Do you need HIPPA for online therapy services?

I get the sense that some online therapists are trying to sound superior to other therapists who do not use their HIPPA system of choice.

 If I told you that if you as a therapist if use your computers to talk to clients and also use them for sending and receiving emails you are at risk of having your security compromised and everything you do is tracked and recorded, HIPPA systems can be compromised like any other systems using software to provide online therapy services.

It’s no good for a therapist working online just thinking everything is safe because as a therapist they use HIPPA AND DOXY and yet they don’t understand how an abusive partner can get access to the client’s computer or other device and compromise the client’s confidentiality.

Creating a false sense of security

 Any therapist like myself working online needs to know when their client needs to be educated about the risks when having online therapy, especially if they are living with a partner who is controlling jealous or violent.

A therapist saying you can trust me because I use this or that is creating a false sense of security if they do not understand what the risks are for the client’s security when having therapy online.

Unfortunately, there are a few bad therapists about, some very well qualified and incompetent or just uncaring and abusive and that means they will probably not care or think to use best practices when working online.

My understanding of online therapy

I have been working online as a psychotherapist for almost eleven years, as well as building my own computers and making and developing my own websites and running my own servers, I also have a good in-depth understanding of online security and computer security in general, I know that I don’t know everything, but I think I have a good level of knowledge about online security.

Unfortunately, there are some therapists who have jumped on the bandwagon providing online therapy services without the required knowledge or have an insufficient understanding of the risks involved. 

Understanding the risks

There are many more risks in providing therapy online for both therapist and client than the traditional face to face option, there are many more considerations to take into account when helping clients from different countries.

A client may be living in what could be a very restrictive culture, where the kind of freedoms we have in the west is not available and where being seen as gay could be very dangerous, so care needs to be taken.

Nothing is completely safe online

When I started providing my online therapy service in May 2011 there were no other therapists working online full-time so I had to learn it from scratch by experimenting testing and learning as I went.

 I can say that in my opinion many therapists are mistaken when they suggest that Doxy or HIPPA make it totally secure. Nothing is completely safe because it’s software and all software is code, and all code can have flaws and be hacked. Not forgetting that the most unsecure part of any therapy service provided online is the therapist behind the computer.

How secure is your therapist?

Therapists working online who are suggesting that all other ways of communication not using HIPPA compliant systems should not be used when providing online therapy are showing a lack of understanding on their part.

Improving privacy standards is always a good endeavour, but do you think that your private data is not all over the web in various servers being used by advertisers and other data profilers? Or has it been compromised because some company’s secure system has been hacked and your sensitive data has been exposed and used?

Your VPN has limitations

Did you know that having a VPN (a virtual private network) does not mean you cannot be tracked by google because everyone has their own data print, like a fingerprint that can be used to identify you by your viewing habits and surfing preferences?

Not forgetting that if you use windows google or Facebook you don’t have much if any online privacy as you gave it away when you signed up for the service.

Does anyone read the privacy policy or terms and conditions that you see on any website like Facebook, is it even possible to understand them?

What to use for online therapy?

I don’t use FaceTime and some others at this moment but I do use what I think is suitable in my opinion, and that could change depending on what I deem to be acceptable.

In my opinion using video calls and sound calls over communication tools like zoom google meet and skype, not forgetting signal and teams, is acceptable in my if you know and understand the risks.  

Is Skype safe to use for online therapy?

To use Skype or not to use Skype for online therapy has been a contentious subject amongst therapists for many years.

Today many online therapists do use Skypes sound and video calls for providing therapy as all Skype-to-Skype voice, video, file transfers including instant messages are encrypted, just like many other online communication options like google meet. Just like the many other communication options using software for online video calls have become more secure over the years.

Is email safe for online therapy?

I don’t use email to provide any kind of therapy service, but I have known therapists in the past who used email to provide a therapy service. In the past, some therapists started to use Gmail, but I think that is not acceptable, as Gmail messages are scanned and read for advertising data collection, by google and their affiliates. In my opinion, I would go as far as to say that unsecured unencrypted email should never be used for transmitting any kind of personal data.

But email can be encrypted and kept secure, so in some circumstances, it can be used effectively if the right precautions have been used. This can be helpful to people who need to express themselves in writing, so there is no need to deny them this service.

The end bit

At the end of the day in my opinion it’s about looking at the evidence understanding the technology and studying the risks, and finally doing a risk assessment and finding the right balance between keeping online therapy secure and widely available.

Nothing is going to be completely secure, there is never going to be a system that is totally safe and secure, it is always going to be a compromise.