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Does Videophone Counseling Work?

Sharon Duchesneau answers a frequently asked question about videophone counseling for Deaf people.

To cite:

Duchesneau, S. (2007, January 26). Does Videophone Counseling Work?. ASC on the Couch. Retrieved January 26, 2007, from http://www.ascdeaf.com/blog/?p=281

45 Comments
  1. Jenn January 26, 2007

    A nice vlog. It seems like videophone counselling is most ideal when combined with an initial in-person meeting between therapist and client and perhaps more directed analysis of the client’s background to compensate for what the videophone can’t show.

    Reply
  2. Amy Cohen Efron January 26, 2007

    Very nice vlog, Sharon! Informative and educational too. I’m pleased that you are providing counseling services via videophone. It is really nice. If this videophone counseling services provide similar benefits, results and outcomes… then it is a wonderful tool!

    Keep up with wonderful job vlogging! You are doing a wonderful service to all of us by de-stigmazing mental illness to more of mental health /wellness. I’m so thrilled!

    Amy Cohen Efron

    Reply
  3. Jules -oo- January 26, 2007

    Great Vlog, Sharon!

    I concur that using VP technology for psychology services is a good solution for individuals who are unable to meet in person for whatever reason that prevents them. The big plus about doing this on VP with a Deaf/signing counselor is the degree of privacy for both client and service provider that the VP technology permits.

    I wonder, though, can VP counseling include group therapy, too?

    Just wondering.

    -oo-

    Reply
  4. drmzz January 28, 2007

    I thought about this for a long time, but it’s good to see someone already tried this with hands on experiences. Yes, it can be convenient and accessible for several reasons that you explained. I think it depends on the level of resiliency within the person. If the consumer is emotionally unstable, using the VP approach is probably not a good idea. There is no chance of physical interventions if the person becomes hysterical or upset. Sometimes it requires physical interventions like holding hands, or hugging, or comforting. In conclusion, I believe it depends on the emotional level of the consumer and the judgment of the center to provide that type of services via VP or requires in person sessions.

    Reply
  5. ToddE January 28, 2007

    Thank you for illustrating a novel approach to counseling via the videophone!

    As you say, this is nothing new. In addition to the military example you cited, there are countless telephone hotlines all over the country that take thousands of calls on a wide variety of subjects.

    Maybe there can be a VP-100/200 hotline! I guess you’re all back onto the computers, writing up grant proposals! 🙂

    Reply
  6. Dianrez January 28, 2007

    Interesting discussion, but would think that face to face is still the best and should be the first option offered in counseling.

    Reasons for face to face being best include: better sense of the person one is counseling if one can see how they relate to the surroundings, your presence, and the presence of other people (who might not be visible in a videophone screen).

    The videophone is a useful tool but needs to be kept in a supportive, not a major capacity.

    Reply
  7. Jimmy January 28, 2007

    Agreed with you and most comments above but again I agree with Dianrez’s comment.

    Just like you say in person you can observe in person better if in vp others need to fill in you with unseen situation or so.

    Great vlog as you bring up the situation most of us never really thought about it.

    Jimmy

    Reply
  8. Karen January 28, 2007

    I think the videophone can be a great option for the reasons you described, especially for those in a rural area without immediate access to services.

    I am looking into exploring this option for mentoring families with deaf and hard of hearing children.

    Reply
  9. thunderdew January 28, 2007

    Great vlog! You’ve pointed out several pros and cons of providing videophone counseling. Two things came to mind that were not mentioned in your vlog….first, do you and the client have some kind of paper or email form to sign for confidentiality issues in using the VP? Second, how do you bill therapy services through insurance companies for videophone counseling, including if the client is out of state?

    If it is not possible to bill insurance companies for videophone counseling, then we need to address this to health insurance companies by promoting the significance for accessible mental health services for the deaf community. Perhaps we should add videophone as part of the accommodations under the ADA law amendment?? 🙂

    Reply
  10. Jean Boutcher January 29, 2007

    Interesting discussion going on here. Videophone is wonderful for
    “post scriptum” or “addendum” talks following each session. A counseling therapy in person is essential, forasmuch as a person seeking professional help basically needs a deep sense of assurance through a direct meeting with a counseling therapist. Both would feel satisfied.

    Reply
  11. ASC January 29, 2007

    Jules,

    Group therapy via videophone isn’t on the agenda yet. We have heard that a Brady Bunch style videophone screen capability is in the works for group videophone discussions. Right now, however, it is a bit hard to imagine doing group therapy that way.

    We have done many couples sessions using the videophone. Getting two heads onto the screen without having people sitting in each other’s laps can be a challenge! So far, feedback has been positive.

