Telehealth & Social Work Practice: Same ethical practice – different locations

Summary

In the webinar hosted by the Canadian Association of Social Workers, the focus shifts to adapting social work practices to telehealth environments. Heidi Sturgeon, an expert in online therapy, outlines the essential steps in transitioning to telehealth, stressing the importance of maintaining ethical standards across different locations. From securing the right technology and setting up informed consent, to ensuring privacy and managing crises, the session offers comprehensive insights into virtual service delivery. Social workers are encouraged to remain adaptable, resourceful, and up-to-date with provincial and national standards as they navigate these new digital landscapes.

Highlights

• Heidi Sturgeon emphasizes the importance of ethical practice regardless of the medium used. 👍
• Technology setup, including good internet, camera, and sound, is foundational for effective telehealth. 🌐
• Adapting informed consent forms to encompass telehealth specifics is now necessary. 📜
• Emergency plans should be part of the client's profile, with current locations noted at the start of each session. 📍
• Maintaining strong privacy and security measures is crucial to safeguarding client information. 🛡️

Key Takeaways

• Telehealth practice maintains the same ethical standards as traditional settings, just in different locations. 🏥
• Ensuring technology is up to the task is crucial for effective telehealth implementation. 💻
• Informed consent must now cover telehealth nuances, ensuring clients understand the process. ✍️
• Emergency management planning remains vital, even in a virtual environment. 🚨
• Regular testing of technology and setup can lead to a smoother client experience. 🔄
• Privacy and confidentiality are paramount; always verify the security of your communication tools. 🔒

Overview

Telehealth in social work is not just a trend; it's a necessary shift as more practitioners adapt to digital service delivery. This transformation necessitates the same rigorous ethical standards typical of in-person sessions, but applied in a digital format. Heidi Sturgeon highlights these aspects, explaining how social workers can uphold their professional duties while embracing telehealth.

Equipping oneself with the right technology is critical. A strong internet connection, reliable software, and familiarity with digital tools provide a solid foundation for effective telehealth service. Heidi shares how testing and preparing ensures both the practitioner and client have a seamless experience, minimizing technical hiccups and maximizing engagement.

Crucial topics such as informed consent, privacy, and emergency management in telehealth settings are emphasized. It's noted that social workers must be proactive in updating their practices with these digital nuances in mind. The integration of privacy laws and ethical guidelines with technology ensures that client safety and confidentiality remain top priorities.

Chapters

• 00:00 - 03:00: Introduction and Housekeeping The chapter titled 'Introduction and Housekeeping' begins with a warm welcome to a webinar hosted by CA SW. The speaker, located in Calgary on a rainy and cloudy day, expresses gratitude for the attendees joining the session. They express enthusiasm about being indoors on such a day and for the webinar at hand. Furthermore, they praise the webinar presenter and hint at an engaging and relevant topic that resonates with the attendees' current interests or needs.
• 03:00 - 05:00: Presenter Introduction: Heidi Sturgeon The chapter begins with a presenter introduction featuring Heidi Sturgeon. The focus is on understanding the context of social work in relation to telehealth. The host extends a warm welcome to participants, acknowledging both returning and new attendees. A brief overview of the platform's unique features is provided, noting its customizable screen settings which allow users to adjust the display according to their preferences, such as resizing the presenter's faces.
• 05:00 - 06:30: Online Therapy Overview The chapter titled 'Online Therapy Overview' discusses various features and options available for enhancing the user's viewing experience during online therapy sessions. Users can adjust widgets to suit their preferences and needs. The chapter also emphasizes the importance of support and interaction, encouraging users to connect with the team via Twitter or email for any questions or feedback. Additionally, it highlights a resource section that provides access to a peer-to-peer support group, which includes 600 social workers. This group offers a platform for individuals to share their expertise and stories with one another.
• 06:30 - 12:00: Why Online Therapy? This chapter discusses the transition to telehealth and online therapy, highlighting the availability of resources such as a Facebook support group. It addresses common concerns about obtaining certificates of attendance for webinars, noting that they are accessible after viewing 40 minutes of the presentation. The chapter acknowledges potential technical difficulties with accessing the certificate and offers reassurance regarding on-demand availability.
• 12:00 - 18:00: What is Telehealth? This chapter discusses the logistics of attending a live telehealth event. Attendees are informed about the possibility of downloading and reprinting their certificate of attendance 24 hours after the event. The chapter also highlights that attendees can submit questions anonymously throughout the presentation, which will be compiled for a formal Q&A session at the end.
• 18:00 - 26:00: Starting Online Practice The chapter titled 'Starting Online Practice' begins with a discussion on the confidentiality of communication during a webinar or online presentation. The speaker assures the audience that anything they type will only be visible to the hosts unless they specifically request to share it with the audience, and even then, it will remain anonymous. The emphasis is on making the viewing experience enjoyable and addressing all necessary housekeeping notes before proceeding. The chapter then introduces the presentation and the collaboration with the Nova Scotia College of Social Workers, who are co-hosting the event.
• 26:00 - 33:41: Informed Consent The chapter titled 'Informed Consent' involves a collaboration between the Canadian Association of Social Workers and the Nova Scotia College, with emphasis on the background work done by the staff in organizing the webinar. The webinar features Heidi Sturgeon, who completed her master's in clinical social work at the University of Toronto in 1997. Her professional experience includes working with adults, children, adolescents, and families, utilizing a blend of Cognitive Behavioral Therapy (CBT), acceptance, and other therapeutic approaches in her practice.
• 33:41 - 45:30: Privacy Considerations The chapter titled 'Privacy Considerations' delves into the integration of various therapeutic approaches such as commitment therapy, solution-focused therapy, motivational interviewing, narrative therapy, client-centered therapy, and mindfulness. It highlights the opportunity for attendees to engage with an expert who can answer questions throughout the presentation. The expert mentioned has a background with the New Brunswick provincial government, holding leadership roles in the health and education departments. She has received specialized training in leadership, particularly in the Caring Environment Leadership Capabilities Framework, in collaboration with the Ontario College of Health Leaders to ensure excellence in performance.
• 45:30 - 47:00: Liability Insurance The chapter titled "Liability Insurance" discusses Heidi's efforts in leadership training focusing on simplicity designs, process improvement, supervision, coaching, mentoring, and attendance management. Heidi is dedicated to enhancing access to mental health therapy, which inspired her to establish an online mental health private practice in 2016. Her practice prides itself on providing secure and confidential therapy, accessible from clients' homes, offices, or locations of their choice. By 2019, the practice expanded its reach across all of Atlantic Canada, marked as the first online mental health practice in the region.
• 47:00 - 52:50: Screening for Fit The chapter titled 'Screening for Fit' introduces the professional activities and personal interests of Heidi, who balances her time between online practice and seeing clients in Halifax. When not engaged in her work as a social worker, Heidi enjoys activities such as being near the water, reading, and savoring coffee. Alexandra Zanna, the policy and communications coordinator at the Canadian Association of Social Work, is also introduced. Alexandra offers her contact information for those interested in policy or communications within the organization, highlighting accessibility for continuing education resources via Twitter or email.
• 52:50 - 56:00: Emergency Planning The chapter titled 'Emergency Planning' includes a webinar session hosted by CAS, focusing on continuing education. Heidi, the speaker, expresses her gratitude to the host and recounts how she was approached by a college in Nova Scotia to present the topic. Though the subject of working with clients and utilizing technology during the session was new to her, Heidi appreciates the opportunity to collaborate.
• 56:00 - 58:00: Ethical Practice: Different Location In this chapter titled 'Ethical Practice: Different Location', the speaker, a social worker from Nova Scotia, discusses their experience with using telehealth to see clients over the past four years. They express gratitude for the assistance they have received while learning and adapting to this system. The chapter aims to share insights and lessons learned from practicing social work through telehealth, as well as addressing questions about this mode of service delivery.
