Episode 36 – Maelisa Hall Founder of QA Prep

Online Therapy Informed Consent

Welcome to the Online Counseling Podcast, exploring the practice of counseling and online therapy through technology. Here’s your host, Clay Cockrell.

Clay Cockrell: Hello, and welcome to the Online Counseling Podcast. My name is Clay Cockrell, and I’m thrilled to have you spend some time with us today as we learn how the field of psychotherapy is changing with technology, and how more and more counselors are becoming online therapists are seeing their clients online. As always, my goal is to bring the most up-to-date information to you, and explore conversations with online therapists that are doing this, and hopefully learning from their successes and challenges. As most of the listeners know, I am an online therapist myself, and I can attest to some of the advantages to having an online practice, because today, February 8th, 2017, I’m recording this podcast from sunny Miami. It’s 81 degrees outside and I’m loving it. Now, normally I’m based in New York, where I think tomorrow it’s going to be 17 degrees. But every winter, my wife and I become snowbirds and head south to warmer weather for about a month or so, and I take my clients with me. A lot of therapists talk about wanting to be able to travel, but when you’re not working, you aren’t earning money, but by doing online counseling you can do both.

CC: So, after recording this podcast and finishing a couple of more sessions with clients, I’m heading to the beach. It sounds glamorous, but I tell you, 20 hour road trip to Florida was brutal. We drive, because we need a car while we are here, and we have a dog that we bring. So, driving is really the only option. So, little road zoned. And as always, you just take some time to adjust. And as soon as I got here, I came down with a head cold, which you probably can hear, but all in all, we’re adjusting pretty well.

CC: And I wanna give a shout out to our web developer Aaron Carpenter of Legendary Lion, who has done a stellar job in helping to develop the directory for onlinecounselling.com. We’re getting all sorts of new clients looking for online therapists. And it was a struggle at the beginning, we’re a very new site, probably active for six, eight months, have a little bit of a ramp up there, had some glitches, and we finally figured all that out. But in a really short amount of time, we are seeing great success, so if you haven’t given us a try yet, please check us out, onlinecounselling.com, and let me know if you have any questions, we’d love to help you grow your practice.

CC: Okay, so, today, I am thrilled to have Maelisa Hall from QA Prep on the show. Now, one of the top questions I get from listeners is, when doing online therapy, what are the requirements for my informed consent? Is it a separate form, or do I need to add specific language to my current form? Well, Maelisa has answers. Her company, qaprep.com, specializes in documentation that therapists need to do. In fact, her byline on her website is “Paperwork support for mental health professionals.” And she just knows her stuff, and really has a passion for helping therapists through perhaps the least liked part of our job, at least for me, and that’s documentation. So, if you haven’t had a chance to check her out, please do. She has all sorts of free information, tons of free information on her blog, and she sells a packet that has templates and guidelines on how you can stay protected and informed on your requirements. It’s really important and you wanna go to the best. And from my perspective, I think she’s it. So, please welcome, Maelisa Hall of qaprep.com.

CC: Hello, and welcome to the Online Counseling Podcast. I am so thrilled to have as my guest today, Maelisa Hall of QA Prep. Maelisa, good to see you.

Maelisa Hall: Good to see you, and hear you.

CC: Yes, we’re connected pretty well. I’m in Miami, and there’s sunshine in February. I don’t even know how to handle all this, it’s incredible. But kinda acclimating, we just got in last night. And you are on the West Coast. Where are you on the West Coast?

MH: I’m in Irvine, California, in my office.

CC: Irvine, California. Okay.

MH: Yes, where it is usually sunny, but just not today.

CC: Not today. [chuckle] A little rain.

MH: [chuckle] Yeah.

CC: Okay. Well, today we want to talk about informed consent and how it pertains to online therapy. I get emails all the time from members and from people who are listening into the podcast saying, “What do I need to have in my informed consent for Telemental Health?” But before we jump into all that, let’s talk briefly about you. And I’ll have to say this, on my way in my 19-hour driving trip from New York to Miami, I listen to podcasts, I downloaded all these podcasts about mental health and entrepreneurship, and hopefully, I’ve learned something about what makes a really bad podcast.

