients, the next item on the agenda is actually conducting your sessions.
There are a number of things you’ll want to keep in mind for conducting a successful, compliant, and therapeutically helpful virtual session, including:
Start with a telehealth check-in. Before you jump into therapy, take a few minutes at the beginning of the session to check in with your client and ensure that you’re good to go for your telehealth session. This includes verifying their insurance (during their first session), confirming that they’re physically in the state where you’re licensed, and making sure that they’re in a space where they feel safe to do therapy.
Have a backup plan. Tech issues are par for the course with telehealth, but they don’t have to derail your session. Have a backup plan in place if there’s an issue with the session (for example, if the client’s internet goes down) and communicate that plan to the client before the session.
Stay present. “Telehealth can just feel different from in-person sessions. You have less access to subtle body language and the physical energy in the room,” says Freedman. “That means you often need to lean in a little more and be super present to achieve the attunement that’s the bedrock of therapy—staying fully present, even through a screen.” For example, it’s important to maintain eye contact during a telemedicine private practice session. If you need to look away to take notes, let them know beforehand so they don’t think you’re distracted or not listening. The more present you are, the more present your client can be—and the better the session will be as a result.
Documenting telehealth services
The standard for therapeutic documentation for private practice telehealth and in-person sessions are the same. But there are a few extra documentation requirements to consider when seeing clients virtually.
When documenting your telehealth session, make sure to include:
That the session took place via video conferencing
The client’s location during the session
The client’s continued consent for telehealth services
Any technical issues that happened during the session
Spreading the word: Marketing your telehealth services
Arguably one of the biggest benefits of using telehealth in private practice is the marketing potential.
“From a marketing standpoint, telehealth also broadens your reach, enabling you to connect with clients across your entire licensure area—not just those in your immediate locale,” says Freedman.
Some marketing best practices to keep in mind when building a telehealth practice include:
Tap into your existing client base. If you have an in-person practice, your existing client base is a fantastic place to start marketing your new telehealth services. Reach out to existing clients and ask if they’d be interested in making the move from in-person to virtual sessions.
Feature telehealth on your website… Your website is where potential clients go to learn about you and your services. So, you want to make sure that it’s crystal clear that you offer telehealth. Consider adding a page or section that outlines key information about your telehealth offerings (including a link to book)—or, at the very least, make sure to include telehealth verbiage somewhere on your homepage. “I have found it helpful to clearly indicate on my website that I offer online sessions—and answer any questions regarding logistics during my initial call with prospective clients,” says Hiebsch.
….and everywhere else. Don’t stop at the website! Promote your telemedicine private practice services on any and all available marketing channels, like your newsletter or social media pages.
Highlight the benefits. Once potential clients start booking consultations with you, take the opportunity to highlight the benefits of telehealth sessions. For example, you might mention the flexibility, convenience of taking sessions from a location of their choice, and eliminating the commute to and from your office.
Get your telehealth practice started
If you’re new to telehealth for private practice, it can feel like a lot to take in. But now that you understand the ins and outs of all things telehealth, you’re armed with the information you need to launch and grow your telehealth practice and start seeing clients virtually.
Download the free private practice telehealth checklist for therapists at the top of this article to keep yourself organized and ready to see clients virtually.
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