You can pay session
by session, or for a course of sessions, but the payment must be made in advance. I abide by professional codes of
conduct of the BABCP.
are 2 main options for email therapy.
brief assessment for mild problems will enable you to receive self-help
direction and relevant materials.
comprehensive assessment, formulation and treatment plan, with more extensive
self-help direction and resources.
is also a new option for live therapy via Skype - see this page.
You will be asked to
complete a preliminary short questionnaire which will help identify whether
email therapy is likely to be helpful for you. On receipt of this
completed form, if I believe that email therapy is not suitable for you, I will
advise you of where you might seek more appropriate help.
If we agree that email
CBT will be helpful for your problems,
the first 'consultation' will involve an assessment process where we can learn and
understand more about your problems and what keeps them going. I will email you the full assessment questionnaire
to complete and return to me. Payment should be made at the time of returning your completed
assessment form - use the payment links on 'Cost'
case of the comprehensive assessment option, I will
then draw up an initial formulation: a road map of the problem helping us
to understand how the problem has come about, and how it affects you now.
This formulation will help us identify our goals and plan of therapy. You
will be supplied with appropriate resources, including therapy worksheets,
information guides and mp3 files.
assessment process, together with formulation, agreed goals and treatment plan,
may be sufficient for you to proceed with self-help materials (which will be
emailed to you, included in the cost) which may include reading material,
individualised worksheets and mp3 recordings. Naturally, you can contact
me via email at any time - individual email responses will be charged
The client should be aware that misunderstandings are possible
with text-based modalities such as email (since nonverbal cues are
The therapist will endeavour to respond to clients emails as soon
as possible after receipt, and certainly within 24 hours.
If it is not able to respond within 12 hours, then the therapist
will acknowledge the email and inform the client when they are
likely to receive a more comprehensive response.
Privacy of the therapist
Privacy is more of an issue online than in person. The therapist
has a right to his or her privacy and may wish to restrict the use
of any copies or recordings the client makes of their
communications. See also the below on theconfidentiality
of the client.
When the client and the therapist do not meet in person (as is the
case in online therapy), the client may be less able to assess the
therapist and to decide whether or not to enter into a treatment
relationship with him or her.
The client should be informed of the qualifications of the
counselor. Examples of basic qualifications are degree, license, and
certification. The counselor may also wish to provide supplemental
information such as areas of special training or experience.
The potential benefits of email may include: (1) being able to send
and receive messages at any time of day or night; (2) never having to
leave messages with intermediaries; (3) avoiding intermediaries and
voice mail; (4) being able to take as long as one wants to compose,
and having the opportunity to reflect upon the content of email
messages; (5) automatically having a record of communications to refer
to later; and (6) feeling less inhibited than in person.
The potential risks of email may include (1) messages not being
received and (2) confidentiality being breached. Emails could fail to
be received if they are sent to the wrong address (which might also
breach of confidentiality), treated as spam by some email service or
internet service providers, failure of email system, failure of
internet provision or computer devices, or if they just are not
noticed by the therapist (very unlikely but possible, especially in
event of e.g. therapist or family illness). Confidentiality
could be breached in transit by hackers or Internet service providers
or at either end by others with access to the email account or the
computer. Extra safeguards should be considered when the computer is
shared by others or used publicly. This website uses a
confidential web-based secure email facility at safe-mail.net
This website uses a confidential web-based secure email
facility at safe-mail.net
The client is able to set up a free safe-mail account for their own
secure email exchanges. The client can take other measures to
ensure themselves against potential risks such as using passwords for
their computer account on a shared computer and logging off when
leaving the computer.
There are alternatives to receiving mental health services online.
Other options might include (1) receiving mental health services in
person (initially via your usual doctor or health professional), (2)
talking to a friend or family member, (3) exercising or meditating, or
(4) not doing anything at all.
In rare instances, a client may not be in a position to consent
themselves to receive mental health services. In those cases, consent
must be obtained from a parent, legal guardian, or other authorized
party - and the identity of that party must be verified.
Standard operating procedure
In general, the therapist follows the same procedures when providing
mental health services online as he or she would when providing them in
person. In particular:
Boundaries of competence
The therapist will remain within his or her boundaries of
competence and not attempt to address a problem online if he or she
would not attempt to address the same problem in person.
Requirements to practice
The therapist meets the necessary requirements to provide therapy
services where he or she is located. In fact, requirements where the
client is located may also need to be met to make it legal to provide
mental health services to that client. See also the above onqualifications.
Structure of the online services
The therapist and the client will agree on the frequency and mode
of communication, the method for determining the fee, the estimated
cost to the client, the method of payment, etc. (as detailed on the
The therapist will adequately assess the client's problems before
providing any mental health services online. The client should
understand that that assessment could potentially behelpedorhinderedby
Confidentiality of the client
The confidentiality of the client will be protected. Information
about the client will be released only with his or her permission. The
client will be informed of any exceptions to this general rule.
The therapist will maintain records of the online therapy services.
The therapist will of course follow the laws and other established
guidelines (such as those ofprofessional
organizations) that apply to him or her.
The procedures to follow in an emergency should be discussed. These
procedures should address the possibility that the therapistmight
not immediatelyreceive an
online communication and might involve a local backup.
Another issue specific to online mental health services is that the
therapist can be a great distance from the client. This may limit the
therapist's ability to respond to an emergency. The therapist will
therefore in these cases request the name and telephone number of a
qualified local (mental) health care provider (who preferably already
knows the client, such as his or her primary care physician).