• 58:00 - 65:00: Lessons Learned and Tips In the chapter 'Lessons Learned and Tips', the author reflects on the experience of social workers transitioning to telehealth services during the pandemic. The author appreciates having the choice and time to adapt to remote counseling, contrasting this with peers who had to swiftly shift to virtual platforms to continue seeing clients. This admiration for colleagues' resilience underpins the lesson that adaptability and rapid adjustment are crucial in times of unexpected change. The chapter highlights both the challenges and the impressive agility displayed by professionals in the field.
• 65:00 - 80:00: Summary and Closing Remarks The chapter highlights the adaptability and efforts of individuals in meeting client needs. The speaker acknowledges the impressive work done by everyone recently. The chapter concludes with the speaker checking on interaction with a poll and engaging with audience responses.

Telehealth & Social Work Practice: Same ethical practice – different locations Transcription

• 00:00 - 00:30 hello everyone and welcome to another webinar with the CA SW we're so happy to have you join us today I am in Calgary and it's rainy and kind of cloudy and it's one of those days where I do feel very happy to be inside and to be doing another webinar we have such a phenomenal webinar presenter with us today and definitely an incredible topic where we're all feeling that need to
• 00:30 - 01:00 start understanding what social work means when we talk about telehealth so welcome wherever you are wherever you're at we're so happy that you've joined us today a couple little housekeeping notes so if you're a veteran at this I know that this might seem a little bit redundant but for anyone who's new we do have a lot of new people just give you a couple little notes about our platform as it's not the same as a lot of other webinar platforms so your entire screen is completely customizable you're able to make our faces bigger you're able to
• 01:00 - 01:30 make the slides bigger you can open some some of the widgets you can close some of the widgets whatever is gonna make it best for your viewing needs we're here to support you please let us know if you have any questions or comments there is the ability to connect with us on Twitter as well as on email please note also in the resource sections the resource widget we have a link to our peer to peer support group so that's a place where you can come together we've got about 600 social workers on that group so you can come together share your expertise share your stories share
• 01:30 - 02:00 your thoughts on this webinar and how you're adjusting to telehealth all of those things you can find on the resource section for today and we will be happy to accept you as a member in our facebook support group as well we always have questions about our certificate of attendance so please know that your certificate of attendance is available after you've viewed about 40 minutes of this presentation it's also always available on demand so if you have some trouble accessing it sometimes the widget will hide behind other screens you may have to get a little bit funky trying to pull it
• 02:00 - 02:30 forward so that you can download it but if you do have any problems with it on the live event you're welcome to login at any time after this event has uploaded usually about 24 hours is kind of good key rule and you can redownload and reprint that certificate of attendance for you again as always we want you to type your questions throughout the presentation I am going to be here moderating Heidi is going to be presenting so I will be able to compile all of your questions for a formal question and answer period at the end all of your questions are anonymous
• 02:30 - 03:00 unless you ask us to push them to the audience which it won't contain your name even if you do that but just so you know whenever you're typing to us as the only people that see it as us unless you ask us to present to life so that should be most of the housekeeping notes do everything you can to make sure that it is a enjoyable viewing experience for you I am going to dive right into now at the presentation and our webinar presenter we are joined by the Nova Scotia College social workers today who is co-hosting
• 03:00 - 03:30 with the Canadian Association of Social Workers to host this webinar so thank you to all the staff time and resources at the Nova Scotia College for helping us put this on they are behind the scenes and we are so grateful for our collaboration with them so today we are joined by heidi sturgeon heidi completed her master's in clinical social work from the university of toronto in 1997 heidi has extensive experience working with adults children adolescents and families her work draws from her training in CBT acceptance and
• 03:30 - 04:00 commitment therapy solution-focused therapy motivational interviewing narrative therapy client centered therapy and mindfulness so any questions on any of those please type them throughout the presentation you have an expert here that can answer them right now so her experience includes working with in New Brunswick provincial government and leadership positions with the department of health and education and during this time she acquired specialized training in Leeds a caring environment leadership capabilities framework with the Ontario College of Health leaders to perform its excellent
• 04:00 - 04:30 leadership training with simplicity designs as well as the training in process improvement supervision coaching mentoring and attendance management Heidi's vision is to improve access to mental health therapy which led her to develop an armed line mental health private practice in 2016 which provides secure and confidential therapy to clients in the comfort of their home office or location of their choice in 2019 her practice extended to all that land to Canada becoming the first online mental health practice in Atlantic in
• 04:30 - 05:00 addition to our online practice hobby continues to see clients in halifax when not working with clients or on her private practice Heidi can be found on or near the water reading or appreciating a good cup of coffee for anyone who doesn't know me my name is Alexandra zanna's I'm the super policy and communications coordinator here at the Canadian Association of Social Work you're always welcome to collect with me any policy or communication since related questions in terms of continuing education you can connect with me on Twitter or by email but Wow are we not
• 05:00 - 05:30 joined by such incredible Center I am so excited Heidi welcome to our CAS w continuing education I'm gonna let you take it away thanks for being here and thank you so much and thank you so much for hosting this webinar when the college and Nova Scotia reached out to me to do this presentation I have to say even though I'm presenting on working with clients and using technology during the webinar it was new to me so I was so appreciative that we could collaborate
• 05:30 - 06:00 and use your system which I hope I'm going to be learning as I go along here but your help is been really appreciated so again I'm in Nova Scotia working as a social worker here and I've been using seeing clients using telehealth for the last four years so today I just want to really have a chance to talk a little bit about that and answer some of your questions hopefully and and share a better what I've learned along the way in doing this so thank you for joining today to hear more about this I also
• 06:00 - 06:30 just wanted to say B you know I've been thinking so much about social workers who have had to move into offering telehealth during the pandemic I had an opportunity to choose to do this and an opportunity to have time to ease into it and and try to figure it out and while I was doing that and I really watched with amazement as so many colleagues and people I know have just had to quickly get online and see their clients and
• 06:30 - 07:00 it's been really impressive to see how everyone's been adapting and and trying to to work to really meet the needs of their clients so hats off to all of you for what you've been doing the last little while it's going to move my so we do have a pull does this show up now on the other end when I do this yes I should be I'm just gonna double-check on the audience oh and people are already responding great so do I let's see how long should
• 07:00 - 07:30 I leave the poll here for everybody the poll is new to me so I just wanted to get to know a little bit about everyone who is curious in terms of how long you may have been doing tell us if you've been doing telehealth before the pandemic I usually so that's about it half the time okay so sixteen and a half percent have been doing tell healthy for the pandemic and eighty three and a half percent No
• 07:30 - 08:00 okay Wow so it's a big it's a learning curve for sure and tiring time during this pandemic to get started with everything okay thank you for answering that I'm just going to go did I miss one here okay thank you guys and just bear with
• 08:00 - 08:30 me as I was learning how to do the poll and the poll results so thank you for sharing that so in terms of the our time together today this is just an overview of what I hope to share with you and to talk about so at first I want to talk about telehealth and online therapy and what it is I want to talk about what do you know what do I need to get started in order to do this work I like to talk about the consent that would be informed consent to to see clients and privacy and ethics want to talk about screening
• 08:30 - 09:00 and with screening it's really about you know what is the fit for the client in terms of accessing and seeing the person online and talk about emergency planning and then I like to end and talk a little bit about some of my lessons learned and trust me there has been there's been a few I've been doing this absolutely I'm still learning and so I wanted to talk a little bit about why online therapy and how I ended up doing this four years ago and it really
• 09:00 - 09:30 started from I you know I worked in government systems for many years for you know 20 years and I had worked I'm originally from New Brunswick I'm from Ann Russia and I shout out to any peeps from New Brunswick that may be online with us today but I worked in New Brunswick for many years and I worked in a machine and I often felt that you know it was difficult at times for clients to access services and there was a lot of barriers to service and when I moved to
• 09:30 - 10:00 Halifax about 6 years ago I started working for the iwk and a part of me as a social worker felt that it would be different for clients to access services in a city in a larger City with more service in it and yes there are differences but there was still some of the same barriers for clients trying to get to appointments and trying to accommodate and just really trying to meet the needs of clients so I decided to go full-time into private practice and in doing that I saw an opportunity
