A lightning storm symbolizing the potential hazards when using the internet for mental health care

Avoiding hazards in online therapy

Privacy breaches when using communication technology

* Don’t use Skype or other platforms that are not designed for confidential medical information. Skype is encrypted in transit, but is recorded on the Skype servers in the US. A professional online therapist uses a platform such as Vsee that is compliant with PHIPA, PIPEDA and other laws governing the confidentiality of medical records.

* Know that your phone messages and texts can be read from your phone, even after you have deleted them.

* Before putting anything confidential in an email, know who can read it. Gmail is encrypted in transit between two gmail accounts, and probably can’t be read by your IT department if you use the web interface; however it is recorded on the Gmail servers in the US, which could make it available to snoops. Hushmail or a similar service is better—so long as both parties have it and it is not forwarded to someone who doesn’t. A password protected communication should be safe unless your computer or smartphone (or your therapist’s) is stolen, in which case it can be read. A reputable counsellor’s computer should be encrypted – but don’t be afraid to ask.

* For more on privacy in psychotherapy and clinical counselling, see
privacy in mental health care

Unqualified counsellors

A commercial outfit can have an expensive and professional-looking website and claim that the “professionals” they provide or list are “licensed”, “approved” etc. Licensed where? By whom? Can you check on it?

For a therapist who actually is licensed it would be foolish to be on such a website, because they could lose their licence. The licensing of mental health workers is at the state or provincial level. If you live in a state or province that registers mental health therapists (virtually all US states plus Ontario, Quebec, Nova Scotia, New Brunswick, and soon, Alberta) it is illegal for someone who is not licensed in your state or province to provide mental health services for you, and they will probably not be covered by malpractice insurance if they do (even if they have it). As with doctors, all government-licensed mental health counsellors are required to have malpractice insurance for the protection of their clients.

Appropriateness and safety of treatment

Except as an adjunct to care you are receiving at your local clinic, distance counselling should not be undertaken by anyone who is unstable or has any condition that could pose a danger to self or others if it escalates—for example, addiction to hard drugs, anorexia, drunk driving, bipolar disorder, violent anger, or suicidal tendencies.