In This Issue | SEPTEMBER 2019

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Celebrating the Role of Intuition in Clinical PracticE

Marilyn Stickle

The common definition of intuition is “knowing without knowing how you know.” It is no mystery then that it has remained in the shadows of theory and practice. Over the past century psychoanalytic scholars, beginning with Freud, have tried to answer the question of how we know things by exploring unconscious communication and anomalous experiences. A review of the history and current understanding of intuition can be found in "Intuition in Psychotherapy: From Research to Practice"  (Stickle & Arnd-Caddigan).

Our book describes qualitative research conducted with clinical social workers who discuss their application of intuition in psychotherapy practice. The findings suggest that while clinicians have not been trained to use their intuition, nor is it generally discussed among colleagues, many use it with consistency and positive outcomes. Our research suggests that intuition is a common factor used in cross-theoretical preferences and practice settings.

I’ve spent decades reading the science and application of intuition and translating it into clinical practice. Many people, including clinicians, practitioners of other disciplines and ordinary people, have confided in me, often telling their stories of uncanny experiences and synchronous events for the first time. The surprise in our research is that clinicians are able to articulate their intuitive experiences and reflect outcomes made by decades of research that they themselves are unaware of.

On a personal level, my exploration of clinical intuition began when there was little written about its application in psychotherapy. I began doing in practice what I had done all of my life, simply listening to the nuances of words and observing the subtle behaviors of people with whom I interacted. As I began to listen intuitively, my internal dialogue shifted from theoretical proficiency as my primary way of understanding, to deepening awareness of my experience in the presence of each person. I began to pay more attention to the images and words that formed in my mind and to my subtle impressions as patients spoke. Paying attention to the overall flow of sessions, I memorized the feel of those with positive outcomes.

Over time, my ability to focus on patients has sharpened, as reflected in my visual experience, where everything in the room has ceased carrying equal weight. My other senses have telescoped as well, aligning my awareness increasingly with that of patients. Overall, my level of interaction has increased as I process my impressions out loud to check their accuracy in an enlivened exchange. In doing so, my patients and I grasp what is being communicated more deeply. Treatment has become more efficient, effective and humane with the active inclusion of intuitive processes.

In addition to our newly published book, this fall there will be two opportunities to attend continuing education programs that will review the literature and teach application of intuitive processes. Please join us on Fridays, October 4th and November 1st from 9:00-12:15 in my office at 5319 Lee Highway in Arlington.  

Register for Marilyn's Intuition workshop here

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One of your important member benefits!

Join Us at the ANNUAL FREE AND FABULOUS

2019 Legislation & Advocacy Luncheon
     

OUR SOCIETY’S ROLE IN LEGISLATION & ADVOCACY

Sunday, October 27, 2019, 11:30 am-3:00 pm

Maggiano’s Tyson’s Galleria
2001 International Drive | McLean, Virginia 22102

Join us for a stimulating discussion with our Virginia lobbyist, Sue Rowland, our Maryland lobbyist, Pam Metz Kasemeyer, our DC co-chair of L&A, Margot Aronson. Adding to the perspectives will be Judy Gallant, Judy Ratliff, Adele Natter – and YOU!

Please note: the luncheon is a free member benefit, but advanced registration is required. If a vegan main dish is requested, please note it on your registration and the restaurant will accommodate this. Several vegetarian choices are being served.

Three (3) CEUs are available for $60.

CLICK HERE TO REGISTER

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Legislation & Advocacy  | Federal

Laura Groshong, LICSW, Director, Policy and Practice

LCSWs and the Use of Texting in Mental Health Treatment

Text Therapy – Start Feeling Better Today with Talkspace Online Therapy.  A Convenient and Affordable Solution That Provides Access to Therapy Whenever You Need. 100% Private & Secure. Secure & Confidential. 1 Million Happy Users. 2000+ Licensed Therapists. As Low As $49/Week.  (Talkspace Website, 

Texts are primarily used for social purposes: short missives conveying limited information.  Much has been written about the negative impact of reliance on this mode of communication (Turkle, 2012), but the popularity of texting is obvious, particularly among those under the age of 30 who have texted regularly throughout their lives. Therefore, the increasing use of texting in the context of therapy cannot be ignored.