• 10:00 - 10:30 to look at how we could use how we could use video to see clients and what that might be like and just so you know I'm not a big video person I'm not online all the time but I really was starting to notice that a lot of people I knew who had grandparents the worst seeing their children online their grandchildren online and keeping in touch with them and I started thinking about you know how is it that we're not using this technology to really help us
• 10:30 - 11:00 remove some of those barriers for clients and what about the clients who would just find it easier to come into the office or you know just to see you online so I started thinking about a bit more about that and again going back to my experiences living in a smaller community in New Brunswick and I was thinking about confidentiality especially confidentiality as a healthcare professional that at times you know it could be hard access services because we as a therapist if we need to see a therapist we probably work
• 11:00 - 11:30 with those people and they're our colleagues and so there's some limits to confidentiality and accessing services and in that regard there's the part the convenience you know the time it takes when where everyone's working and busy to to get to appointments thinking about childcare and all of that there's the you know being comfortable in terms of going to an office appointment you know for some people there's a lot of fears about coming into the office and somebody seeing them or what that might
• 11:30 - 12:00 feel like or their their anxiety about that and and then you know just thinking about how online therapy allows us the opportunity to really be client focused and thinking about meeting the client where they're at in their location so those are some of the reasons that kind of led me to doing online therapy and I have to say when I first started doing it I had a lot of fear and I remember the first client I saw was in July of 2016 and I
• 12:00 - 12:30 was literally I I was scared to even tell people that I was going to see people online because it seemed and you know I didn't really know anyone that was doing that so it seemed quite unusual that I would be starting out seeing clients online and and I didn't have a system to use and I couldn't really find a system at that time that I felt I should be using so the first client I saw I was using Skype and it was like I said in July of 2016 and I
• 12:30 - 13:00 was really nervous and I wasn't sure if I was going to like it or not or how it was going to be but from the first client on I have really you know like seeing clients online but it's been a learning but I did have a lot of fear about it and but that was so just going on over here just to think about you know what is telehealth and what is when we're seeing clients online it's also referred to as telehealth so it's really you know we're providing mental health services or
• 13:00 - 13:30 health services and the provider that would be us as a social worker and the recipient the client of the service are in different locations so we're no longer in the same location when we're working with the client and the service is delivered over electronic means and you know it seems even though it seems that it's really new to be offering telehealth and doing online therapy I was thinking a lot about some of the other services that have not been
• 13:30 - 14:00 offered on location with clients and I was thinking about crisis phone lines and when I went back and did a little bit of history on that you know we've actually been seeing clients electronically with telephones for over 60 years it's actually close to 70 years that we've been you know offering services to clients by telephone which is often crisis services and the first crisis line was actually started in 1953 in the UK so I was thinking you know
• 14:00 - 14:30 about this and how you know as I was starting online I had so many fears and worries about privacy and confidentiality and all of the things that I was that I'm worried about and been concerned about and tried to put in place to ensure for those things and I was thinking about you know what we've been doing telephone crisis work since for almost 70 years and you know my age will speak to this but I grew up at a time when we had one telephone in her house and it was in the kitchen and you had to like you know if someone was on
• 14:30 - 15:00 and you had to pretty much go underneath the court to get by so everyone heard all your conversations so I was thinking about you know people were offering crisis services to clients using telehealth for all these years and you know it's been a really valuable services service and now we get to move online and offer it in an even more private way for people and so again about telehealth and offering
• 15:00 - 15:30 the sessions online how I think about it is it's really there can be supervised sites and unsupervised sites so when I say on supervised I mean that I'm working in one location and my client is in another location so they're either in their home or their office or their car or wherever they may be to access their video so that we can communicate together now there could also be supervised sites for
• 15:30 - 16:00 telehealth that's not what my experience is in but there may be some of you on this webinar who are doing something like that so a supervised site you know an example of that would be perhaps if you had a client that was incarcerated and perhaps you went to the facility to meet with that client it was on site but because of the pandemic perhaps you know you're seeing them by video or maybe they're not able to to meet there so there's you could be on site meeting with someone by video and there's support there for that individual if an
• 16:00 - 16:30 emergency were to happen that would be supervised but the work that I do I'm in my home office my clients are in there you know home or car wherever they might be and the client isn't supervised by anyone else during the session there's no one else on site for support unless there's a family member that I know of ok so just a little bit of information about that so that's kind of a little bit about the
• 16:30 - 17:00 online therapy and a little bit about getting started and you know after we've DC you know once you decide to start doing online therapy and I know that right now a lot of people you know are probably in situations where they need to start offering online therapy because of the pandemic so it really you know getting started we have to think about what we need to offer the service to the client and the things that we need for online therapy are the things that are really important are things that
• 17:00 - 17:30 sometimes some of us may not think about as much because it's technology so we need to have hardware and software and so the hardware would be starting off with we need to have a good internet connection and that has to be an internet connection for you as a therapist or as a social worker and also for your client needs to have access to an internet connection so you can check with them to see if they're able - you
• 17:30 - 18:00 know do they watch Netflix can they stream movies and they can kind of check and see and you can check your you can check your home internet connection just by googling internet speed test and you can check the speed of your internet to kind of know what what it is and that can be really helpful and you also need to have watch knowing you have a good internet connection you have to have a good working computer so you're going to want a computer that you know can upload and download quickly
• 18:00 - 18:30 that has most likely you're going to want a computer with a good quality camera if your computer doesn't have a good camera you can purchase an HD camera like a webcam little camera to put on your your laptop or your computer so that's another option but you definitely want to have a good camera for the video um with me when you're working online with clients you're going to want to think about the internet connection that you
• 18:30 - 19:00 have so you're going to want to make sure that all your other programs are closed down on your laptop or your computer before you start seeing clients you know if you have children or a lot of people living in your home you may want to ask them not to be streaming things not to be using a lot of excess Wi-Fi and Internet while you're online with your clients to ensure that your computer is working well you're gonna want to have headphones you a lot of people like to have a mic I use the headphones and I don't use them I have
• 19:00 - 19:30 not used to mic with it I find my headphones are fine and the audio with my laptop works well a lot of people prefer to have headphones with a mic and so there's different options that you can purchase for that but I do find as much I really like using the headphones and you're going to want to ensure you have good lighting and the lighting is really important because you want to know that you can see you want the clients to be able to see you well and you also want
• 19:30 - 20:00 to be able to see your clients well so if we have a lot of overhead lighting you might notice behind me the light on my ceiling I'm not sure if you can see that or not I never have that on when I'm in session with clients because if I do it will cast a lot of light on me and a lot of shadows so the clients wouldn't be able to see my to see my face and if you have a window in your office you're going to want to have it sitting so that your desk is facing the window you don't
• 20:00 - 20:30 want the window behind you because you don't want all that light coming in on you as well that will make it harder for the clients to see you and there are some different and things that you can get for lighting there's something called a ring light and you can just Google ring light and for telehealth and they're on Amazon they range in price from probably fifty to one hundred and fifty dollars and I haven't used I don't have one and but a lot of people really like them they have you can get if you
• 20:30 - 21:00 do get one you can get one with a dimmer on it so these are kind of gadgets you can you can have things that you can get if you find that your space isn't conducive with lighting there's things that you can do to improve that just like with your internet there's things that you can do or with your camera there's there's things that you can get for that and so you really need to start oh sorry hello
• 21:00 - 21:30 we can hear you sorry I think there was maybe just a little bit of feedback there not sure what happened but you're gonna okay okay so you'll want to ensure that you know you'll want to make sure you have a good your internet speed a good working computer your headphones your lighting you want to have a distraction-free background so some things you might want to think about if you're just setting up your home office what is behind you you