MH: That’s awesome.

CC: Yeah, I’m listening to these podcasts and going, “Wow, I hope I’m getting better than some of my first ones.” But we wanna get… Sometimes people just have this conversation about movies, and that’s not why I downloaded this podcast. So, let’s just tell a brief history of you and how you got into some of the documentation process and what QA Prep is all about.

MH: Yeah, yeah, and I’ll try to avoid those faux pas and not take 15 minutes to introduce myself.

CC: Okay.

MH: So yeah, I listen to a lot of podcasts too. So, I started QA Prep because I was working as a Quality Assurance Training Specialist or Quality Improvement Training Specialist at an agency. And what that means is, I was training therapists in how to do documentation. And it was a really large agency, and we did trainings every other week, so I was doing this a lot. And I kept hearing the same thing from people over and over, and people were saying, “We never got anything about this in grad school. I feel so unprepared. Thank you so much for this training.” And that agency did a two… Like a full two-day training on documentation, so it was pretty in-depth, and we got to do a lot of practice with people. And I found out just how much people were seeking that type of thing out. It’s not exactly the topic that everybody is like, “Oh, I wanna talk about paperwork,” you know? [chuckle] But it is a topic that gets very overwhelming very quickly for a lot of people. So, I started a QA Prep so that I could help out people who are in private practice, who don’t have a quality assurance person they can just call up any time or have someone reviewing their records every three months, that kinda thing.

CC: Right.

MH: And it’s evolved over the last few years, where I have a lot of trainings that are online that people can just purchase whenever they need, and I have a ton of blog posts on all things documentation. And you’d be surprised, but yes, you really can write a blog every week about documentation. There’s always something new to talk about. So… [chuckle] And I haven’t even talked about this stuff that we’re gonna talk about today.

CC: You are inspiring with your blog, ’cause there is so much information. Any time I have a question, you’re my first stop, because there’s gonna be something on there. So, anybody that has any kinda questions needs to be a regular reader of the blog. I have to admit, I hate paperwork. I’ve yet to meet a therapist that goes, “I love my paperwork, I get to go write all this down.”

MH: Yeah. [chuckle]

CC: It’s… I hate… I’m always behind. I remember pulling all-nighters when I was in agency work, just trying to catch up. We knew we were gonna be audited, and we’re there all night, and lots of pizza and coca-cola and trying to… And this is just awful. So, you’ve got resources on your side, you’ve got paperwork packets that people can purchase. Is that like templates, guidelines, what are your paperwork packets?

MH: Yeah, the… I sell one paperwork packet, so it has a bunch of different things, and it is templates, but it’s mostly filled out. And what I do is just highlight the things that you want to adjust. So things like even the use of the word therapist versus counselor, right? Like some of us refer to one another as different things. So, I have all that stuff highlighted, so you can just cut it and change it or whatever, add your practice information, that kinda thing. And then I actually, as a part of the packet, have some training videos that go along with it to walk you through. Okay, how does this apply to your online therpy practice? So, everything that I do with QA Prep is really about making the paperwork as meaningful to you as it can be, and as meaningful to your clients as it can be. So, I really encourage people to not just download something, copy and paste, but actually look through it, understand it, see if it makes sense to you. If you ever had to explain it to a client, would you be able to, and does it make sense with your policies? All that kinda thing.

CC: Okay. Now, it strikes me that it would be different, I would assume, for the different professions, and maybe I’m wrong about that. From psychologist to social workers, to counselors, marriage or family therapists, across the board, is it basically the same or are there are a few little quirks?

