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Getting on Board with Going Online

Digital therapy tools have been around for years, but most clients and counselors still opted for therapy in traditional settings. When the COVID-19 lockdown hit a year ago, though, they had to make the switch.   We checked in with Professor Donna Sheperis, associate chair for clinical training in the Department of Counseling, and Professor Kelly Coker, program director of the master’s in counseling programs, to learn about the long-term repercussions in the field and how counselor training has been affected by the pandemic. Both women are board certified in tele-mental health and have been distance-teaching for about 12 years. Sheperis migrated to online treatment delivery seven years ago. “I started to use the platforms to prove they weren’t as good as in-person counseling, but I soon came to see it’s not necessary to breathe the same air as my client,” she says. “The technology gets better and better, and access has improved as more clients have internet and a computer or smartphone.” “Clients love it,” she says, noting that it’s more time-efficient. With in-person counseling, a one-hour appointment can take three hours of a client’s time when you factor in travel time and parking. That’s difficult when you’re taking time off work or have to pick up kids from child care. And studies show that virtual counseling is just as effective as in-person therapy.   While it’s not for everyone, Sheperis believes the demand for virtual treatment will only grow. She sees the future of counseling as a digital apothecary, where the therapist is the pharmacist, developing the treatment plan and choosing the appropriate tools for each client. She points to the model developed by PAU Distinguished Professor of Clinical Psychology Ricardo Muñoz, which outlines four delivery modalities, from face-to-face video and video augmented by digital tools, to guided self-help tools and fully automated self-help tools.   Increased demand means increased specialized training in online delivery of service. PAU counseling skills courses include strategies specific to tele-mental health for engaging with clients on video and through messaging apps, doing risk assessments and effectively communicating nonverbally. Coker notes, for example, the counterintuitive notion that to make eye contact with someone on video, you have to look at your camera, not their picture on the screen. “You want clients to feel like they’re getting the same experience they would get if they were sitting across from you in the same room,” she says.  Students also need to familiarize themselves with the laws and requirements for tele-mental health, which vary from state to state, and ensure that whatever platforms they use are HIPPA compliant.   Another area where PAU students are honing their digital skills is in the e-Clinic, of which Sheperis is the interim director. When shelter-in-place orders put many practicums and internships on pause, the clinic gave counseling and psychology students the opportunity to get required hours and supervision in tele-mental health. With its robust online program offerings and the e-clinic, Sheperis says, “the aim of PAU is to be the place to learn this.”    The pandemic hasn’t only increased demand for online counseling, but training in online education as well. Over 170 educators attended PAU’s virtual Counselor Education Distance Learning Conference on February 19. Pre-COVID, the conference drew primarily online educators, but this year attendees included many who had never taught online. The conference included breakouts on teaching group therapy skills, the ethics of online education and a session on teaching counseling skills by Coker, Sheperis, Darlene Chen and Cristen Wathen on their preliminary findings after moving the summer counseling skills intensive to an online format last year.   “The wonderful thing about PAU is we’ve got this good blend in the counseling department of asynchronous and synchronous learning,” Coker says, “so when we had to pivot to go online, we felt very comfortable in how we made some of the adjustments for our students and our program.”