• 21:30 - 22:00 know some people may have to set up their home office in their bedroom because of space so if you're meeting with clients online you're gonna want to ensure that they're not seeing your bed in the background or maybe seeing a whole bunch of other things in the background that might be personal or a lot of photos or or things that you may not be comfortable sharing so just thinking about what they're seeing and the background is really important as well and you want to think about the noise level in your space and this this is
• 22:00 - 22:30 very important and I'll share an experience that happened that just recently I have a client I was working with I've been seeing her for quite some time and when the pandemic happened my partner started having to work from home as well he works in another room and we have a plan he's supposed to be in a room with the his door shut and I have a noise machine but I was having a session one night and my client hurts a man's voice and so I had to get up from the session and go close the door to his
• 22:30 - 23:00 office because it had been left open and she could hear that voice no it worked out okay because I do have a relationship with the client I apologized and we were able to kind of pick up where we left off but if that had have been a new client or someone it might have been really it could have been even more concerning for her to hear someone's voice and so just to be really conscious about that you know I try to be and and things do happen but you know we can keep going with it but it's important to you know just thinking
• 23:00 - 23:30 about that how the clients can hear you know what's happening in our home whether it's dogs barking or children or our partners and just wanting to keep that annoys level down so that the clients are feeling comfortable again with the confidentiality being kept and the other part around you know setting up your your stage and getting ready to see clients online is you really is the camera so I am sitting now at my laptop
• 23:30 - 24:00 and I have my laptop of raised up a bed it's sitting on something and you really need to adjust this for your own hype and your eye level my webcam I try to I'm not staring directly at the camera my gaze is just down a bit and that usually works fine what you can do so it's important to think about that if you're staring directly at the client sometimes you may not be looking at them so if you're not sure you can always
• 24:00 - 24:30 check clients you know just check in and and see you know asked him if it feels like there that you're you're looking at them because you can adjust your your camera or your laptop or your computer to accommodate for that and that is really important so thinking about the adjusting that trying to have your gaze just below where the webcam is on your computer or your laptop so that you're just looking a little bit under that and other things in terms of getting ready for your sessions you know you want to
• 24:30 - 25:00 be ready a few minutes ahead of time and for a lot of clients starting to see people online and the technology is there for them so especially when it's new clients and they you know they really appreciate it when we show up and we're ready kind of when when they get logged into the session so they're not waiting if they if it ever happens that they show up ahead of me I often find that they feel that maybe they missed a link or you know they did something wrong so it's really important to kind of try to be there before they are if
• 25:00 - 25:30 that's if that's possible and the other thing for all of you that are just transitioning to online practice is test test and test and what I mean by that is get a friend a family member anybody somebody in your life a colleague who is willing to help test do some test calls with you check it out play around with your camera and your lighting and it will really help you to feel more confident and with the sessions that you're having and the more we feel
• 25:30 - 26:00 confident with offering the sessions online our clients really start to notice that too and it puts some ID so just keep testing and testing and testing and do the test calls and you can n do the test calls at different times of the day so that you can adjust for your lighting according to what's coming in and for daylight and things like that and you'll find that that's really helpful and it'll help you to feel more confident with the sessions and so we talked about the hardware and some of this set up at the end of things is
• 26:00 - 26:30 around the platforms I get a lot of questions about this and this information on this slide was actually provided by Alex Trafford who's our executive director and register here in viscacha at our college and he shared this information it's also in a blog post that came out yesterday I believe with the college but this is information that he just really wanted to ensure came across during our presentation I won't read the whole slide to you but the
• 26:30 - 27:00 information is there and but you know something that I would stress and he was in the college with stress as well is it to consider whether you're using a secure internet connection not that not public or free Wi-Fi so you want to be on a secure connection which most likely if you're in your home you would be when you're doing that but just thinking about that and the other part that's really important around the security is just having passwords protected for your
• 27:00 - 27:30 and when you're logging into whatever platform you might use that that it's only you that can have access to that so that's really important I'm part of that so that's some information we're going to talk more about the the platform's actually I will talk a little bit more about the the privacy around past passwords later on in the presentation so in terms of thinking about what you need so now you're going to see clients online you've kind of made the decision and so we know we talked about the hardware
• 27:30 - 28:00 and some of the software so the next piece is around practice management and I would say this is probably a part that I get the most questions about from other social workers and therapists and the practice management is really how do I see my clients what do I do what system should I use with what works best what's okay and and what I really say with the practice management is to think about it think about what your needs are because what I what I'm using may not be the right platform for you because what
• 28:00 - 28:30 I'm using right now is based on what I need to run a private practice and depending on where you're at that may not be what your needs are so if you think about if you want to see your clients by video and that's really the main thing you want to do and perhaps you work somewhere else and you have everything you have all your forms and your files and you have a way to have everything set up except the video and you just want to add the video onto your practice and there's some options in the
• 28:30 - 29:00 first column of this slide better for video so doc C is offers free video you can sign up for it they also have paid versions what I would encourage you to do I think the paid one is around $35 a month and there's different opinions on doxy whether people like it or don't like it but it is very widely used and again I think because it is free it's an easy option it's really easy for the
• 29:00 - 29:30 clients to connect with doxy sometimes people feel the video quality isn't as great as they would like it to be and with the pandemic there were so many people logging in at once that there seemed to be some problems with that but I'm hearing that that's kind of getting worked out again so again I don't use I don't use it I have tried it but I think if you're looking for an option for video it's definitely an option worth worth trying and it's also it's also free PC is another option that's free
• 29:30 - 30:00 and is available for video only so again if you're just looking for a way to see your clients by video that has some security around it these are these are options the next one is zoom no zoom is we've been hearing there's been a lot of talk about zoom lately there's different versions of zoom and there is a paid version of zoom which is zoom for healthcare now that cost around 200 dollars a month but you can have up to
• 30:00 - 30:30 10 different therapists using that paid version of zoom which is around like I said $200 a month for the video and it does work really well the thing that's great was zoom is that most people are familiar with it and a lot of clients are using zoom in their workplaces right now so they're finding or they're using zoom to see family members so it's becoming a name that people know so you know they they're familiar with it so
• 30:30 - 31:00 zoom for health care does have more privacy require then the free version does not meet privacy but it's an option for people to choose absolutely by the zoom for health care and would be the one that is more private and secure for healthcare and but it does cost around two hundred dollars a month but up to ten people can be on that plan then there's metió metió is actually a system I used to use and it's a competent video is was developed in BC and it was
• 31:00 - 31:30 developed by physicians for physicians so it's very much a healthcare system it didn't I'd the reason I moved away from IDEO is it didn't offer all of the things that I needed to manage my practice but the video did work with me do and I can't remember how much it was because it's about three years ago now that I used it but it was definitely reasonable at the time Microsoft teams also has a video option G suite has video option I have not used either one
• 31:30 - 32:00 of them so I can't comment on them but they're definitely ones that you could look into if you're looking for video and then there's Skype for business I have used site before but I haven't used it in a while and I hear they've done some upgrades and the video is a little bit better but again I haven't used in a little while but these are things it's really important to kind of test some out and see what's gonna work well for you so again thinking what do you need if you just need video those are all options you could explore for video only
• 32:00 - 32:30 if you need video and you also need email and you want to have secure email these are just some hush mail is a Canadian company that does offer a secure and private email option so that would be something to consider if you're looking for a secure email to use again I haven't used hush mail but I hear good things about it and do sweet and pronto mail are just another couple of options for email that you could you could explore the last column here is where we have
• 32:30 - 33:00 video and we also have a practice management system so when I say practice management system I'm really talking about how you run your your practice in your office so for example a practice management system allows will allow you to do you know all of the other sorry all of the other options in terms of running your office so when I think about seeing my clients online it's very much an office is how I I look at the system I have I'm using on-call um I