MH: It’s basically the same, it really is. The few little quirks are things that don’t typically impact the documentation. I would say state differences are more relevant. So things like in California recently, they gave us a new limit to confidentiality, where if we find out that someone has sexted with a minor, then that’s something we also have to report. Whereas, before that wasn’t explicitly part of child abuse reporting. So, that would be like a California specific thing that people have to keep in mind. The only other thing I can think of is, there’s one state, and I always forget, it’s like Wisconsin or Minnesota, it’s somewhere in the middle of North, [laughter] and they’re actually the only state that’s required to use an EHR. So they have to do all of their record keeping online.

CC: Wow.

MH: So there are little state differences like that, but for the most part it’s pretty similar. The differences are more in the ethics.

CC: Okay.

MH: And again, those are still pretty minor, but as far as online therapy stuff like ACA, the American Counseling Association actually does have pretty specific guidelines that they’ve put out regarding things like emailing and texting with clients, which I think… I think Roy Huggins might have talked about it a little bit when you interviewed him or…

CC: Yeah.

MH: At some other point. [chuckle] And of course, we all know he’s a great resource for all online therapists, but…

CC: Of course.

MH: You know, whereas like for me, I’m a psychologist, so the American Psychological Association hasn’t really said much about all that stuff. They’re kinda purposely vague, and they purposely wait to see how everybody else does it [chuckle] before they give us really specific guidelines. So, I just have to sort of follow my general ethics around that, like, I have to consider confidentiality and apply it in a practical way. So those are minor differences.

CC: How do you keep up with all of the changing landscape out there?

MH: I try to… I mean, I do research every once in a while. I mean, there’s only so much you can do, and so, I do make… I do give that caveat whenever people are downloading my stuff, and I say, “You have to make sure you check your own state laws,” and…

CC: Okay.

MH: And check your own professional guidelines, because it is impossible. And I have people that actually follow me from other countries, as well, and so… You know, I have someone from Australia contact me and I’m like, “I have no idea what the policies in Australia are like. I can’t tell you whether or not… ” ‘Cause it is too much to keep up with, but I do try to keep up with the general… At least like the professional associations, their general guidelines around things.

CC: Okay. Alright. Okay, so now we’re gonna jump into Telemental Health and the world of online therapy, but before we do, could you tell me maybe some of the top pitfalls that therapists and counselors encounter with their documentation? The things that like, yeah, we genuinely just mess up.

MH: Yeah. The first one that comes to mind is just getting behind in notes. So, that’s really common, and a lot of people are surprised to hear how common it is. They think that they’re the only one and they get really embarrassed, and there’s actually a lot of shame around it, and people won’t ask for help. And then I’ll talk with therapists who contact me and they’re desperate, and they’re six months behind in their notes. I’ve talked to people who have…

CC: Wow.

MH: Like hundreds and hundreds of notes that they have to write. I’ve talked with people who have told me that they’ve never written notes for clients, and they’ve been a therapist for years. So, that’s obviously not recommended, but… [chuckle] But I would say just falling behind is so common and it’s one of the most stressful things for people, ’cause that’s when you go and you do your sessions, and then you wanna go home and you’re sitting there knowing that you haven’t done any notes yet this week, or maybe even this month, but you’re exhausted, and then you go home, and then they don’t get done, and it becomes this really dark cloud hanging over people. So, I would say that’s probably the first thing that comes to mind. I’m actually running a group right now, it’s a paperwork catchup group. So it’s specifically for people who are really behind, and we’re giving support and creating a catchup plan, and then checking in with that every few weeks to make sure everybody’s staying on top of it.

CC: Nice.

MH: And that’s how big of an issue it is.

CC: Wow, okay. So here’s a question that I’ve gotten. Someone came to me and said, “You know what, I don’t take insurance, I only do private pay. Do I have to take notes?”

MH: Yeah, yeah, and I’ve had people ask me that. And yes, you do. So, that’s where the professional guidelines come in, your ethics. So, every professional code does specifically state that we have to document, and this I have a presentation where I go through all the different ethics codes, and basically, that’s all they say, [laughter] that you have to do it. They don’t really give you any guidelines about how, so that’s where people get mixed up. People work… Like, a lot of times therapists may start out at an agency, like I did, and there’s all these guidelines and there’s a ton of paperwork you have to do, and then you get out of that agency and you have your own practice, and some people kind of rebel and then don’t really do anything, or do as little as they can, and other people I’ll find who kinda freak out, because, while they weren’t excited about all the paperwork they had at the agency, when they have to decide on their own what to do, they realize like, “What the heck am I supposed to do?”