While there is no definitive research as yet, it appears that texting can play a useful role in some mental health treatment. Certainly for anyone who is most comfortable with texting as the preferred form of communication, this may be where a treatment relationship can best begin.

Responsibilities of the LCSW Providing Text Therapy

Clinical social workers should be knowledgeable about the promise of digital innovations in treatment, and equally about the potential downside. LCSWs choosing to engage in text therapy must be willing to explore ethical complications, perhaps even license violations, in the terms of agreement with the client and/or the texting platform. 

The first issue:  is text therapy really psychotherapy?

• Psychotherapy -- also called "talk therapy" or just plain therapy -- is a process whereby psychological problems are treated through communication and relationship factors between an individual and a trained mental health professional. Modern psychotherapy is time-limited, focused, and usually occurs once or twice a week for 45-50 minutes per session (Herkov, M., “What is Psychotherapy?”, PsychCentral, October 8, 2018.)

This simple definition of psychotherapy, paired with the already quoted Talkspace web advertisement, illustrate the very real differences that exist between psychotherapy and text therapy. Psychotherapy (whether in person or through synchronous videoconferencing) is a continuous process based on an established emotional relationship, an ongoing dialogue between two people in real time about complex issues with deep emotional content.  Texting, on the other hand, is by its nature short, often with a gap in the timing of communications between client and therapist; it is not consistent with a dialogue based on emotional meaning, as with psychotherapy.

• Talkspace User Agreement - This Site Does Not Provide Therapy. It provides Therapeutic conversation with a licensed therapist.   (Essig, T., “APA Cancels Talkspace Ads Moving Forward”, Forbes Magazine, July 29, 2018.)

While texting platforms may emphasize, in the small print of the User Agreement, that the services provided are not psychotherapy, most continue to display the term “text therapy” prominently in their ads.  This can create confusion for clients seeking psychotherapy and may give an appearance of misleading advertisement.

How, then, do we as LCSWs conceptualize and engage in text therapy?  Perhaps “text therapy” might more accurately be called “text assessment” or “text coaching”.  Texting might also be the means for starting the therapeutic process, to be converted to an in-person or videoconferencing process if it becomes an ongoing psychotherapy.

Reading any contract with care is essential, and this is most certainly true for provider contracts offered by texting platforms.  Does the contract address issues such as diagnosis, HIPAA compliance, state-to-state licensing laws, and dual relationships?  Does the platform set limitations on helping a client understand the differences between in-person treatment and text therapy, or on recommending in-person therapy when such treatment is indicated?   

LCSW Standards of Practice

The use of ongoing asynchronous texting changes the process of therapy for LCSWs.  The therapeutic alliance is significantly different when the primary means of communication is not direct ongoing communication between the client and therapist, as the asynchronous method of communication tends to preclude in-depth exploration of emotional understanding.  Further, a key part of psychotherapy, the “frame”, is lost if client and therapist text and reply at different times, or if the client is limited – as with some agreements - to making and receiving two texts a day to a therapist five-days-a-week.

LCSWs base their understanding of a client on a biopsychosocial assessment, leading to a diagnosis. ASWB Technological Guidelines (2015) identify additional factors that may contribute to determining whether a client is suitable for text therapy:  age, technological skills, disabilities, language skills, cultural issues, and access to emergency services in the client’s community.  How does the platform provide for assessment?  Can you ensure that our standards of practice will be upheld by the texting platform?

When more intensive treatment is called for, will the platform respect and support the licensed provider’s clinical judgment?  LCSWs know that a client with a psychotic disorder, an autistic-spectrum disorder, or an acute episode of depression or anxiety may need in-person communication or hospitalization.  Are there contractual provisions for such a situation? 

Regulatory Considerations

Benign as texting seems, some texting platforms ask clinicians to communicate in ways that may violate state laws and regulations and/or federal laws and rules.

Most states require a clinical social worker to be licensed in both the state where the LCSW resides and the state where the client resides, if different, to provide therapeutic services.  A text platform’s claim that text therapy is not psychotherapy but rather “therapeutic communication” is a blurry distinction not necessarily recognized by state social work boards. It is the LCSW’s obligation to ascertain and comply with relevant regulations of both state boards. 