    Reply
  12. jared January 29, 2007

    I like the idea of setting up VP hotlines. This should be something that needs to be explored…

    Reply
  13. ASC January 29, 2007

    Thunderdew,

    Yes, we do cover confidentiality issues with all of our clients, whether we meet in person or over the videophone. If we are doing VP sessions, we also address issues related to feasibility of VP therapy, appropriateness (i.e., not for clients who are suicidal and out-of-state), and technical glitches that can arise.

    Some insurance companies do cover videophone counseling. Some people choose to go with life coaching VP sessions and pay out-of-pocket if their insurance companies won’t pick up the cost of VP therapy. Definitely, we need people to advocate for more companies to do this, especially given the lack of accessibility to mental health services for Deaf people all over the country

    Reply
  14. Jay January 30, 2007

    I think this is wonderful. Sure, we can not expect to have a single one-size-fits-all solution for all possible situations, but I think, based on my experience, the deaf community could take advantage of additional access to qualified mental health staff through use of this technology.

    Reply
  15. gloria January 31, 2007

    hello
    I would like to get some information of this counselor for vp that is cool ,I m wondering if you have any expreice of disabily delevpment that where I work with adult clients, they are deaf too so I m wondering if you have some feedback.. yes I notice here in my home area does not have a good counselor with the sign language for disbaily delevmpent .. they dont understand how that person who has disibatly delevmpent deaf desire to get help. so how can I get hold of to vp and talk you so maybe some of my client would like to talk you thur vp how s that working out .. Let me know.. thank you ….

    Reply
  16. Lisa February 3, 2007

    I don’t support this counseling through video phone. Person to Person as physical works better. Hearing people see therapist instead of using video phone. Video phone don’t encourage deaf and hearing people to get out of the house. Some people have OCD as they are afraid to go outside as it wouldn’t help them. All of us need to get out of the house instead of staying home as 4 walls. There are a lot of old fashion ways works better than today. Working with our hands keep our mentals working as keeping going. I’m sorry that I don’t support this. Video phone is for chatting/visiting. Thank you

    Reply
  17. Katie February 3, 2007

    Lisa,
    I respect your opinion, but I personally prefer to see a deaf counselor using videophone than to see a hearing counselor locally if there are no deaf counselors. Also, for your information, some people who are afraid to go outside may want to start with videophone to talk about fears before going out.
    Katie

    Reply
  18. Lisa February 3, 2007

    I understand about all this. I still don’t support it. I don’t want the insurance company to say to deaf people “You have to see deaf counselor because you are deaf (sign language).” Some deaf people prefer to see a counselor of their choice. It can be a hearing or deaf counselor. I don’t want to see the insurance, and resources to limit our choices of which and who we should see. I know some deaf people (who don’t use an interpreter) prefer a hearing counselor for some reasons. Some others prefer a deaf counselor. I don’t want to see hearing counselor to ask a deaf person “Why didn’t you want to have a deaf counselor by using videophone?” For myself, I rather to look at qualifcations of a therapist who is right for me as no matter if this therapist is hearing or deaf. For example, there was one deaf attorney who didn’t do a good job, when my deaf client need help with legal service. I referred this person to Legal Aide. They send my deaf client to this deaf attorney. That client knows that this attorney didn’t do well with other cases. She/he looked at this attorney’s qualifications. She/he tried to request a different referral. They said no because both of them are deaf and capable of communicating each other. That is what I’m trying to say. I have some concerns. I don’t want any deaf people to be forced to choice to some poor qualifications which isn’t right for them. Thank you

    Reply
  19. ASC February 4, 2007

    Lisa,

    Thank you for taking the time to share your concerns about videophone therapy. You are right – freedom of choice is important. Insurance companies should let people see the therapist they are most comfortable with. Videophone therapy is one choice for Deaf people who may want to see a Deaf therapist, but do not have one in their local community. Most of the time, insurance companies force Deaf people to see a hearing therapist with an interpreter or a hearing therapist who signs. As far as we know, in more than 15 years working in the field, we have never seen an insurance company force anyone to see a Deaf therapist. If you know of an insurance company that does that, please do let us know. We will be interested to know which company does that. Thanks.

    Reply
  20. Grant W Laird Jr. February 7, 2007

    Good deal. I think it is wonderful idea.

    I am familiar with counseling and how important it is. In some cities like here, it can be very difficult to set up appointment with qualified counselor (Deaf or CODA person) these days. Sometime it get hard to find one thru insurance (HMO) network. Ugh.

    Also, I plan to share my personal experience with psychology and counseling service at hospital with one of my family member in my own vlog soon.

