Thrive Counseling in the Examiner

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eCounseling Therapists Must Adopt More Stringent Security Protocols to Ensure Client Confidentiality

Google recently updated Gmail’s security standards. Users of the webmail service will notice that Gmail’s default URL setting has changed from HTTP:// to a more secure HTTPS:// location. However, this change has been misunderstood by some users. The HTTPS:// setting does not provide a solution for messages sent using Gmail to be ‘encrypted’. The new default HTTPS:// setting, by Google’s description, instead provides greater security when users are logged into their accounts while using public WIFI hotspots.

Dr. Anthony Centore, Founder of eCounseling.com, states “Many counselors don’t realize that while they and their clients need a password to access their respective email accounts, email is still inherently unsecure. When emails are sent between counselor and client, there are several places along the delivery pathway that an email could be opened and read by someone other than the intended recipient.”

An article on Wikipedia.org titled, “Email Privacy” provides a clear warning to email users, stating: “Because e-mail connects through many routers and mail servers on its way to the recipient, it is inherently vulnerable to both physical and virtual eavesdropping. Current industry standards do not place emphasis on security; information is transferred in plain text,…every e-mail leaves a digital papertrail in its wake that can be easily inspected months or years later.”

Ethical codes, such as one released by the American Counseling Association (ACA), states in section A.12. Technology Applications, “When the use of encryption is not possible, counselors notify clients of this fact and limit electronic transmissions to general communications that are not client specific.” By this standard, the use of Gmail for online counseling, even with HTTPS:// protocols, still violates published ethical standards for online counseling.

As a way to provide a secure method of communication for online counseling, websites such as eCounseling.com have developed platforms where emails messages can be sent between counselor and client without the risks inherent in email. Instead of utilizing typical email delivery methods where messages travel across the internet, at eCounseling.com all communications are stored on a secure server and both counselor and client use assigned passwords to log in to the website. The website, utilizing secure socket layer technology, complies with the ethical standards of the ACA.

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About eCounseling.com

eCounseling.com is the leading provider of Online Counseling and Telephone Counseling technologies, and exists to connect professional counselors to clients in need, 24 hours a day, 365 days a year. eCounseling.com was created by counselors who perceived a need for better online counseling methods. Its founding directors include Dr. Anthony Centore, who practices therapy at Thrive Boston Counseling, and Ryan Neace, of the nearly 50,000-member American Association of Christian Counselors.

For more information, contact Dr. Anthony Centore, Founder of eCounseling.com, who practices counseling at Thrive Boston Therapy, in Cambridge, MA.

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EXCERPT of Thrive Boston Therapy Interview:

Five Question Friday: EHR Use in a Behavioral Health Clinic
This Week’s Guest:
Anthony Centore, Director, Thrive Boston Counseling

Thrive Boston Counseling is a Cambridge, Massachusetts-based provider of individual therapy, life coaching, couples and marriage therapy. Its mission is “to facilitate dramatic improvement in persons’ mental health, happiness, relationships and life success such that clients passionately tell others about our services.”

– Thank you Dr. Centore, for agreeing to participate in our series about EHRs and their impact on health care professionals. What motivated you to start using an EHR?
It is in our “DNA” at Thrive to continually try new things that might improve the high-quality of care we provide our clients and patients. We thought that an EHR system would help us to better organize records, and would make records easier to retrieve when there are client requests.

– Was everyone on board with this? If not, how was the decision made?

….Read On at: http://www.ehrbloggers.com/2010/01/five-question-friday-ehr-use-in.html

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Five Question Fridays:

Interview with Anthony Centore, Director, Thrive Boston Counseling.

Thrive Boston Counseling is a Cambridge, Massachusetts-based provider of individual therapy, life coaching, couples and marriage therapy. Its mission is “to facilitate dramatic improvement in persons’ mental health, happiness, relationships and life success such that clients passionately tell others about our services.”
– Thank you Dr. Centore, for agreeing to participate in our series about EHRs and their impact on health care professionals. What motivated you to start using an EHR?

It is in our “DNA” at Thrive to continually try new things that might improve the high-quality of care we provide our clients and patients. We thought that an EHR system would help us to better organize records, and would make records easier to retrieve when there are client requests.
– Was everyone on board with this? If not, how was the decision made?

Everyone was on board from the beginning. However, once implementation began, feet started dragging. Our therapists want to focus on client care, not on learning new software. As it turns out, the system we chose (like many we have tested since) is not nearly as user friendly as we would have liked, and the learning curve was brutal.