Licensed therapists are also responsible for making sure that the text platforms used by both client and therapist are HIPAA compliant.  Further, the texts themselves are personal health information sent electronically (PHI) and must be kept private and secure.  It has been reported that one text platform permitted employees – even non-clinically-trained employees – to review the content for training purposes.  A Business Associate Agreement might provide a guarantee of the LCSW’s confidentiality standards, if the platform agrees to sign. (HIPAA Basics for Providers, 2018, https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/HIPAAPrivacyandSecurity.pdf )

Ethical Considerations  

Most states use the NASW and CSWA Codes of Ethics as the basis for ethical clinical social work practice. Some text platforms have contractual terms that require the therapist to meet sales targets through their text exchanges.  For a clinical social worker to engage in such a dual relationship, i.e., as a corporate representative for the texting services and, at the same time, as a therapist addressing mental health problems, is a clear and serious ethical violation.

Some companies use marketing techniques that also may be ethical violations.  One example, potentially misleading advertising, has been mentioned.  Advertising with testimonials from former clients is another.  From the NASW Code of Ethics (2016 4.07(b)) : Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client's prior statement as a testimonial endorsement) from current clients or from other people who, because of their particular circumstances, are vulnerable to undue influence.

Would the company agree to keep the LCSW provider from being caught up in these sorts of business-driven ethical dilemmas?

Summary

Basic to mental health treatment is thoughtful consideration of the conditions being treated and of the biopsychosocial needs of the client. The challenge for the LCSW is incorporating these basics, along with accepted standards of practice, regulatory requirements, and ethical considerations, into the texting format as contracted by the particular text platform.  It is the responsibility as LCSWs to apply clinical social work standards of practice, ethics, and regulations to any work we choose to do.

References

• Association of Social Work Boards (2015). Technological Guidelines.
• ASWB, CSWA, CSWE, NASW (2016). Technology Standards in Social Work Practice.
• Clinical Social Work Association (2016). Code of Ethics.
• Centers for Medicare and Medicaid Services (2018). HIPAA Basics for Providers, https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/HIPAAPrivacyandSecurity.pdf .
• National Association of Social Workers (2016). Code of Ethics.
• Turkle, S. (2012) Alone Together: Why we Expect More from Technology and Less from Each Other. NY, NY: Basic Books.

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Legislation & Advocacy | District of Columbia

Margot Aronson

DC Board of Social Work update

The effort of the DC Board of Social Work to develop policy to enable LGSWs to work in private practice settings in order to gain their supervised work experience for the LICSW application is nearing its final shape; the Board is planning to vote on a final policy statement at the September Board meeting. Creating such a policy has required considerable work on the part of the Board: although LGSW training and supervision in agencies is monitored by the Department of Behavioral Health, at present there is no comparable system in place for monitoring LGSW training and supervision in private practice. In fact, just this spring the ASWB (Association of Social Work Boards) established a task force to consider issues in supervision, in light of a variety of questions and concerns raised by Boards across the country.

GWSCSW members anxious to have the new policy in place have diligently attended the Open Session of Board meetings over the past 8 months. They presented a carefully crafted petition for the Board to review, presented information based on their clinical experience, and gradually earned a role as a sought-after resource. For its part, the Board maintained transparency and decorum as they deliberated (not always an easy feat); they followed through with research when needed; and where in the early sessions patience at times wore thin on one side or the other, the July meeting was collegial, collaborative, and mutually respectful, as well as very productive.

The Board will not be meeting in August; the next meeting will be Sept 23, with the Open Session beginning, as usual, at 10 AM. Hopefully the policy statement will be ready for a final vote.

Wanda Wheeler, LICSW, joins the DC Board

At the July meeting, Board Chair Velva Spriggs, LISW, introduced Wanda Wheeler, LICSW, who joins Danielle Nelson, LGSW, and Selerya Moore, Consumer Member, on the Board. A warm welcome to Ms. Wheeler!

The Board is still lacking its LSWA member.

