online counseling

Virtual LPC Podcast #16 featuring Dr. Martha Ireland

Martha Ireland, PhD, RN, CS, CEDS, DCC is a Psychotherapist, Licensed Clinical Nurse Specialist, Certified Eating Disorder Specialist and Supervisor, and a Distance Credentialed Counselor with over 25 years of experience working with the eating disorder community. She successfully owned and operated a multidisciplinary outpatient clinic for treatment of disordered eating. She has been a CEO of both profit and nonprofit organizations, been published, led workshops, and lectured around the country. 

Dr. Ireland, Co-Founder of Virtual Therapy Connect, is currently active integrating technology with mental health services. Virtual Therapy Connect is a cost effective turn-key secure video teleconferencing platform that is a HIPPA and HITECH compliant solution for clinicians, groups or institutions to connect, with clients, from their virtual office.  She is currently located in Ashburn, Virginia.


In this episode I talk with Dr. Ireland about her journey as a therapist.  Currently, she has created a virtual therapy site that I amazing.  Click the link below for more details:

During the episode, Dr. Ireland discusses the ups and downs of creating a private practice, as well as an online counseling website.  I love to hear her excitement and enthusiasm when talking about her work.

Below are some other resources she uses to maintain her life and practice:

Wellness: technology free Sundays (this is great.  I need to start implementing this!); meditation, exercise, and remaining connected to her personal life.

Books: Conscious Evolution by Barbara Marx Hubbard and Online Counseling by Ron Kraus

Internet Resources: Virtual Therapy Connect (Dr. Ireland's site); American Telemedicine Association; Zur Institute; Telemental Health Institute, Therapy Sites, and Influential Therapist.

You can also listen to the episode in your browser by clicking here

Breakthrough Update

I recently received an update from Breakthrough reporting some exciting changes.  Due to the recent merger with MDLive, some new opportunities will be available starting in 2015.  Here's the main takeaways:

  1.  Breakthrough is beginning to contract directly with insurance companies.  For example, if you are a Texas provider, Breakthrough already has a contract with Aetna that allows them to conduct the benefits and eligibility lookup and they will file the claim for you.
  2. After doing one additional credentialing step, providers will now be able to join large contracted employer groups to receive referrals.  You will receive a flat rate of $60 per session.
  3. Breakthrough reports they will be adding additional contracts with organizations and insurance companies, which could translate into more business for providers.

Technology continues to change the way all businesses are being run.  It seems that online counseling will continue to be a growing market in the 21st century.  There are people that believe this is bad for our field, but I think we either adapt and change with our technological culture, or become obsolete.

Update Regarding Breakthrough

Breakthrough has recently switched to another platform, causing all providers to make the switch as well.  Here's what the email I received about the switch stated:

As the leaders in our industry Breakthrough is committed to providing you with best in class products and services. That’s why we’re excited for the release of our new video platform, VSee. VSee provides a more streamlined and improved user experience, and we’re happy to bring our providers and clients an innovative and trusted video solution for your Breakthrough sessions.

New features
There are a few major differences between VSee and our current video platform, Adobe, you’ll notice right away:

1. One of the best benefits of VSee is that it uses low bandwidth (30-50% less than most video calling solutions!) so you conserve data usage.
2. VSee delivers superior HD video quality, even in low bandwidth networks.
3. VSee keeps the session window on top of other open applications so you can always see yourself and your patient during a session.
4. With VSee you can resize the session window and move your client’s session window closer to the video camera so it appears like you are looking directly at your client.

Best security as always
VSee offers a secure level of end-to-end (from the moment it leaves your computer all the way to its final destination, the receiving person) encryption that eliminates the possibility of anyone eavesdropping in and is HIPAA compliant.

Ready to get started?
VSee requires downloading and is easy and fast. VSee is compatible with Windows and Mac systems and works with any of the browser you use.

If you want more info on VSee, go here:

I am actually very excited about this change in platforms.  Though I haven't conducted an actual session using Breakthrough, my initial "practice" session was somewhat frustrating because of the visual issues.  Now that Breakthrough is using VSee, those problems should no longer exist.  The biggest issue was eye contact with clients.  Now that you can move the picture of the client to the top of your screen (where the camera on your computer is), you can now look at them while talking instead of staring at the camera.


Telemental Health

A popular and growing industry in the medical field is telehealth services.  Basically, it's providing medical care and consultation via telephone and internet based services rather than being in the same room with the patient.  I have worked at a halfway house for incarcerated youth for years and this is the way some of the psychiatry appointments are conducted.  Seems to be very beneficial.  It's not a valuable use of the psychiatrist's time to drive all over the state when they can sit in their office and provide the exact same service.  In fact, they can actually treat more patients due to minimizing travel time to each location.

When it comes to utilizing technology in counseling, this appears to be a really good option for counselors.  It's already in use in the medical field, there are HIPAA compliant technologies available, and it's a service that can be used from anywhere.

A couple things to consider.  

  • In many states, you are not allowed to provide counseling services outside of the state that you are licensed.  Personally, I think that's stupid, but until we have a national organization that is able to create license portability so that counselors can offer services to anyone in the US (or world), your license is at risk if you choose to counsel people outside of your state of licensure.
  • There are other ethical and legal considerations, but each state is different.  I recommend starting by reviewing your national and state licensure code of ethics.  You can also contact your associations free legal services (if available) to ask questions about offering counseling services via phone or internet.  Make sure what you are doing is legal and ethical!
  • It's still a relatively new technology.  I think the medical field will start to use telemedicine and telehealth more in the future, which will open doors for other medical professions including psychology and counseling.
  • It might be awkward for you and/or the client.  It's difficult to truly engage a person without seeing them.  BUT, there are now online counseling formats like Breakthrough that allow clinicians and clients to meet via Internet through the use of webcams.  I think this is fantastic opportunity for the future for counseling.  Just imagine, sitting in your home office doing your work instead of spending a bunch of money on office space.  Plus, you are in the comforts of your own home.  You could also grow your business to other markets, especially if you live in a rural town where it is hard to maintain a full caseload of clients.

For more information on this subject, just do a Google search.  There is a ton of information.  The only thing I would caution you is being wary of paying a bunch of money for "certification" in this field.  Currently, there is no recognized certification in telemental health that will provide you any real benefit other than additional knowledge.

Here is an in-depth article written by Rob Reinhardt that can offer further information about telehealth:

Welcome to Virtual LPC!

Glad you found the site, and I hope you find the information valuable.  Please check back often, as I will be updating frequently with posts and information on ways to develop a counseling practice that does not require an office.

See the picture above?  That was the beginning of this website and I didn't even know it yet.  As I sat on a Caribbean beach relaxing, thinking about how much I enjoyed the moment, I began to ask myself why I don't have this experience more often?  Why do I feel stuck in this life of work, work, work?  Why do I only get a short amount of time off each year?

There has to be a better way.  This site has one goal: help counselors and other mental health professionals design a lifestyle that encourages experiencing life, while still providing counseling services to others.  Please send me a quick note if you feel the same way.  If you are tired of the 8 to 5, and looking to enhance your life while still helping others, let me hear from you.

If you know of any resources out there, send them my way so I can post them on this site.  I truly hope we all can find a way to utilize technology to offer the highest quality services while living where (and how) we choose.