• 33:00 - 33:30 have you see other systems on here as well news talk and Jane and with is also speak about on-call because that's the one that I've been using for the last few years and it allows me to process the payments for clients it allows me to you know the receipts are sent to clients that's all automated the clients can sign their consent that can be up you know online everything's everything's automated for the clients and it's a very it's a secure system
• 33:30 - 34:00 because I have my own private log in to go into the system and every client has to have a login and password to go into their side of the system I can share clients you know documents and things like that with them in that secure system so and it's also a Canadian company so it adheres to Canadian privacy laws so those are some of the things that I like about it and again it's really I've tried a few times in the list it's really unique it's the thing it's about testing out and
• 34:00 - 34:30 thinking about what your needs are News Talk is another platform that offers all of those similar things in on call offers and is also a Canadian company and Jane is a really great practice management system when I was using Jane in the past they didn't have video as an option which is why I didn't stay with it because for me having one system was really important because I'm not and the technology is not my not my favorite part so I wanted things to be a
• 34:30 - 35:00 streamlined for me as possible Jane has just adopted now they do have videos and I think that just started since the pandemic so I haven't tried that but I've heard that they do have that video as an optional so these are systems that again you're looking for how to run basically manage your practice you know schedule your clients if you're kind of looking for how to move and you do everything these are the options where it's a practice management system okay and
• 35:00 - 35:30 so we talked a little bit about just Gloria so you have your starting with your hardware and software right from getting your laptop and your headphones and then you're thinking about what system do you need practice you need a video or do you just video and email or do a whole practice management system and then once you have those things then it's time to think about informed consent so I just sharing the definition for informed consent which I actually borrowed from here are taken from the CI
• 35:30 - 36:00 SW definition and I shared a link to their guidelines for ethical practice there as well just to in terms of around informed consent so in the voluntary agreement reached by a capable client based on information about foreseeable risk and benefits associated with the agreement participation in counseling or agreement to disclose a Social Work report to a third party so with informed consent for any of you who are transitioning from your office
• 36:00 - 36:30 to online you would need to have adapt your current the consent that you were using to include telehealth services because we would want to have the clients consent to also known to telehealth services if that's new and I also just shared a link here for the national standards for Social Work they have some information on Social Work and telehealth practice that I thought might be of interest as well so if you're thinking about adapting your consent
• 36:30 - 37:00 form to see clients online used to be some things that you might want to consider including in that consent so talking about what are the risk and benefits of online therapy you know she's talking about that in your informed consent and how often are how does online therapy work you might want to share you know how does a client what is the system that you're going to use like are they going to have to download something or do they just get a link the email and click on it you know so how does it actually work so you may
• 37:00 - 37:30 want to share that in the consent how to set up the technology for the session and so in our office practice if we're a meeting with a new client we would be covering confidentiality and the limits of confidentiality so we're so going to do that with online client but we're also going to talk about you know cover any any limits and confidentiality for online therapy practice so for example I often talk to my clients even though I
• 37:30 - 38:00 have it in a consent when I meet with them for that first appointment and review confidentiality now I'll talk to them also about you know where are you and you where are you having your session does it feel private for you are you comfortable talking and start talking about that as well as the importance of using them you know what where are they having their session is it on their phone or on their laptop does anyone else have access to that you know if they're downloading an app to me with me and maybe they don't want anyone else to know they're seeing a therapist
• 38:00 - 38:30 then that's important to kind of I have that conversation with the clients to help explore that with them and to kind of get them thinking about that and I I also in my consent that you might want to consider I have a consent around social media policy and social contacts in terms of what clients because I have some social media sites so I talked about that in my consent as well as the rates the billing the payment how that works and then policies about how to
• 38:30 - 39:00 contact me so these are just some ideas of things that you may want to consider in your consent although talking about the risks and benefits of online therapy and confidentiality are obviously extremely important so I kind of already covered this I was just saying about the you know brain story with the clients where they're going to have their session are they going to feel comfortable with them with where they're talking with me and you
• 39:00 - 39:30 know and in brainstorming with them you know sometimes it's even brainstorming around the time of their session have some parents that I work with and they choose to have their appointment when their child is napping if it's a you know an infant baby or a theory on child it's still nap so I'll kind of schedule with me around those times I've met with parents when the children have gone to to bed in the evening I you know have clients who sit in their car to have their appointment I have clients who
• 39:30 - 40:00 choose to have their you know pre-pandemic they would have it you know go to a board room in their place of work and they felt that was a private place for them rather than being at home so really you know and the more you brainstorm with clients around it they'll come up with some thoughts on where they where they're going to feel comfortable for their session and you know so it's just helpful to kind of open that off and talk about them and to help them think about where that might be so we'll move into privacy and
• 40:00 - 40:30 privacy is a big topic and but we'll touch on a few slides here with privacy a Pepita which is the personal information protection and electronic documents Act and is a Canadian federal privacy legislation that governs how your person how our personal information is collected used and stored and and then there's Kia which is a personal health information act for Nova Scotia
• 40:30 - 41:00 and each province would have some different a different act around this and I'm just speaking to the I've just mentioned the one for another Scotia because I'm presenting in Nova Scotia for all of our other colleagues that may not be another Scotia I don't want to leave anyone out but at this kind of and the PIA recognizes both the right of individuals to protect their personal health information and the need for social workers as health custodians to manage a client's personal health information while providing support and
• 41:00 - 41:30 managing the clients care and well-being so as social workers we are considered we are health custodians of client information according to to this act so when we think about privacy and trying to protect the privacy of clients in an electronic world we have to think that there you know with technology there is always a risk of a potential security breach with any electronic communication over the internet or phone the web and phone are not going to be
• 41:30 - 42:00 100% secure so we really have to think about that in terms of that protection piece as much as possible knowing that there's always a risk for a security breach and so some of the things that we can do to help clients protect their privacy as we can we can do this and we can also encourage clients to do it to maintain updated antivirus protection on your computer you can ensure your computer and phone are password
• 42:00 - 42:30 protected with strong passwords and again I mentioned this earlier but only use clients might want to only use their device for the therapy session and not save the login information they might want to log in each time rather than having their computer or phone save that data if they want to ensure other people can access it so it's kind of like our phones are their phones if people are texting or emailing you know anything like that with their
• 42:30 - 43:00 clients and your and your phone isn't password protected then anyone can really pick that up or log in and see that information so that privacy you know thinking about that goes both ways and this is another question that gets asked a you know gets on asked a lot and I'm definitely not an expert on this I really encourage people to to seek a legal opinion on it or or contact our the Privacy Commissioner for information
• 43:00 - 43:30 but my understanding so it's around can they can client data be stored on a server outside Canada so when I first started online practice a lot of the programs I wanted to use for HIPAA compliant which meant they meant privacy laws for us not Canada we have a lot more options in Canada now thankfully with the practice management systems have really over the last few years more options so for me you know I think keeping our data on Canadian server it
• 43:30 - 44:00 simplifies things rather than following provincial federal and then international laws we can just adhere to Canadian and provincial privacy laws for data security and then knowing Canadian cloud providers have the best knowledge of the country's privacy laws so they are in the best position to securely store data from public and private companies so we think about where that so again the company that I use is a Canadian company so they're meeting Canadian privacy laws there's a lot of
• 44:00 - 44:30 practice management systems that are based out of the US so they're going to follow follow on privacy laws for us and some you know there could be a debate you know some people feel that comfortable using that so again I think it's everyone has to make their decision for me I really like the fact that I'm with a Canadian company and that is Canadian privacy law and I'm not thinking about anything else my terms and my consent and all of that when I