MH: And you start looking at what other people are doing, and everyone’s doing it differently, and there really are no specific guidelines. So you have to sort of figure it out. So, that’s where I come in and help people walk through, what does your practice look like? What’s realistic for you? What can you get done? And here’s some tips and here are some different ways to do it, figure out what works best for you, so that you do get it done, and get it done well.

CC: Okay. My biggest problem when I was a young therapist was writing too much. I would just verbose. I had a supervisor, he’d come and look at my notes and he’d say, “You wrote three pages… ”

MH: Oh, wow.

CC: “On a 45 minute session.” He said, “I don’t know if you have just the transcription it would be three pages.” [laughter] He’s like, “You need to get… ” So I guess there are those that write too much and those that write too little.

MH: Yeah, yeah, and that’s actually… That’s the title for one of my blog posts. [laughter] Because that’s one of the biggest questions that I get. It’s like, “Am I writing too much, or am I writing too little?” And I tend to be the writing too much person, and I think partly just because I’m a really fast typer, and so… I mean, if I spend 10 minutes on a note, it’s gonna be a pretty long note, and I can sorta go through, “He said, she said, and this is what happened, and then this happened.” So, I’ve had to learn the art of paring things down quite a bit. And what I usually tell people is, think of a theme for your session, so you don’t have to go through the whole play-by-play of the story that the client gave you. You can just say, discussed a conflict with their partner. But that might have been a 20-minute conversation you had about the fight they had with their partner. But there’s no need to document every little detail about it, you can go more into the therapeutic aspect of what insight was gained or what you practiced or what you reviewed about that, that kinda thing.

CC: Okay. Good, alright, let’s jump in then to the…

MH: Yeah.

CC: The topic and the title of the podcast: Telemental Health and Online Counseling, what do we need to know, and what do we need to be doing about documentation and informed consent?

MH: Yes, yeah, and this is a big one. So, it’s not drastically different, but it is a little different from regular informed consent. So, first of all, informed consent, and Roy Huggins and I actually did a webinar about this, which I think is available on his website, there’s a little plug there.

CC: Yeah, go, go check out Person Centered Tech, Roy Huggins, all hail Roy. [laughter] He’s got amazing stuff, go check his stuff out.

MH: I know. And one of the things we’ve really highlighted in that webinar was that informed consent is a process and not a form. So that’s the first thing to remember, is that informed consent is a conversation you have with your clients about what therapy looks like, what the limitations to confidentiality are, and it’s an ongoing discussion. So it’s not like you have that discussion the first time you talk with them, and never talk about it again. No, you talk with them at the beginning, and make sure they’re informed, but then, it’s an ongoing thing. So as things come up, like, as an issue comes up where they have trouble getting a hold of you, or you need to get a hold of them, and they say that somebody saw their text message, and then they had to explain why they were in therapy. That’s an ongoing informed consent discussion that you’re having with people. So, that’s the first thing to remember.

MH: And then another thing with informed consent is, every time you do have those conversations with clients, that you wanna document it too. So, it’s not just enough to have clients sign a form, because if you think about it, how many of us go to the doctor and sign a form, and I’m just like, “Oh yeah, I know what HIPAA is, and I signed the form, right?” [chuckle]

CC: Right.

MH: And I’m like, “I’m not worried about it.” But have you actually reviewed that stuff with your clients? At least the highlights. Not that you have to sit there and read the document to them, but making sure they understand it, and then in your note, just making a quick… Like, on my first note I just say, “Reviewed limits to confidentiality, benefits, and drawbacks of online therapy, obtained… ” What do I say? [chuckle] “Obtained consent for treatment.” Yeah.

CC: Okay.