    It is one of my TO DO LIST.

    gwlj

    Reply
  21. ASC February 11, 2007

    Grant,
    We look forward to seeing your vlog about your experience with counseling services! 🙂
    Candace

    Reply
  22. Grant W Laird Jr. February 27, 2007

    To view my vlog with my personal experience…

    http://grantlairdjr.com/wp/2007/02/26/deaf-family-member-at-hospital/

    Reply
  23. Candace A McCullough March 5, 2007

    Grant,

    Thank you for taking the time to share about your family’s experience in dealing with the lack of accessible services from a psychiatric hospital. I am sorry that you had to experience that. There is nothing worse than trying to get help and finding yourself oppressed and treated without much respect.

    Sadly, although things have improved in some places, there are still many psychiatric hospitals in the US that continue to be inaccessible for Deaf patients. I am hopeful that as the number of Deaf professionals in the mental health field increases, so will their presence in such hospitals lead to positive changes for Deaf people who may need psychiatric treatment one day.

    Candace

    Reply
  24. Carrie March 19, 2007

    I think it’s a great idea, it’s all depends on the Clients’ preferences. Some would prefer in person, some would prefer thru VP. If it provides to both access, then I think its great idea!

    Reply
  25. Mallory Malzkuhn April 5, 2007

    I have to admit that Counseling on VP seems like such a great idea but it’s sad how we’ve been depending so much on technology nowadays. I think that counseling in person is more personal…like you mentioned, VP is great if you’re busy or couldn’t drive but I still am leaning towards the typical counseling sessions because face-to-face conversations are always much more special.

    Reply
  26. Canela April 8, 2007

    it is very interesting and good idea about this comment. but I am concern that techincology lead to VP problem with on screen like frozen, vague and missed. however, it’s awesome ideal.

    Reply
  27. Tourlova April 8, 2007

    First of all, VP shows a lot of great idea like the lady Sharon said. I do support some of it but not all of it. Just because using VP all the time, it won’t help or improve their english skills like grammar and vocabularies. It depends on individuals and their situations.

    Reply
  28. Josef Pfaff April 8, 2007

    I would rather to see a counsler in person, but just like what sharon said, if there is no option to meet in person.

    Reply
  29. Melissa Miller April 12, 2007

    ahh i have mixed feelings for this one. i hate it when we depend on technology too much and honest when i vp with my friends or whatever, i dont feel like we bond a lot- id just have normal conversations and i cant imagine having a counseling session through VP. i understand for those who can’t drive or anything but stilll ehhh. i feel that if we use VP, what if there will be no privacy? who knows what if someone is looking or not? thats how i would feel. insecure, that is.

    Reply
  30. Brittany Williams April 12, 2007

    Counseling on VP? That seems like a great idea, but isn’t everybody depending too much on videophone? Wouldn’t it be weird if someone said, “I have an appointment with my counselor on VP soon”?
    Meeting a counselor eye-to-eye and being in the same room seems rational to me. It’s more confidential and you know there is nobody in the room except for you and your counselor.
    The clients have right to choose and if they want to use VP, then that works =) Personally, I’d opt for the traditional one but nice Vlog!

    Reply
  31. Aarron Loggins April 15, 2007

    I do support on Sharon’s lecture. What if there is place where some of deaf/hoh/hearing cant find anyone? VP does work mostly for the deaf/hoh, however it works for everyone who need consueling in case of emergency. If I was you when the situation comes and dont have anywhere to talk to in town, I will grab the opporunity to use VP of conuseling. This worth it for everyone who need it.

    Reply
  32. Roy Lotz April 15, 2007

    It is somethin I would have to disagree, I don’t support Video Phone because it is not natural and don’t feel right vibes. It is something I haven’t try yet and I wouldnt want to do a counseling through the video phone. It is best to do something real by doing it in person and being in right environment to do some counseling.

    Reply
  33. Cara Keith April 15, 2007

    I like the idea of videophone counseling being available to those who would like to use the service. I agree with the comments from my classmates in that it shouldn’t be the only way therapy is done. That counseling does need to be in person as well. This type of counseling would be immensely helpful for someone who lives in a town with no Deaf therapists, but through VP they might be able to solve some of their problems.

    Reply
  34. Karen April 16, 2007

    Roy
    I used to think the same way as you do, but I realized that I would prefer videophone counseling with a deaf counselor than be in person with a hearing counselor. I would be willing to give up the idea of having face to face counseling in order to see a deaf person. Sharon is talking about offering videophone for those who DON’T have access to deaf counselors in their town.

    Reply
  35. Tamara Ward April 19, 2007

    I think its a great idea for those who are blocked from getting deaf counselor to same playing field. The biggest concern on my part is the rural area where this is limit connection to VP due to limited high speed internet services. It is known to be the hardest hit most of the time. I have seen it time after time. I would prefer deaf counselor as the counselor would fully understand what the individual says and what they mean by a certain comment. If there is one locally i would prefer to see them in person.