• 44:30 - 45:00 share that with clients I let them know where the data is stored and I feel more confident with it but that's kind of in my learning as I go along with that but it's definitely important to kind of consider that as you're thinking about the systems that you're going to use and just going to move in to touch on liability insurance and this is a slide that was provided by Alex Trafford again who is our executive director and register at the Nova Scotia College of
• 45:00 - 45:30 Social Work and just touching on the importance of in private practice we need to have liability insurance and so which we really need to check with our insurance provider to ensure that that also covers for and seeing clients online and I do know that the insurance that is offered through BMS with the SE SW insurance plan that they have with VMs offers options for this and has for the last you know definitely for the last four years that I've been getting the liability insurance through them and
• 45:30 - 46:00 they're always able to answer questions about online and it's really good to check that out and to if you're moving to online practice and you're in private practice to ensure you how that part as well sorry Heidi I'm just gonna be insurance for anyone I was looking for more understanding of what our if you are a member of BMS with the CAS W and you're looking for information from this host a webinar that you can find on our way
• 46:00 - 46:30 with BMS on the current state of what your liability looks like a mist coated okay as Heidi mentioned they love to respond to emails with them if you have any questions please them they're happy respond but it did want to just a quick refresher we do have a webinar on what the current current state of ability is with the with BMS V we co-hosted so yeah great thank you yeah I have found
• 46:30 - 47:00 they've been really helpful and answering questions in the past and yeah it's been great okay so I'll leave this slide there for you to kind of read through and there's some links as well to some articles that they have so I'm going to move right along to we've kind of talked about you know touched on kind of from getting your laptop set up to then thinking about your platform and the the privacy piece the informed consent with the client so
• 47:00 - 47:30 the next part I really want to talk about is screening for fit so how do I decide who to see online and you know it's probably different for who I'm gonna see that for who some of you may see in terms of where your you're working at right now and but so in my own experience what I do is I talk to all of the clients before I schedule them for their first appointment and that allows me a couple of things allows me to screen to see what if I if I may
• 47:30 - 48:00 have the competencies to meet their needs at this time I have other associates who work with me so if I don't I could possibly refer them to one of the associates so I really want to kind of you know connect with the clients before they broke their first appointment and and I'm kind of somewhere talk I'm during that screen I'm talking to them to find out a bit about and you know what's our experience how do they feel about having their session on video and you know it's interesting even as I say this because so much has shifted since the post
• 48:00 - 48:30 pandemic as opposed to prepend make you know in terms of now everyone's you know a lot of times now I hear people say well I'm actually using zoom for my work calls or you know I'm helping my children do their homework and they're on they're on calls video calls so it's things have shifted a lot in the last six weeks for sure but prior to that you know I was talking to people to find out what their experience is like have they ever been on a video call and they use Skype or FaceTime and how do you get a sense for that I'm asking them their age
• 48:30 - 49:00 that's important for me to kind of know what their age is for me that's important I don't see clients online under 8 under you know age 18 right now so I kind of want to get a sense for that the other thing that's really important that I asked them I'm shortly after I I started to call with them is where are they located and that's really important because if they're outside of Nova Scotia then I need to know whether or not I'm regulated to practice the social work in
• 49:00 - 49:30 another province and and I am registered unable to practice and social work and other provinces but that's taken some time to get to to get to there and so I want to know that's part of my screening is it because if they're in a province that I'm not I'm registered in or not able to provide social work by electronic means and that's going to screen them out right away um I also during the screening once I get to know you know that I'm moving towards scheduling with them I do explore if there's any past or current a suicide
• 49:30 - 50:00 ideation because I do want to know that before I start I'm seeing them online and because if if they are risk for suicide and if I am going to see them I'm going to want to start doing a bit more emergency management planning of rate from that screening call that doesn't happen often but I do like to kind of have a sense of that from from that initial contact with them um and then I you know I just go over with them during the screening call I talk to them about what they will need for video
• 50:00 - 50:30 space I talked to them about like having distraction free time I added some things into a screening I'm smiling a little bit as I say this because it's been interesting things that show up in terms of where clients may um have felt they could have their their sessions and I guess now I so now I try to have the conversation ahead of time so one thing that started happening in the beginning is sometimes clients would um you know a couple times clients were driving and I
• 50:30 - 51:00 think I even have it in my consent now where I start I meant to if I didn't but so I can't have a session with someone when they're driving because you know they could be distracted and what if they had an accident and then what would be the liability for me so there's all kinds of thoughts around that so I asked them to if they've ever you know when that did happen I asked them to pull over and once they weren't able to so I just said you know what let's just reschedule I feel better and you know so that was in the beginning I that's one of my lessons learned was talking about that I've had clients who want to go for
• 51:00 - 51:30 walks while we're talking and I find that really distracting because the video is moving and it's almost a little bit nauseous you know watching the trees go by so you know I asked for them to be in a space that's distraction free but also where they can sit for the session um so just some things that I would be looking for here's a little bit more in the next slide around registration are there jurisdictions and this information was again provided by Alex Stratford with the Nova Scotia College of Social Work
• 51:30 - 52:00 and just speaks to the importance of understanding the regulatory requirements outside your jurisdiction so to me this is really important again just for that screening for fit that we need to know it's each of us have that responsibility to kind of know what's expected or what the regulations would be if we if we're going to try to see a client that's not in the province that were regulated in for any social workers on this call who are outside of Nova Scotia it would be similar social
• 52:00 - 52:30 workers from outside Nova Scotia must prove to the Nova Scotia College of social worker that they meet specific criteria if they want to engage in telepractice with clients in Nova Scotia so it's time's going both both ways and in just in terms of the registration in other jurisdictions this is a slide to share with you for any of you who are wondering how it works and other provinces or what they may have for information there see all the contact information that you can you can look
• 52:30 - 53:00 into it if you do have a client that moves and you need to follow up just to find out about that the information is there this is a piece that I've really noticed a big shift in over the last four years in terms of the information that's available for social workers and understanding the process that goes with this it's really on I've seen a lot of a lot of change and it's really moved forward which was really great to see okay and it's every time so I'm gonna try to quickly get into emergency planning here
• 53:00 - 53:30 so emergence how we are planning right it's an emergency and it feels quick when we're doing it and so in terms of we often think about emergency planning and what would I do if I was in a session and that happened and you know I think it's kind of thinking of it we're still showing up you know as social workers doing our work and we're just going to the clients just in a different location so same as if they were coming in and we might be meeting with them and we feel they could be at risk we want to
• 53:30 - 54:00 have a plan and have a safety plan in place and a plan with them so the most important thing that I can say for this and it's been a learning app solutely to be really aware this that always have the clients phone number and their location address in front of you and the reason I say in front of you is because for anyone who uses I use an electronic health record so everything's on my computer so if I'm on the video with the
• 54:00 - 54:30 client and they were in crisis I don't want to have to try to get into the electronic system to get the phone number and address I'm gonna want that in front of me so if you and the other part you can ask clients is you can ask them at the beginning of the session what their address is if you feel they're a client that kind of is a bit more transient or moving around a lot to really know where that address is if you were if they did need emergency services you need to know the address and you
• 54:30 - 55:00 need to have a phone number so it's really really important to have that and to have it in front of you because you're not going to want to go through your computer to get that information or also if there was ever a technology failure let's say the power goes out or you're you know browser decided to update itself anything happens you know you just want to have it in front of you and that's gonna be more helpful and if you're working with clients who are online and you feel they're at risk for their safety and their home because of
• 55:00 - 55:30 violence and you know that that perhaps is a client group that you work with often you might want to have a safe word that you and the client kind of established so it's part of your emergency plan so you know that that's a if they if that's a word that's safe for them you know to let you know that they're in trouble might be something that you want to arrange with the client so I put this on here ethical practice different location and you know I just linked a hassle links here to informed