MH: So, super brief. It’s not like a lot, but it is in my note too that I reviewed it with them. So, that’s a big thing. And of course, you wanna review the usual things, whatever your limits are based on your state. Like even self-harm, I think is different. Like, how you report it is different in Texas, I’ve heard from some people, versus how it would be here in California.

CC: Oh, okay.

MH: Someone described it to me as, in Texas, you think like a Texan, which is [chuckle] basically that you can be really independent, and you can do what you want, right? [chuckle]

CC: Yeah.

MH: In California, we’re much more about, “No, we’re not gonna let you do anything that’s gonna be harmful to you.” [laughter]

CC: I can imagine the difference between Texas and California being larger.

MH: Yeah, right?

CC: That doesn’t surprise me at all that my friends in Texas would do things just a little different.

MH: Yeah.

CC: God love ’em. Okay. [chuckle]

MH: That’s great. And of course, I only had one person explain that to me, so I don’t know the specifics about it, but…

CC: Okay.

MH: You know, you wanna go through that kinda stuff, make sure you review that with your clients. But as far as when we get to the online piece, you wanna highlight for people kinda how working with someone online might be different from in person.

CC: Okay.

MH: So, things like, I’ll tell people… Because I do online therapy as well. So I’ll tell people, “Sometimes if the camera freezes or you can’t see, you only see me from the shoulders up, whatever, you may not get all the body language. So if you feel like you’re reading something or something is a little off, just ask me, let me know.” So I will make a point to communicate that with people, that communication may be a little bit limited, even if it’s video. But especially if it’s phone, then I’ll let people know. And I’ll say, “It’s totally fine. It might not be anything, but if there’s just something you’re concerned about, let me know, bring it up, we can talk about it.”

CC: Good, good.

MH: Another thing…

CC: Along those lines… Not to interrupt. Along those lines, I met with an online therapist who was thinking about doing more online counseling. And he had this question of… I forget how he phrased it, but, “How do I handle that, and the difficulties with the tech part of it?” And I said… I just say, “Hey, this is an imperfect connection, and we’re gonna figure it out as we go, and just to be aware that sometimes things are gonna be lost in translation, or the camera’s gonna freeze, or we’re gonna lose audio, and we’ll work around it.” He’s like, “Oh, okay.” So it was like the freedom, we can work around that and I’ll be pretty casual about it.

MH: Yeah.

CC: So yeah, okay.

MH: Yeah, exactly. And that’s the thing. I mean, and that’s… I know, as far as APA guidelines for doing Telehealth is… That’s part of it, is making sure that I’m comfortable with the technology I’m using, that I’ve practiced with it ahead of time. [chuckle] And then… ‘Cause I tend to be sort of like, “Well, I’ll figure it out as we go along or whatever.” So, I do have to be mindful of like, “No, other people might not be comfortable doing that.” So I should be very familiar with it, because somebody else that I’m seeing as a client might not be comfortable just logging in and playing around figuring it out themselves, right? So that’s a big thing to consider too, is just the technology part and…

CC: Right.

MH: And having a backup plan.

CC: Yeah.

MH: So, that’s a one thing you wanna do is… The first time I meet with clients, I make sure that I have the phone number that I can reach them at if our connection completely goes bad, and we might try to fix the connection a little bit, but after a couple of minutes, I’m just gonna call them up and we’re gonna do the session over the phone, because I’d rather spend time talking with them than sitting there trying to figure out the technology. And that does happen, and like you said, you just deal with it, and everyone’s pretty used to it, I think.

CC: Yeah, I think people are. They kinda work around it. Sometimes the weather in Guatemala is going to affect my client’s ability to hear. And the lips are not gonna meet up with the sound sometimes, but we get the gist.

MH: Yeah, exactly. And even weird things like, this is just a week or two ago, I had a client who was crying, and she was crying for a while, and so then I could tell she needed tissues, and I was like, “I’m in my office, and I have issues, but I can’t give them to her through the screen,” and so I had to be like, “Hey, you can get up and get some tissues.” [laughter] And she was like, “Oh okay, yeah, thanks, I should do that.”

