CCD Counseling, PA
Online Therapy Guidelines

Session Structure
It is important to maintain a setting that is as similar to being in an office together as possible. Maintaining the structure of the setting is critical. Sessions will continue to be 50 minutes in length. In order to have effective online, telephone, and/or video counseling sessions, the following guidelines must be followed.

1. Your device must be placed on a steady surface throughout the session, and not held in your hand if it can be avoided. If it must be in your hand, please hold it as steady as possible. You should also be in a set location and not moving about.

2. Make sure that you are in a private location where your session cannot be overheard by others. Make sure to adjust the volume on your device to ensure your privacy. You are required to inform me if there is anyone in the room with you, or who you believe may overhear the session.

3. Try to have proper lighting so that I can best communicate with you, if using video counseling.

4. You must be decently attired each session. No underclothes will be permitted.

5. No provocative postures or gestures will be tolerated.

6. Minimize background noise. Turn off TVs, music, or other sounds. Close your door, if possible.

7. Minimize distractions. You should not be playing games on a device, be on social media, or working on other things while in therapy. Make sure that pets, children, household members and roommates will not be distractions from treatment.

8. You may not invite others into our session time without discussing this with me first.

9. If the connection is broken for any reason, I will call you to try to remedy the situation.

10. Screenshots, photos and recordings are strictly prohibited and will result in immediate termination of session, online services and may result in discharge.

CCD Counseling PA
Telehealth Statement of Understanding

This statement of understanding is in addition to the agreements already contained in the client’s original “Client Information and Consent” and “Notice of Privacy Practices.”

1. The client wishes to receive services via online, telephone or video platform. The client understands what other modalities are available to them. The client understands that the therapist or the client can discontinue the telehealth session if either believes it is not adequate for the situation.

2. Much of the counseling process will remain unchanged. The client and therapist will spend the session working toward the goals identified in the client’s treatment plan, just like they do in face to face sessions. However, some things will be different because the client and therapist will not be in the same room.

3. These electronic modalities offer advantages and disadvantages. Advantages include client convenience, ease of access and comfort. Disadvantages include not being able to read non-verbal cues as easily, the possibility of a sudden disconnection or other technical difficulties, and a more complex environment for maintaining privacy. There are additional advantages and disadvantages, including some that we may not anticipate.

4. The client understands the relative privacy risks for each modality. CCD uses a video platform that utilizes encryption. Phone conversations are not encrypted. Unlike face-to-face counseling, the therapist cannot guarantee the same degree of confidentiality since telehealth partially takes place in a space outside of the therapist’s control. This means the client has to take full responsibility for where they decide to initiate telehealth and how they will protect the confidentiality of my conversation.

5. In addition to the fee for service, the client understands that depending upon their internet or phone plan, they may incur additional expenses or the use of available minutes in their phone/data/internet plan.

6. Certain situations, including emergencies and crises, are inappropriate psychotherapy services via telehealth. If the client is in crisis or in an emergency, they should immediately call 911 or seek help from a hospital or crisis-centered health care facility in their immediate area.

By signing this form, I certify:

I have had a direct conversation with my therapist, during which I had the opportunity to ask questions in regard to this procedure. I have read or had this form read and/or had this form explained to me. I fully understand its contents including the risks and benefits of the counseling via telehealth. I have been given ample opportunity to ask questions and that any questions have been answered to my satisfaction.