• 55:30 - 56:00 consent and privacy and this is really just done summarizing and some of the links that I've been sharing but I just wanted to say the ethical practice different location the reason I look at it this way or call the presentation this this title was really I was thinking about the work that we do as social workers you know I was over in my years as a social worker I've seen clients and many locations from coffee shops to courthouses to home visits to
• 56:00 - 56:30 offices and correctional facilities I've been in many many locations with clients and at all of those times you know is my responsibility to show up and to be there with the client in the location that they were at at that time and try and help them meet their needs and I try to look at online therapy as another way it's just another location it's not a different form of therapy is just meeting the client and they're in a different location and it's really their
• 56:30 - 57:00 location and it gives us of where they're at as well so I really wanted to just kind of that's important to me just kind of thinking of it as not another mode it's really about showing off and seeing them in their location so I just want to some of the things I have learned I probably wrote ten at least ten slides or more and as I learned I'm still learning a lot okay one of the things I learned was about
• 57:00 - 57:30 the distant abyssion effect which was a concept that was named by a cyber psychologist researcher John Sewell err in 2004 I believe it was the years and there was that those experiencing online exists in addition effect may loosen up or feel more uninhibited express themselves more openly and this is so true there's something that happens online it definitely clients may start to you know clients and therapists could both start to feel a bit more relaxed
• 57:30 - 58:00 because they're in their own environment perhaps because of the video and there can be some benefits to that and it can also be distracting so it's really important to be aware of that in terms of even how we show up for for the therapy session to still get ready and you know notice our posture and how we're sitting in our office space and what we're showing to clients is really important and for us to not be distracted during session because we're watching people on screen you know we
• 58:00 - 58:30 want to have our notifications and things turned off because if they're on we're naturally going to look at them when they pop up and clients may seem more relaxed as well and they might show up in their bathrobe or their hair in a towel and you know you have to think about how do you have those conversations around around that when that happens and kind of the ethics around some of this so it you know people can feel more relaxed and there are again it can be a benefit and a distraction so just to be aware of that
• 58:30 - 59:00 because it will happen and people may feel less nervous so they may start to open up a little bit more I'm quickly with video and the other part I've learned is to really Norma what's happening you know sometimes life happens you know someone might have set aside a private space and then their child walks in and they might feel a little bit nervous maybe they don't have a relationship with you yet so just kind of things like normalizing not asking but they want to introduce their child if they want to or you know sometimes
• 59:00 - 59:30 their dog is barking and they might feel a bit embarrassed about that and so just kind of normalizing those things a bit has been really you know that you know we're in their environment and they're also in our environment and just showing up with our clients and you know and just really just just being there like treat you know showing up the same way we do in our offices for them having a sense of humor when things go wrong and things will go wrong technology happens
• 59:30 - 60:00 problems arise and we need to think on our feet and manage that so you know having a sense of humor when that happens is really helpful and kind of can put both ourselves and the client at ease and yeah just really knowing the hardware and softens we're using is really important and something I didn't mentioned earlier but that was really important to me in choosing a platform was having tech support and that was
• 60:00 - 60:30 something I felt I needed because and yeah technology is not my thing and I'm doing an online business so having tech support was another factor for me so just to kind of throw that out there that that can sometimes be a factor that was another lesson learned that tech support is important and other lessons learned and yeah so if clients are not if I feel their lighting isn't okay or I can't see you then well I just asked them to rearrange put a blind down and you know
• 60:30 - 61:00 things like that and they're they're really comfortable with that and I ask them if they can see me well and just kind of have a you know informally check in with that with them and that goes well again I mentioned having their phone number and things written down and something I learned that I really have loved that online therapy is especially my office clients have came to online is how often people talk to me about their pets and then meeting them on seeing them
• 61:00 - 61:30 online after meeting them in the office they would be so excited for me to get to meet this pet that they had shared or talked about in session and and now you just naturally get to meet to meet all the pets so that's been really you know that's a really something I love about online therapy the I fatigue is real so definitely take breaks try not to book people back-to-back I still do that sometimes and then I remember that it's good to take breaks and kind of move my
• 61:30 - 62:00 body between sessions um I actually have I don't know if you can see it or not but I now have my yoga mat on the floor in my office and I have a foam roller so I would have to actually like walk over the yoga mat to get out of my office so it's a very good reminder that it's really important for me to stretch and do do some of those things because I do get really stiff sitting for long hours maybe something with age I'm not sure but but it's helpful to just have my yoga mat right behind me on the floor
• 62:00 - 62:30 and and the other thing I have learned and this is probably and having a private practice having my own business and doing having a company that's online with technology when technology is scary and intimidating for me at times is I've really learned to ask for help and that hasn't always been easy but I even asked for help today in terms of my slides because when I was asked to do this presentation the first thing I thought about was when will I get time to make a PowerPoint presentation and so I have a
• 62:30 - 63:00 good friend who is a graphic designer Sarah Hart and she actually put my slides together for me I did the information but she you know made them them look presentable like this and did a great job so so asking for help has been a big lesson for me that I have learned and I'm I feel like I better check in because I'm over my time it can we go in about ten minutes after our platform allows so don't feel too too rushed well
• 63:00 - 63:30 I'll just quickly summarize because this is just this is just a checklist that is here that basically kind of summarizes some of the things I've touched on and you could think of it like a checklist for things that if you're starting to do see clients online some of the things that I've already talked about but they're just kind of summarized into questions you could ask yourself and for that so it's just a couple of pages the
• 63:30 - 64:00 first one is questions and the second one is just checking in in terms of you know what do you want to do for paperwork and what about you're filing an email and phone and space and all of the things that are important in terms of having your practice online so there's kind of two slides there that are really I won't go through because it's what we've touched on but you could use it as a checklist for your own practice in terms of trying to think about the pieces that are important for you and starting to do this work and the
• 64:00 - 64:30 last slide is just a link with some some of the resources in terms of the privacy and standards and informed consent so the links are there for all of that and I did put the link for Sarah Hart because she is the person who did my slides and I really appreciated that and her link is there she helps people with courses and graphics and all of us all of those things that are important in our work yeah and it's 503 and yeah I feel like
• 64:30 - 65:00 that was a marathon so much content in like 50 minutes of content and I wanted to like stop and ask questions and I just kept on going so totally well that's you know that's tends to be the format of our our webinars so I had a lot of people asking about informed
• 65:00 - 65:30 consent and links to that so please take a look at this final slide for anyone who is wanting the slides after the presentation they are in your resource sections so they are in the resource widget in the bottom of your of your screen okay so I have a couple really great questions I would love for you to be able to answer if we have a little bit of time and I'm now I'm thinking about the light behind me and all these all these incredible things I'm like
• 65:30 - 66:00 okay some of the questions are how do you approach one of the really good questions I thought we you should bring out just because of the increased rates of domestic violence as well as you know Lucian is how do you approach suicidality and screaming sessions yeah yeah yeah you know it's I just do it as part of the call it's basically people
• 66:00 - 66:30 um booked in most people booked like a 20-minute consoles I say 20 minutes on my website but it depends and the person how long it is but I just say it's 20 minutes and I just check in with them around I'll just let them know I'm asking them you know I'd like to know a little bit about what your goals are in coming to therapy and and do you have any previous experience of therapy and you know usually as I asked a few questions I get a sense of you know what's been
• 66:30 - 67:00 happening and then I usually just let them know um you know because I'm going to be seeing you online or I'm going to be assigning it to another therapist is going to be seeing you online and you know I really like to have a sense ahead of time if there's any if you have any concerns about suicide if you've ever had any history of suicide ideation or been hospitalized for that and and just kind of bringing about as a way that you know because I'll be working with you online I like to know that kind of upfront so we can have whatever resources an emergency
