Mental health issues are far more common than the general public may believe. Today, over 40% of Americans report depression and anxiety symptoms, up from around 10% prior to the COVID-19 pandemic. With the increasing need for mental health care and preferences for telehealth services, telecounseling is more necessary than ever.

What is telehealth counseling?

Telehealth counseling is just one of the many telehealth modalities. Services that fall under telehealth counseling include:

• Child therapy
• Family therapy
• Therapy for homebound or medically fragile patients
• Patients from rural areas
• Adolescent consulting
• Trauma-focused treatment (excluding EMDR)
• Individual counseling
• Couples therapy

Telehealth counseling can also help patients who suffer from many different disorders, some of which being:

• Substance abuse
• Agoraphobia
• ADHD
• Bipolar disorder
• OCD
• Anger management
• Domestic violence
• Depression
• Anxiety

The telecommunication technologies include the internet, streaming media, store-and-forward imaging, videoconferencing, and terrestrial and wireless communications. These elements are supposed to aid those who are unable to see their counselors in person.

What are the benefits of telehealth counseling?

Telehealth counseling comes with many advantages for both patients and counselors. Some studies say that telehealth therapy is equally as effective as in-person therapy. Over 59% of clinicians and 63% of patients stated that the quality of treatment remained the same with telemedical appointments. It was also found that patients experienced a 32% decrease in depressive symptoms and a 31% decrease in anxiety thanks to telehealth counseling.

In addition to the many benefits telecounseling offers for patients, telehealth counseling comes with plenty of advantages for therapists, as it:

• Increases their revenue significantly because they can consult more patients online
• Allows them to dedicate more time to patients by organizing their own workflow
• Allows them to provide better care to patients in rural areas where patients have limited or no access to specialists

Additionally, telehealth counseling allows therapists to remain competitive with an ever increasing number of mental health apps that provide services ranging from general information to teletherapy and meditation. 

Does telehealth therapy have any downsides?

Although telehealth therapy comes with plenty of benefits, there are also some downsides you should be aware of as a therapist. The main ones consist of legal and regulatory concerns that also apply to telehealth as a whole:

1. Privacy
2. Credentialing
3. Medical malpractice
4. Security
5. Fraud
6. Privileging
7. Payment
8. Coverage
9. Abuse
10. Online prescriptions of controlled substances
11. Licensure for healthcare workers
12. Equipment maintenance

All of these issues should be addressed before you decide to offer in telehealth counseling. Although there are many challenging ones, you should know that each state is working toward having better-defined laws, rules, policies, and regulations for telehealth. Telemedicine and telehealth are constantly evolving and improving, which helps healthcare workers provide better and safer care for their patients.

What are the requirements for telehealth therapists?

If you want to offer telecounseling, you need to meet specific requirements to practice. Keep in mind that each state has its own set of rules and you should understand the regulations in your state. No two states have the same policies, but some of the most common requirements that the majority of them propose are:

1. Being a citizen or having an up-to-date legal permit to live and work in the United States issued by the Immigration and Naturalization Service
2. Paying a fee proposed by the state you live in
3. Being at least 21-years-old and having good moral character
4. Obtaining training, education, and supervision in an adequate clinical setting
5. Being competent in the telehealth counseling field, as determined by your supervisor
6. Providing recipients with a well-explained informed disclosure
7. Informing recipients about confidentiality 
8. Letting recipients know about all the potential risks
9. Paying attention to the effectiveness of the treatment during each session
10. Maintaining all patient data and records in line with all applicable state and federal laws, rules, and regulations

As of January 2022, there are 23 states and territories that modified their licensure requirements for telehealth in response to COVID-19 pandemic. 

What are the telehealth licensing issues in the United States?

One of the biggest issues for all healthcare workers who want to partake in telemedicine is licensure. The majority of the states in the U.S. require practitioners to have a medical license obtained in the same state where their patient resides. 

The idea of Interstate Medical Licensure Compact (ILC) was introduced in 2013. Then it became fully operational in 2017. The goal of the Compact is to make cross-state practicing easier, which doesn’t mean that it resolves all cross-state licensing issues.

If you move out to a different state, you will most probably have to obtain a new license if you wish to practice there, even if that state is part of the Compact. 

There are 29 states that are part of the Compact. Keep in mind that each state has its medical board that reviews applications. This means that some states can take a few weeks to review your application, whereas others may take months to do the same job. 

How to become part of the Interstate Licensure Compact?

If you want to join the Interstate Medical Licensure Compact, here are the requirements you need to meet:

• 25% of your practice of medicine must be in SPL
• Your primary residence must be in your licensed state
• Have no criminal history
• Use the SPL as your state of residence for the federal income tax
• You must work for an organization, person, or business situated in the licensed state to practice medicine 
• No history of disciplinary actions toward your medical license
• Pass the COMLEX-USA, USMLE, or anything equivalent in three attempts at most
• Complete either AOA- or ACGME-accredited medical education
• No history of controlled substance actions toward your medical license
• Be a graduate of an accredited medical school in the International Medical Education Directory
• Hold valid and up-to-date specialty certification or certification obtained through an AOABOS or ABMS board that is time-unlimited
• Not be under investigation during the application process
• Pay a non-refundable fee of $700

The team behind Interstate Licensure Compact says that around 80% of applicants manage to meet the requirements. If you are a qualified physician, you can obtain your license easily. You will have to exercise patience, given that certain medical boards across different states can take ages to review your application.

What is telehealth reimbursement?

Insurance payers and health care professionals (HCP) associations have supported the transition to telehealth services during the COVID-19 pandemic. The Centers for Medicare & Medicaid Services (CMS) issued multiple waivers that provides flexibility such as type of health site and geographic location during the COVID-19 pandemic and granting equal payment between in-person care and telehealth for Medicare. Medicaid programs are administered at the state level and states can choose whether or not to cover telehealth services as an alternative to traditional in-person methods of care.

Integrate Curogram into your practice’s system to have a successful start in telehealth counseling.

Curogram is a HIPAA-compliant telemedicine platform that comes with two-way text messaging, automated appointment reminders, and patient review collection features. Using the software specifically developed for practitioners and patients in need of care, you can set up your virtual clinic in 48 hours. Curogram also integrates with any electronic health records system, reducing duplicate work and the risk of errors.