Of the 5,386 licensed DC social workers, 3,718 are LICSWs; 1,533 are LGSWs, 56 are LISWs, and 79 are LSWAs.

House of Representatives Hearing on DC Statehood Bill

Please take note that a House of Representatives hearing on H.R.51, Washington DC Admission Act for DC Statehood, will take place on Thursday, September 19, 2019 at 10 AM in the in Rayburn House Office Building, Room 2154. Will you be there?

Statehood requires approval by a simple majority vote of each House of Congress and the President’s signature. It is the simplest and most constitutional way to make the people of the District of Columbia full citizens of the United States of America. Maybe not in this Congress… but every step counts!

Margot Aronson, LICSW, chairs the GWSCSW L&A committee for DC. A past GWSCSW president, she has also served as newsletter editor and director of Legislation & Advocacy. Margot currently advocates on mental health and LCSW practice issues for us all at the national level as the Clinical Social Work Association Deputy Director for Policy and Practice.

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Legislation & Advocacy | Maryland

Judy Gallant

Martin Schnuit, LCSW-C, Appointed to MD Board of Social Work Examiners

We extend our hearty congratulations to our member Martin Schnuit, who, backed by a recommendation from GWSCSW, was appointed by Maryland Governor Larry Hogan to the position on July 1, 2019. Mr. Schnuit received his MSW from the University of Maryland in 1995 and has worked in a variety of settings. For over 20 years he has maintained a private practice in both Anne Arundel County and Baltimore City. He specializes in the treatment of anxiety disorders, phobias, and obsessive compulsive disorder. As a Board-approved supervisor, he has mentored and provided clinical supervision to MSW's for years. In addition to his GWSCSW membership, Martin is also a member of NASW, and is a clinical fellow of the Anxiety & Depression Association of America. We wish you great success in your new position, Marty!

We continue our reporting on bills from the 2019 Maryland General Assembly, begun in our June newsletter article:

Substance Use Disorder Issues

House Bill 116/Senate Bill 846: Public Health – Correctional Services – Opioid Use Disorder Examinations and Treatment (passed) establishes specified programs of “opioid use disorder” screening, evaluation, and treatment in local correctional facilities and in the Baltimore Pre-trial Complex. The program begins in four counties and phases-in to include all counties and the Baltimore Pre-trial Complex. The State must fund the programs of opioid use disorder screening, examination, and treatment of inmates, and the bill establishes requirements for screening and treatment.

House Bill 599/Senate Bill 631: Health Insurance – Coverage for Mental Health Benefits and Substance Use Disorder Benefits – Treatment Criteria (passed) was heavily amended by the committees. Initially, the bill required carriers to submit two extensive reports to the Maryland Insurance Administration on how the carrier complied with federal mental health parity and addiction equity laws and on the carrier’s data for mental health benefits, substance use disorder benefits, and medical/surgical benefits by parity act classifications. The committees amended the bill to only require carriers to use the American Society of Addiction Medicine criteria for all medical necessity and utilization management determinations for substance use disorder benefits. The bill also repeals the limitation on a carrier charging a co-payment for methadone maintenance treatment that is greater than 50% of the daily cost for methadone maintenance treatment.

Child Advocacy Centers Expansion and OP Civil Commitment Pilot Program Revisions

House Bill 1007/Senate Bill 739: Child Advocacy Centers – Expansion (passed) alters and establishes numerous requirements for child advocacy centers in the State. The Governor’s Office of Crime Control and Prevention must ensure that every child in the State has access to a child advocacy center. The bill also requires the Governor to include at least $300,000 in the annual budget bill for child advocacy centers.

House Bill 427/Senate Bill 403: Behavioral Health Administration – Outpatient Civil Commitment Pilot Program – Revisions (passed) requires the Behavioral Health Administration (BHA) within the Maryland Department of Health (MDH) to allow an eligible individual to request enrollment in, and allow an immediate family member of an eligible individual to request voluntary enrollment for the individual, in an existing authorized pilot program for outpatient civil commitment. BHA must include specified information in its annual report for individuals admitted into the program, both voluntarily and involuntarily.

As always, do not hesitate to contact Judy Gallant at judy.gallant@verizon.net with input on the laws discussed above, or other issues in Maryland mental health policy.