    Reply
  36. Deaf Client (Anonymous) June 13, 2007

    I would opt for videophone counseling because I’ve had awkward moments when I see deaf clients that I bump into either before or after my session. This way it would keep my life totally private and not having to endure the awkward moments anymore.

    Thank you,
    Deaf Client who see therapist on regular basis.

    Reply
  37. Jean Boutcher June 13, 2007

    I can perfectly well understand Deaf Client (Anonymous)
    in #36 (vide infra). In light of the deaf world that is
    very small, every deaf individual knows one another. That
    would reduce tension and anxiety if videophone would be
    opted. Videophone is a blessing in disguise, so to speak.

    Reply
  38. Ravi Nayar November 21, 2007

    Videophone is now very affordable at U$23.99 per month, less then a regular Phone.

    We are creating a project to make a difference for elderly & the deaf.

    I do not want to promote the product on this site so please email me if you would like more info.

    Reply
  39. Robert Baldwin November 26, 2007

    Great work Candace! Nice to offer more options to clients/patients who are Deaf. I have a few questions:
    First, what is known of the encryption of the VP100 and 200? Is it encrypted enough to provide secure communication over the internet?
    Second, how difficult was it to convince those insurance companies to acquiesce and pay for the service? What arguments were used to convince them?

    We are interested in reaching out to rural areas in Colorado, but are only beginning to explore this possibility.
    Thanks!
    -Robert

    Reply
  40. smap19541 November 27, 2007

    I am glad u bring this up. I had experience with vp counseling and it is definitely worth it! Since I live far from MD and need counseling. This is positive for deaf community. Suggest some of u should try and see for yourself. Have a nice day!

    Reply
  41. Katie November 27, 2007

    For more discussion, also see http://drmzz.blogspot.com/2007/10/code-of-ethics-issues-for-deaf.html. Thank you for participating in discussion there.

    I want to say that it is my pet peeve that hearing counselors try to do VP counseling because they want more business for themselves. I wish hearing counselors will leave vp counseling to Deaf counselors only.

    Robert, I think you can argue that it is important that clients have DEAF counselors. Insurance companies may acquiesce. We can’t justify hearing counselors working with Deaf clients.

    Reply
  42. ASCDEAF November 28, 2007

    Robert,

    We are strong advocates of this delivery modality of counseling, especially when more and more Deaf clients are specifically asking for Deaf therapists and have no local options for such. It is great to see more of our Deaf colleagues taking an interest in videophone counseling.

    To answer your questions, the issues involved with videophone counseling can be complex (i.e., some malpractice insurance companies will not even protect you if sessions are done via videophone), so getting certified in distance counseling is the way to go in order to understand all issues and ethics involved. In all forthrightness, we can’t really recommend anyone getting into videophone counseling without first obtaining certification in distance counseling. This is the best way to protect yourself and your clients. Certification will enhance your credibility with insurance companies as well as clients.

    Having said that, we’ve found that what works best in convincing insurance companies to cover videophone sessions, is to educate them about Deaf clients’ right see a Deaf therapist. In our particular caseloads, at least, this is the primary reason clients are contacting us for videophone sessions. Rural clients, from what we’ve found, tend not to have access to the high speed internet that will allow videophone use. Even when they do reach us by videophone, their reason for requesting videophone sessions is the same – a desire to work with a Deaf therapist.

    In our experience, insurance companies respond well to analogies about cases of female clients wanting to work with female therapists or members of minority races preferring to work with therapists of a similar background, when we make the case for Deaf clients wanting to work with Deaf therapists. We have had positive outcomes when we explained that a Deaf client working with a hearing therapist, with or without an interpreter, whether or not the therapist is fluent in ASL, is not the equivalent of offering the option for the Deaf client to work directly with a Deaf therapist.

    Nine times out of ten, insurance companies have no local Deaf therapist in their network and will accommodate clients’ requests to turn to videophone counseling sessions to meet their need for a Deaf therapist.

    Candace

    Reply
  43. Karen June 15, 2008

    It is wonderful that your therapists are certified in videophone counseling., I am concerned that many therapists are doing videophone counseling without certification (i.e. Linda Pratt of Washington and many others). What can I do about them? Who should I report them to?

    Reply
  44. Todd Thompson November 6, 2008

    It would seem only logical that having the ability to see who you are talking with would increase your awareness of that person. Part of counseling is reading body language and seeing facial expressions. A video phone will allow any counselor the ability to see and hear their patients. The video phone will never replace face-to-face counseling, but it is a very valuable tool to assist in providing excellent quality care for your patients.

    Reply
  45. ASCDEAF March 24, 2010

    We thought we’d share this link with all of you. Enjoy reading!

    http://www.time.com/time/health/article/0,8599,1974196,00.html

    Reply

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