[laughter]

CC: Yeah, just needed that little bit of permission.

MH: Yeah, so it’s little things like that. And then it’s funny, ’cause then we kinda laughed and it sort of eased the tension in the room, so to speak, for a minute. But it just requires you to be comfortable with it and comfortable talking about it, I think.

CC: Okay. Alright, so I interrupted you there. So, going back to informed consent, and some of the things that need to be in there for Telemental Health.

MH: Yeah, well, then you brought up, like, what you just brought up is the other stuff about technology and how it works and doesn’t work, and the reliability of it. So that’s something you wanna talk to people about, and having that backup plan and what is it. Another part that you wanna talk about with the technology is the possibility of transmitting through… Other people having access to their online therapy session. So, you don’t have to get super techy, like, you don’t have to understand all the technology and how it all works, because I certainly don’t, but I can pretty easily explain to someone like, “Hey, if you’re at your home and you’re on a network, and you’re on the same network as your family members, there is a chance that someone could possibly access something.” So, that’s something you wanna consider. And you wanna make sure that people have just thought that through. For most people I’m working with, it’s not an issue, and so it’s not something like we go through that, and then they say, “Oh no, I don’t wanna do therapy online.” It’s just something you wanna make sure that they are aware of. Just like with email and texting. So, you can email and text your clients, but you just need to make sure that they know, “Hey, email may not be secure. Somebody might have access to that information, either through how the email gets to them or if somebody hacked into their account, anything like that.”

CC: Okay, alright. So those are your basic highlights. Now, you have in your paperwork packet a template for informed consent for Telemental Health, correct?

MH: Yes, yeah, I have it as an add-on that you can either copy and paste into my bigger informed consent form, or you can just use separately if maybe you only have a couple of clients you do Telehealth with, that way you don’t have to review all that stuff with everybody, it’s just not applicable.

CC: Now, do you have them sign it and then scan it in and send it to you, or is it just something you give them, and we have a verbal agreement?

MH: I do have people sign it. What I have been doing up until this week, I just switched EHRs. So now I’ll have an EHR where people can electronically sign and everything’s gonna be all in one place, that’s gonna be a lot simpler.

CC: Nice.

MH: Up until now people have had to print it out themselves, sign it, and upload it. So it’s much easier if they can just do it electronically.

CC: Okay, good. So here’s a question that I’ve had a few times is, do we need to have the information for the local police department? Because if my client in a session says that they are suicidal… If I call 911 in New York, it’s really in New York City, it’s not going to help the people in Albany or in Guatemala. So, what are the requirements on that?

MH: Yeah, so that’s the other thing that you wanna have documented that you’ve gone through, you are not gonna have… So that’s a great example of something you’re not necessarily gonna have in your informed consent form, right? Because you can’t outline that for everybody who you may see all over the place. But it is something you need to have a conversation about, and you’re gonna document in a note that you talked about potential crisis plan. So, you do wanna at least have contact information for who you would… Like, know who you would call. So, you wanna know your client’s address, where are they when they’re talking to you. And… I mean, I always have an emergency contact for people, so that’s… It depends on the situation, but that’s probably the person I would contact first. Obviously, it depends on what’s going on, but then you would wanna have at least a local police department, or look up if there’s a crisis hotline.

MH: So for example, in LA County, we have a mental health crisis hotline that will send a mobile response team anywhere in LA County. So, you might just need that number rather than the local police department, but you do wanna know that. And also think about things like child abuse reporting. So in California, I don’t know how many counties there are here, but we’re a really big state. [chuckle] And if I tried to make the report in Orange County for someone who lives in San Diego, they’re gonna say, “I gotta call San Diego and make the report there, ’cause that’s where it happened.” So, you might… You don’t need to have all those numbers. Those could be things you probably look up in the moment, but if you have a sort of general locations where people are, then you could have it just collected for yourself to make it easy. But you do wanna have that, and you wanna let people know what your plan will be if something were to happen.