– How did you select the EHR you’re now using?

As a mental health counseling practice, we bill less per-clinician than other medical practices. Unfortunately, many of the solutions we looked at were priced much too high as they charge several hundred dollars per user per month. Such cost structures will never be realistic for a mental health counseling practice.

– Who was involved in selecting the EHR?

As the director of the practice, it was my job to solicit feedback from the team to determine what features would be helpful. The final selection was mine.

– Describe the process?

I had a hard time finding other counseling centers to recommend a program. Most aren’t using EHR, and others weren’t using a program that made sense of our practice. For one, we wanted to find a web-based program we didn’t need to have installed on each computer, and this eliminated a lot of options. Price eliminated many more. Trying out demo-versions eliminated almost the rest. In the end, there was only one or two programs we could find that would work for us.

–When did you start your EHR implementation?

We started September 1st of this year (2009).

– Are you done?

For now, I think we’re done. But we’d be open to trying another program in about a year, if we find something that looks easier to implement, more affordable, and better suited for our needs. I think it will take us some time to feel up to it after the hassle switching over to the first program caused.

– Are you still using paper or did you make a complete transition to paperless?

We use paper only for the first session, for some intake documentation. After that, it’s all online!

– What do you like about your EHR?

I think it has improved our note-taking overall. In addition, it’s easier to view a history of sessions at a glance. It’s starting to make billing simpler–but that’s after 3 months of set up. It’s nice not to have a growing mountain of filing cabinets in the office.

– What do you dislike about your EHR?

It takes much long to train new counselors to use the EHR system, and it’s not intuitive. There’s a lot of conversation during the training process that sounds like, “It doesn’t make a lot of sense, but you need to click here, then here, then this drop down here, and ignore this, this, and that, because those choices don’t apply to us.”

– What kind of support have you received from your EHR vendor?

The support has been helpful. They’re available to talk by phone during normal business hours.

– Can you elaborate about the support you receive?

They are there to walk you through the program, which is nice. However, I don’t have my counselors call them anymore because they teach too much–much of which staff doesn’t need to know. After two hours of phone calls with support, they are overwhelmed with what they think they need to learn, and don’t know the basics. To train Thrive Boston Counselors adequately, I now bring new hires through 25 minutes in house training, which I need to go through with them usually twice over a one-week period.

– Anything else to add?

When someone is trying to sell me on an EHR or Practice Management system, I’ve found that asking the following basic question stumps 99% of them. The question is, “If a client arrives and pays $100 cash for their appointment, how do I quickly log that into the system?” The answer to this question–if it’s not “our EHR system doesn’t deal with the payment side of things”–often takes over 15 steps and sounds like this: “No problem! Simply click here, then scroll down to the bottom, then select the second tab on the left, then the third drop down option, then here, then there, select the patient, select the appointment, click billing options, enter a diagnosis and procedure code (necessary even for cash pay), enter the amount, click submit, go back to the billing page, click edit, then apply, then confirm. Done!”

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The article is titled “Parenting During Difficult Financial Times” and addressed steps parents can take to keep relationship with their kids strong when the family if expereincing above-normal financial stress. 

Here is an excerpt from the published article: 
“Kids cost money. School clothes, cell phones, video games, baseball, girl scouts, daycare, music lessons, karate, field trips, birthday gifts, 5 meals a day, braces, contacts, car insurance, and the list goes on.

If you’re feeling the pinch of the rising cost of parenting and a tighter budget, you’re not alone….”

Click here to read the complete article on this therapy blog: http://thriveboston.com/counseling/parenting-during-difficult-financial-times-boston-child-therapy-and-parenting-information/

Click here to read the article on the Wicked Local Parents website: http://www.wickedlocalparents.com/content/parentingduringdifficultfinancialtimes

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To respond to the many requests we have received for Group Therapy services, Thrive Boston Counseling now offers Therapy groups for a variety of life issues, including:

• Women’s Issues Boston Therapy Group (and Cambridge Therapy Group)
• Men’s Issues Boston Therapy Group (and Cambridge Therapy Group)
• Sexual / Pornography Addiction Boston Therapy Group (and Cambridge Therapy Group)
• Substance Abuse Boston Therapy Group (and Cambridge Therapy Group)
• Parenting Skills Boston Therapy Group (and Cambridge Therapy Group)

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View Susan’s Picure and Bio on the Thrive Boston Counselor’s Page 

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Thrive Boston Counseling Therapy

CCT magazine is a leading counseling therapy publication. It is subscribed to by nearly 50,000 readers. 

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