• 67:00 - 67:30 management plan in place I have to say when I first started asking people I felt a little in that screening I felt a bit uncomfortable because I was I felt perhaps it could be intrusive at that point to ask but I also felt it was really important from a risk management perspective so ethically I was back Florence but as I you know I've been doing that and I have to say people have been really they either if they do have any suicidal
• 67:30 - 68:00 ideation they usually tell me and or if they've had some history they tell me or if they don't they'll be like no I've never I've never thought about that but I can understand why a lot of people have said to me I can understand why you'd want to know that so I'm not sure what that answers the question oh definitely yeah I mean I think also just for a lot of the social workers on this call and what we've been seeing as well as if there's a lot more students who are on the calls as their placements have been disrupted unfortunately so you know just kind of bringing it up and
• 68:00 - 68:30 having these open honest communication okay I'll go on to another question if you don't mind yeah have you ever recorded your sessions at any point and if you have what are the considerations for that okay so in my informed consent of the
• 68:30 - 69:00 clients sign I actually say that and I ask that they not that they're basically considered consenting that they will not record the session and that I will not record the session and so I've never recorded them and if I were going to it would only ever be with the clients consent to do that and to have it recorded yeah so just being very transparent everyone
• 69:00 - 69:30 I think that there is the conversation about ensuring that you have a therapeutic relationship with your clients and so maybe bringing up recording might you know hamper that so just just trying to have those conversations and and being open to adapting to clients needs is really important as well one of the questions we have is ever okay to use FaceTime or regular Skype so the thing with faith with FaceTime is it's not as it's not secure so if you
• 69:30 - 70:00 and I I don't I think I think FaceTime is like messenger so you have to think too if you're using facetime how are you connecting with your client on FaceTime do you have to friend them or do you have to fault like do they have to be a friend or have access to a Facebook page or anything like that in social media so I'm not sure if you need to or not but just in terms of even thinking about that but faith and where is the data stored if you're doing any messaging and FaceTime and things like that in terms
• 70:00 - 70:30 of that information so do people use FaceTime for therapy absolutely so that's the part one is it's important to you know to think about that and if you're not sure about the privacy to really consult with someone on it because we are health custodians and we are responsible to you know ensure and you kind of insurer how we're meeting with people but for some clients you know social work everything's always and it depends because I you know the other part is
• 70:30 - 71:00 depending on the client population you work with the risk the risk of not seeing that client on FaceTime might be larger than seeing them i FaceTime if that so the population I work yeah so depending on who you're working with and the the ethics around that and the risks to that client those are factors that I think it's important the conversations that are important that we have as well yeah I agree completely
• 71:00 - 71:30 so wondering about if a regular cell phone would be considered secure for a phone session you did kind of bring up phone sessions at least when you were talking about in the beginning so for telephone I I don't know how secure the cell phone is because of is it on the Wi-Fi network you know
• 71:30 - 72:00 yeah yeah I I think I don't know honestly it's a good question I mean obviously I have caught like I talked to clients scheduling I a landline and I have a cell phone my cell phone is not my public number but there's definitely times when I call clients back on my cell phone but it's more for scheduling the same as my email
• 72:00 - 72:30 I do scheduling with email but everything else is not done that way um but yeah I I don't really have an answer for your cell phone sorry yeah that might be something that you want to look into depending on your carrier and whatnot and I do think that there is a lot of benefit to going through the platforms that Heidi's already gone over because those are you know the ones that we can we can reasonably gather our secure you know
• 72:30 - 73:00 when we kind of get into the other fields it'd be hard to explore every kind of if if every app out there would be confidential so yet what we do know is confidential okay I think we have time for one more and then I'll wrap it up at about 1:00 Susan Paine okay one of the questions and I think that this is something that I've considered as well as I think that social workers have and I've been reading a lot of columns of social workers who are missing you know the
• 73:00 - 73:30 nonverbal cues and whatnot so have you found whether you know the therapeutic rapport is more difficult to establish online then then in person and is there anything that you try to stay away from or run towards in terms of building that therapeutic rapport mm-hmm so I would say over the last four years I mean it's something I've thought about a lot and I
• 73:30 - 74:00 really don't find that it's any different okay I honestly I feel when I show up on video and that I show up the same way I do at the office and I really if clients have a really poor internet connection and this has been this has happened to me once in four years but somebody scheduled their appointment and then we started the session I couldn't see them well they did not have good and I stopped the session I didn't charge some we didn't go any further I just
• 74:00 - 74:30 told them I said like I really can't provide you there because I can't do your internet connection it's just not I couldn't see them like I you know they were on video but it was could have been their camera whatever so most of the clients I work with I can see them well they can see me and I've asked most of my you know I asked people for feedback and clients have told me that they feel that it's like very much like being at the office they don't find it any different you know I've had clients tell
• 74:30 - 75:00 me that they can if they feel like they can feel my energy you know through the session I've had a client saw me she felt like she could almost like touch me it's so like she feels really connected so I've had a good feedback from from it and I think what helps is being the more we get relaxed with it and I mean you know comfortable and feel confident and get used to the technology and all of that the more it helps our clients to be at ease same as I with office you know same
• 75:00 - 75:30 yeah totally and I mean being being gentle with yourself as well as as we're all kind of transition to this online world absolutely and and again for any of you that have just had to transition to throughout this pandemic like please be kind to yourself this is a huge learning at a time when it's really exhausting right now for people and there's a lot of stress with everyone so be kind to yourself absolutely
• 75:30 - 76:00 yeah actually I just sorry one more quick question and from we're sorry if we didn't get to your question there's a lot of people on this call or this webinar so and but I do I just want to get to this and do you have any rationale for I think you had mentioned that you work with only 18 and years old and you rationale for that as to why you don't work with anyone under 18 so it's probably more preference than rationale I haven't loved have
• 76:00 - 76:30 experience working with children and adolescents but I just feel that getting into working with with underage that I also need to you know just know all the you know get into some of the reporting and all of the the other pieces that go with that also when I work with children and and youth I often like to meet with the families and work with them as well so from a logistics point of view in terms of doing the online practice and trying to do work the way I like to do
• 76:30 - 77:00 work I didn't feel that it met my needs in terms of how I wanted to work right now so that's a just a really honest answer I think that if you are you know you work with children or adolescents I think we could do some really great work online and I think you could do really great group work with teenagers right now like I see a lot of potential for that age group and I've seen some people talking doing training and play therapy with four kids online I saw some things
• 77:00 - 77:30 advertised on Facebook about that and so definitely I think there's lots of potential it's really a personal preference or where I'm at in life right now yeah awesome well thank you so so much hi Dan says to all of you out there be kind to yourselves I will echo that please be kind to yourself if you need to access your certificate of attendance it is the yellow widget you may need to play around with it to access it but it will be there if you want to log on
• 77:30 - 78:00 again if you can't get it right now as well please check out our peer-to-peer support group the CA SW is also running a contest right now where you can share your story for a chance to win one of six Google Play gift cards to either get yourself some books or get something for your kids to do well you're busy taking client calls or whatever share your story we want to hear from you we want to hear about the incredible work that you're doing and the transitions that you've made and we want to give you something back so please take a look at
• 78:00 - 78:30 that on our peer-to-peer support group in terms of the Nova Scotia College of social workers and high B thank you so much for taking time out of your insanely busy days to host this at the CA SW for our membership the comments are flooding in right now and everyone is so so so grateful and it was such an excellent presentation any final words before we sign off Heidi no just thank you so much and I'm sorry
• 78:30 - 79:00 I ran over time people who know me on here will say they're not surprised but I am sorry but it was yeah I just say thank you for the opportunity and yeah if people have questions you can find me on online there I think my website is their contact information yeah in the speaker BIOS you can connect with either me or Heidi if there's any questions in the CAS W please always feel free to get in touch and you can get in touch with Heidi and the Nova Scotia College of social workers as well again wherever
• 79:00 - 79:30 you are wherever you are wherever you're at we're so happy that you were able to join us today and that you've been able to ask so many engaging and incredible questions and just know that we're always here to support you any way we can so thanks so much enjoy the rest of your day and we will see you soon bye I