CC: Okay.

MH: And that’s something you can kinda go more in-depth depending on how you feel, how necessary you feel it is. So obviously, if a client’s starting to focus a lot on suicidal ideation, then it’s something you’re gonna be thinking about a little bit more clearly, versus someone who is not expressing anything like that at all, and you’re not this concerned.

CC: Right. Right. Okay. This has been very helpful. And one of the things I thought about while you were talking, what platform do you use? ‘Cause you said you do online therapy, what platform do you use?

MH: Yeah, so I was using, and I do still use for a contract position I have, WeCounsel.

CC: Okay.

MH: And so they allow you to do video sessions within the EHR, which is really nice. And so, I like having everything in one place. I don’t wanna have to login to different accounts to do different things, ’cause that just drives me crazy. But I actually just transitioned to Counsol with an O, C-O-U-N-S-O-L.com. And so far, I’m really impressed with it. This is day one. So, maybe ask me a month from now.

[laughter]

CC: Okay.

MH: But they also allow you to do video sessions. And one thing is, I do like… I’m a little bit non-traditional about the type of online therapy I provide, so I actually do like to have contact with my clients outside of session, and allow them to write messages and exchange… Text back and forth, that kinda thing.

CC: Yeah.

MH: So Counsol allows clients to do journaling within the EHR. It allows you to do emails within the EHR, and they only have one place that they have to login to do all that stuff. So they could do… Login there for their sessions, they can login there to view intake paperwork that I want them to fill out, and I can upload… I do evaluations and career assessments, so I can upload different assessment tools and have them fill it out ahead of time. So it was the most convenient for me.

CC: Okay, alright. I’ve not used Counsol before, but I’ve heard about them, so…

MH: I know, there’s so many. And there’s so many good ones. You know, there’s a lot you can recommend, it’s really just a preference thing, and see what works for you. I say try them all out. Most of them will at least give you a run-through.

CC: Yeah, absolutely, absolutely. In fact, over… I don’t know… The online therapy hub in the UK, they’re rolling through each one and doing a review. So they’ve got three or four therapists that will sit and work with this on different… Mac, and Windows, and they’ll use them and kinda do a test run, and then they write a review on each one. So, that’s kind of a nice resource if you’re looking for a new platform.

MH: Yeah. Yeah. And I know Rob Reinhardt of Tame Your Practice, he has a bunch of reviews of EHRs as well. I don’t think he’s gone that in-depth with Windows versus Mac, which sometimes matters.

CC: Yeah.

MH: And I think some of his reviews might be a little bit older, and certain EHRs, like Simple Practice is a big one a lot of people use.

CC: Right, right.

MH: And they’ve made a lot of significant changes in the last six months, so you can always check things out too, because these EHRs are so new, and they’re constantly adding things, which is awesome. And if you’re using one and you don’t like it, let them know, they might change it, [chuckle] a lot of them do.

CC: Yeah, they’re very responsive, and yeah, they’ve great resources. Alright, any final thoughts for the listeners of the Online Counseling Podcast?

MH: Yeah, I would say just remember that all of this paperwork stuff, it’s just the physical representation, or the cloud representation in some cases, [chuckle] of the conversation you’re having with people. Like, you’re talking with them about what therapy means, and what it’s like to work with you, and what you’re gonna do if something goes wrong. Those are all normal conversations we’re used to having. They don’t have to be a big deal. And the paperwork that goes with them is… It’s just that little confirmation that you did it, so don’t worry too much about it. Definitely get it done, but focus on the conversation you’re having with people, and just remember to document that in your notes too.

CC: Very good. Alright. Maelisa Hall of qaprep.com, you’ve got continuing education, you’ve got webinars, you’ve got an amazing blog, you’ve got paperwork packet, and a whole whole list of resources out there for therapists who are doing this kind of work. So, I encourage everyone to go over there and look at qaprep.com. Maelisa Hall, thank you so much for coming on.

MH: Thank you, and thank you everyone for listening.