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Tele–Mental Health: Our Experience, Improving your Experience + Q & A

By Teresa MI Schaefer, PHD

We are now eight weeks into providing tele-mental health services here at Chester River Behavioral Health. This was not a process or way of delivering therapy that we had engaged in before; but, as has been true with so many things in this COVID era of our lives, necessity became the proverbial “Mother-of-Invention”.

Both our staff and clients have had to be quick studies of these new technologies. Most of us were not excited about the change, but it was necessary. Some clients elected not to participate at first, but many are now participating. And, it hasn’t been all bad. Nope, not at all. There are times when the audio lags or the video becomes glitchy but there is usually a reasonable remedy.

While we started our tele-mental health with individuals ten years of age and older, we are now serving families, couples, and groups. The younger clients (9 and younger) will soon be able to participate as well.

Perhaps you stopped treatment because of the changeover, perhaps you have delayed calling because you just were not certain this was for you. We invite you to call. To try this out. I think you will be impressed by how easy it is to do.

To optimize your tele-mental health experience, we suggest you try the following:

  • Find a comfortable, quiet, private setting with limited distractions.

  • Sit in a room with good lighting but not with your back to an open window or door.

  • Set your device (phone, tablet, iPad, computer) on a stable platform (table, desk).

  • If you are operating from a Wi-Fi connection, you may find that locating your device close to your modem/router will improve connectivity. If you can, plug your device via Ethernet cable directly into your modem.

  • If using your phone, temporarily turn off all notifications, emails, text messages, calls. This is most easily accomplished using the DO NOT DISTURB in your settings. It is a very simple toggle you can do right before and right after your appointment.

  • If using a computer, tablet, or iPad, close all tabs accept the link you will follow through your email to the tele-mental health waiting room. Go into your settings and temporarily set notifications to OFF (a very simple toggle that you can change back at the end of your appointment).

  • Complete a video/audio test that you will find in the virtual waiting room – usually in the bottom left of the image.

  • Use the image you can see of yourself to help you adjust the angle of your device so your therapist can see your whole face.

  • If you are bothered by seeing yourself in the little box in the corner, you can click on the image. Next, click the three dots . Next, click Hide preview and your image will be hidden. Or you could cover it with a post-it note.

Would I prefer face-to-face contacts? YES. But tele-mental health has become another option through which we can deliver mental health services to clients, now and into the future.


Q: Do I have to plug my device into the modem?

A: No. But if you do your internet performance is likely to be better than using your Wi-Fi connection.

Q: Why should I avoid sitting with my back to a window?

A: Your face will be dark like images of individuals in the Witness Protection Program.

Q: Can I walk around while we talk?

A: Yes, as long as you are in a private setting.

Q: Will my insurance company pay for this?

A: 99.9% of insurance companies are paying for tele-mental health during this health emergency.

Q: Do I have to do both video and audio? Can I do just audio?

A: Technically the laws are written such that tele-mental health must be both video and audio and completed on a HIPAA compliant platform. However, during the COVID crisis, these requirements have been made more lenient. Phone (audio only) is permitted. Ask your therapist. If you hate seeing your image – see the last bullet above.

Q: Why do I need to set my device on a stable platform? Can’t I just hold my phone?

A: Yes, you can just hold your phone, but please refrain from a lot of fast or big movements. These tend to make your therapist feel dizzy.

Q: What if I do not have good internet connection?

A: Talk with your therapist about alternatives.

Q: What happens if the connection is lost?

A: Simply follow the link back to the waiting room.

Q: What happens if I cannot hear or see my therapist?

A: Your therapist will help problem solve this situation. Sometimes simply exiting the program and re-entering can be the solution. You can also use the message box to the bottom right to type a note to your therapist about what is happening on our end.

Q: Is the platform you use HIPAA compliant?

A: Yes.

Q: Do I need to download an App or program of some kind?

A: No. We simply send you an email with a link that you click and bingo you are in our ‘Waiting Room’. We will open the program and then be connected.

Q: Is there a way to do couples work if my spouse and I are in two different locations?

A: Yes. Our program allows us to add you together in the same video chat.


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