Judy Gallant, LCSW-C, is the director of the Society’s Legislation & Advocacy program, as well as chair of the Maryland Clinical Social Work Coalition, our GWSCSW legislative committee in Maryland. She maintains a private practice in Silver Spring.

Pamela Metz Kasemeyer, JD, and her firm of Schwartz, Metz & Wise, PA, represent us in Annapolis and guide our advocacy strategy. Ms. Kasemeyer is an acknowledged authority on Maryland’s health care and environmental laws and has represented a variety of interests before the Maryland General Assembly and regulatory agencies for more than 25 years.

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Communications Branch 

Kate Rossier, Director of Communications | Email: kazrossier@hotmail.com

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EDUCATION Branch 

Susan Post, Director of Education | susan.post@gmail.com

Our committees have been evolving over the last few months. Shauna Alonge has joined Leila Jelvani as co-chair of the Continuing Education committee and they are hard at work on the schedule for fall and winter. The MD/DC Brown Bag committee is sad to say goodbye to Amy Johnson and is looking for a new volunteer to co-chair with Robin Seiler. If you are interested, please contact Robin at  rsseilerjr55@gmail.com or the GWSCSW volunteer coordinator, Beth Pascoe at bethdpascoe@yahoo.com (who also happens to be co-chair of the VA education committee).

The very popular annual Alice Kassabian Memorial Conference will be held November 9, 2019, so put that on your calendars. As always, issues related to social justice will be discussed, this year in the context of racial and cultural diversity.

Also in the fall will be a two-part workshop on planning for emergency coverage of your practice. This workshop will offer ethics CEUs to all who need them last-minute for license renewal.

The full schedule for CE events will show up on the GWSCSW website as it evolves, and of course you’ll be getting emails when it becomes time to register. AND – think about being a presenter yourself, on any topic you know and find interesting. Contact Leila Jelvani, leila.jelvani@gmail.com. Our education programs are intended at least in part to give our members the opportunity to teach each other!

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Committee Reports

Continuing Education Committee
Shauna Alonge| Leila Jelvani
cecommittee@gwscsw.org

The Continuing Education Committee is accepting proposals for Fall 2019 and Spring 2020. Do you have a topic that you know others are interested in learning about? Would you like to share your expertise? This is a great opportunity to highlight your experience while promoting your practice. For shorter presentations, consider offering a Brown Bag lunch topic, typically lasting 1 ½ hours.

Click here to submit a proposal. Once submitted, the proposal will be reviewed by the Education Chair and the Continuing Education Committee. 

Legislation & Advocacy Committee
Judy Gallant
dirlegislation@gwscsw.org

Annual L&A Luncheon scheduled for Sunday, October 27, 2019, 11:30 am-3:00 pm: REGISTER TODAY!!

DON’T MISS this FREE benefit of your membership! It is always a fun and informative event where you can learn more about what is happening in each of our jurisdictions and share your ideas about what is important to you. Look for additional information in the boxed announcement in this newsletter.

Answers to BCBS/HPN network questions

In June, many of our members received a letter from Blue Cross Blue Shield Associations about a new “High Performance Network” or HPN being planned and asking providers to become part of the new network

On July 26, 2019, Mary Moore, Margot Aronson, Pam Metz Kasemeyer and I spoke with 5 representatives from BCBS, including the VP of Government Affairs for CareFirst, the Senior Director of Provider Relations and the VP of Network Management.

We started off requesting that the deadline for our ability to opt out be extended to September 1. We were told they couldn’t do that, but that because the Network won’t be effective until Jan.1, 2021, there is no risk to providers, as we can opt out of the HPN network at any time with 90 days notice. We would need to send a letter to Provider Relations, as specified in our original CareFirst contract, saying that we wish to terminate ONLY with HPN. They acknowledged that things are still being worked out at their end; performance standards will be provided in a manual which will not be published until next year. They readily said that as expectations from them become clearer, providers could easily decide they don’t want to sign up for providing services under these conditions and can send a termination letter at that time. Our decision to participate or not to participate with HPN will NOT affect any of the other product lines we participate with, such as the CareFirst PPO, RFP, and the Blue Choice network.

Some context they gave was helpful. HPN is designed as an EPO, which they described as an HMO with leeway. EPOs generally have more flexibility than HMOs but not as much flexibility as PPOs. They expect HPN to have a very small set of members. HPN is a national network product, not a locally-insured product. So, for example, members of Carefirst whose coverage is through a contract with their local school system, could never become part of HPN while employed by the school system. The product will not be sold by Carefirst, or any of the regional BCBS Associations. HPN can only be offered by large employers (such as Amazon or Boeing) who have self-funded (ERISA) plans; the BCBS Associations are the Administrators.

In terms of continuity of care, if we are seeing a patient under CareFirst and they change their plan to HPN, it will be as if they are changing to a new insurance company. If the provider does not become a provider with HPN and the patient wishes to continue to see them, an exception to the rules of their contract would need to be requested. Medical and clinical people from HPN would review the request and grant it based on medical necessity.

They stated that there are no new liabilities for providers; we have the same responsibilities with HPN as in other networks. "The responsibility for seeing in-network providers lies ultimately with the patients, and their contracts will clearly state that. If none of the in-network providers are available to them and they ask us for alternatives, there is no problem with our giving them out- of-network referrals. " Again, an exception to the terms of their contract can be requested, and the decision will be made based on medical necessity. The member’s insurance card will have contact numbers on the back of it.

I hope this information answers many of the questions you sent to us. We obviously could not get to everything, so if there are any glaring omissions in information you were hoping for, please let me know.

Be sure to contact one of us with any questions or suggestions you might have, or to join one of the committees: in DC, Margot Aronson at malevin@erols.com or Adele Natter at anatter@verizon.net; in Maryland, Judy Gallant, judy.gallant@verizon.net; and in Virginia, Judy Ratliff, jratliff48@hotmail.com. We look forward to hearing from you.

Membership Committee
Cindy Crane, Nancy Harris, Catherine Lowry
membership@gwscsw.org

JOIN US IN WELCOMING NEW MEMBERS TO OUR FALL BRUNCH
Click here to RSVP: Fall 2019 New Member Brunch! FREE!

Sunday, October 20, 2019 | 11:00 AM-1:00 PM 
7313 Millwood Road Bethesda, MD

Any GWSCSW member who has joined in the past 2 years is warmly invited to join us! And all current members are invited to come meet new members!

This is a chance to learn more about what GWSCSW can provide you, how you can get involved, plus a chance for us all to get to know each other better and enjoy a beautiful brunch!

Mentoring Committee
Nancy Harris
mentoring@gwscsw.org

The Mentor Program is always looking for new mentors to guide the newer social workers who are looking for guidance and help as they start their careers. You determine how much time you want to give; this is worked out with the mentee. For questions please contact Nancy Harris, coordinator of the Mentor Program at (301) 385-3375, or nlharris1214@gmail.com. Thank you for your support of this important benefit of GWSCSW membership!

Newsletter Committee
Nancy Pines
npines12@aol.com 

Your newsletter welcomes ideas and articles about clinical social work and practice. We are also very interested in hearing from members who have specialized knowledge or adjunct therapy practices they want to share. As above, letters to the editor are OK too.

Please consider your own life experiences and how they may have affected how you practice. One of the things I love about our profession is how we are always learning. Why not share your expertise and life lessons with fellow members? Send an email with your story/article ideas to npines12@aol.com. 

I am looking for a new "proofer," a volunteer who likes to edit and who reviews the newsletter once it is in digital form. This is in case I have missed anything! Please let me know if you are interested, at the above email address 

Social Media Committee
Chana Lockerman
socialmedia@gwscsw.org

The Committee is excited to continue the work of sharing exciting content related to social work and mental health and updating the GWSCSW Facebook page with articles. Please visit the page, like or comment on the posts. Let us know if you have an idea about how to make the page more relevant to YOU. We are working on getting more traffic to the Facebook page. Please like the page if you haven’t already, and share the page with your fellow colleagues! Feel free to email us at socialmedia@gwscsw.org if there is something you would like us to post about on the listserv. We are also available to field any personal questions you may have about your own social media pages and accounts. Contact Chana Lockerman chana@rockcreekcounseling.com with any questions or suggestions for future Tech Tips columns.

Volunteer Committee
Beth Pascoe
volunteer@gwscsw.org

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Tech Tips: exploring social workers’ experiences with technology

Chana Lockerman

Instead of “tips”, this column is also exploring social workers’ experiences with technology. How does technology inform your social work practice? What do you wish existed, but doesn’t yet? What do you wish never existed? How are you helped or hindered? To get the conversation started, I’m sharing my own experience and I hope in forthcoming columns to share yours.

The bulk of my agency work involved off-site sessions in clients’ homes and schools. Because I often was far from the clinic at the end of the day, I ended up carrying a lot of paperwork around. It made me nervous to say the least. Sometimes I saw 15 clients before stepping foot in the clinic, and the number of paper notes I had to carry grew and grew. I enjoyed the work and being on the go was fun and exciting, but the issues around transporting paperwork weighed on me. I thought about how I would feel if my own therapist was walking around with my file in her bag or her car. I found a solution that eased my conscience when I found a lock box that fit in the trunk of my car. It had two locks with different combinations, and felt like a godsend. It was bulky and heavy, but I felt much lighter.

When I started my private practice in 2014, I knew that technology would play a role. I was subletting space from another therapist and planning to offer home visits and I wanted a practice that didn’t rely on paper charts. Once I left my agency job, the lock box retired to my basement. I chose my first electronic medical record company on the recommendation of a friend and because they had a reputation for great customer service. It took hours to learn, but eventually I felt comfortable with it. I also learned to file my own insurance claims, and my technology-informed office was on it’s way.

A couple of years went by and I had regrets about the EMR (electronic medical record). It didn’t collect fees or integrate with insurance billing. Moving to another EMR meant moving every single client’s file over from one system to the next, and it was a very long process. It turned out to be a great choice. The new system takes care of insurance billing, collects credit cards, automatically charges for co-pays, and offers telehealth infrastructure.

Mostly because it was easily available, I decided to give telehealth a try. First I attended a training on the topic and talked with therapists already using the technology, then decided to jump in. I offered a current client a telehealth session. It went really well. And telehealth quickly became a mainstay of my practice. I limit its use in a few important ways. It is only available to current clients who come in to the office for weekly sessions. Now, if they are home sick, or with a sick child, we can still have our scheduled session. I specialize in perinatal mental health and the technology allows me to start evaluating postpartum moms in the early days after birth, before they are able to come into the office. I always explain that if they aren’t doing well, they will need to come see me in person, but we can make this determination together instead of waiting for them to progress enough in their physical recovery to come in and get evaluated.

What is your technology journey? What excites you? What scares you? If you would like to share your story, please email me chana@rockcreekcounseling.com.

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OUT & ABOUT

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GWSCSW Job Board

GWSCSW is proud to feature a job resource to connect career opportunities with our members.

Visit the GWSCSW job board to look for jobs or to post a job today.

Manage Your Career:

• Search and apply to positions that value your credentials!
• Upload your anonymous resume so employers can contact you, but you maintain control of your information and choose to whom you release your information.
• Receive an alert every time a job becomes available that matches your personal profile, skills, interests, and preferred location(s).
• Access career resources and job searching tips and tools.

Recruit for Open Positions:

• Post your jobs, or your institution's jobs, where the most qualified professionals will find and apply to them.
• Email your jobs directly to job seekers via the exclusive Job Flash email.
• Search the resume database and contact qualified candidates proactively.

See some featured jobs below.

classified advertising

Advertisements, accompanied by full payment, must be received by  GWSCSW by the first of the month preceding publication. Material should be sent to admin@gwscsw.org. For questions about advertising, call 202-537-0007.

Classified Ads: 75¢ per word | Minimum price $15 (20 words)
Display Ads: Full page 7 x 9¼ $325 | Half page $250| Quarter page $125 | Eighth page $75  

Electronic submission (JPG) preferred. Publication does not in any way constitute endorsement or approval by GWSCSW, which reserves the right to reject advertisements for any reason at any time.

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