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volume 3, Issue ONE Fall 2012

Why Conventional Media Still Matters Insights for Growing Your Practice PAGE 22

PAGE 15

First Chat: Attracting EAP Users Through Online TextBased Chat Services PAGE 41

Turn2me: Online and Integrated Mental Health Support PLUS...

Legal Briefs, Cybersupervision, Marketing Toolbox and much, much more...


TILT - Therapeutic Innovations in Light of Technology TILT is the magazine of the Online Therapy Institute, a free publication published four times a year online at www.onlinetherapymagazine.com. ISSN 2156-5619 Volume 3, Issue 1, fall 2012 TILT Magazine Staff Managing Editors Kate Anthony & DeeAnna Merz Nagel Magazine Distribution Coordinator Sophia Zollman Magazine Design and Layout Delaine Ulmer Associate Editor for Research Stephen Goss Associate Editor for Innovations Jay Ostrowski Associate Editor for Supervision Anne Stokes Associate Editor for Marketing and Practice Building Clinton Powers Associate Editor for Film and Culture Jean-Anne Sutherland Associate Editor for Coaching Lyle Labardee Advertising Policy The views expressed in TILT do not necessarily reflect those of the Online Therapy Institute, nor does TILT endorse any specific technology, company or device unless Verified by the Online Therapy Institute. If you are interested in advertising in TILT please, review our advertising specs and fees at www.onlinetherapymagazine.com Writer’s Guidelines If you have information or an idea for one of our regular columns, please email editor@onlinetherapymagazine.com with the name of the column in the subject line (e.g. Reel Culture). If you are interested in submitting an article for publication please visit our writer’s guidelines at www.onlinetherapymagazine.com.

TILT is about envisioning therapeutic interventions in a new way. While Kate was visiting DeeAnna on the Jersey Shore, they took a late afternoon boat ride and a display of sail boats tilting against the sunset came within view. It reminded them how, as helping professionals, we should always be willing to tilt our heads a bit to be able to envision which innovations – however seemingly unconventional – may fit our clients’ needs. Our clients are experiencing issues in new ways in light of the presence of technology in their lives. As helping professionals, so are we. TILT and the Online Therapy Institute is about embracing the changes technology brings to the profession, keeping you informed and aware of those developments, and entertaining you along the way.

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Features 15 First Chat Attracting New EAP Users Through Online Text-Based Chat Services

22 Why Conventional Media Still Matters

Insights for Growing Your Practice

41 Online & Integrated

Mental Health Support The range of services at Turn2me


Issue in e v e r y

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News from the CyberStreet

10 Research Review 20 Wired to Worry 35 Reel Culture 37 Legal Briefs 39 Technology Enhanced Coaching 50 A Day in the Life: Therapist 53 A Day in the Life: Coach 56 CyberSupervision 60 New Innovations 64 Marketing Toolbox

68 For the Love of Books 70 Advertiser’s CyberMarket


A Note from the Managing Editors… Welcome, or welcome back, to TILT – Therapeutic Innovations in Light of Technology, and the first issue of Volume 3. In this issue, our main feature is by Julie Hanks who walks us through tips and experiences of using traditional media – including the Internet – to promote practice. This includes a rationale about why we would want to use the technology before us kate anthony & deeanna merz nagel with the (and by “technology”, she is including print media as online therapy institute in second life well as what we may recognise more easily, such as television news), and goes on to give definite information and top tips on handling the media to one’s own advantage in becoming a successful – and expert – therapist. Eoin O’Shea offers the experience of setting up Turn2Me, an online support organisation for those affected by suicide. He tells us how two brothers turned the tragic loss of their brother after his suicide into being an inspiration to help others via online forums and groups, among other resources such as a Directory, articles and blogs. Another interesting feature of the site is the ThoughtCatcher – a tool to track moods “based broadly on the cognitive behavioural therapy theoretical underpinning which highlights the extent to which our appraisals of various thoughts, feelings, and events maintain or alter any suffering experienced as a result”. Our final feature in this issue is from Barb Veder, Stephanie Torino and Kelly Beaudoin, who describe their work with Shepell•fgi, an EAP based in Canada. They talk us through the research behind their FirstChat service, improving access to services via electronic means. In our Day in the Life of an Online Therapist, you can read about the day of one of the authors who uses the FirstChat system daily, and how the work is different from face-to-face services and how valuable the clients find it. Our aim continues, issue by issue, to keep you up-to-date with developments in innovations in service delivery. In particular, the Cyberstreet is about what is new and noteworthy at the Institutes as well as with our Verified Members and Certificate Trainees. All our other regular columnists are here, with useful and entertaining comment on research; marketing; legalities; innovations and CyberSupervision. In particular this month, DeeAnna gives us her perspective on the use of vision boards with coaching clients and how technology can fit into that use. Our featured “Day in Life” therapist and coach are Stephanie Torino and Sheevaun O’Connor Moran respectively – we hope you find it as interesting to hear about their work as we do. And of course there is a good dose of humour from our resident cartoonist, Christine Korol. We hope you enjoy this issue, whatever professional world you inhabit. J

Managing Editors T I L T M A G A Z I N E fall 2 0 1 2


NEWS CyberStreet

TILT – Therapeutic Innovations in Light of Technology

from the

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Provider for credentials:

the

following

organizations/

Our courses qualify toward maintenance of the above credentials (CET, BCC, ACS) as well as:

INSTITUTE NEWS! Look who has become verified for inclusion in our Directory!! Newton Counseling Center

Click here for more information about inclusion in our Directory.

The Center for Credentialing and Education’s Distance Credentialed Counselor (DCC) Employee Assistance Certification Commission’s Certified Employee Assistance Professional (CEAP) As always, our courses are approved for the required continuing education for most mental health professional licenses/accreditation. New Courses!

News from the Training Room!

We have several new courses at OTI/OCI! Remember, all our courses are approved for CE!

Course Approval Towards Credentials:

This workbook offers 5 clock hours that will help you strategize how to add a clinical supervision program to your workplace.

Online Therapy Institute/Online Coach Institute is proud to be an Approved Training Provider for the following organizations/credentials:

Applying Clinical Supervision to Our Work

The Florida Certification Board’s Certified E-Therapist Credential (CET)

Ethical & Legal Considerations in Clinical Supervision

The Center for Credentialing and Education’s Board Certified Coach Credential (BCC)

This course offers 10 clock hours of course work focused on the ethical and legal issues of clinical supervision.

The Center for Credentialing and Education’s Approved Clinical Supervisor Credential (ACS)

Clinical Supervision Series

Continuing Education to Maintain Your Credential: We are an approved Continuing Education

We offer a 30 hour Clinical Supervision Series- that includes the two courses mentioned above. This Series qualifies toward the coursework needed for the Approved Clinical Supervisor (ACS) credential from the Center for Credentialing and Education (CCE).

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TILT – Therapeutic Innovations in Light of Technology

40-hour Specialist Certificates We now offer several Specialist Certificates with self-paced and fast-track enrollment options! It is not too late to enroll for winter classes! Read more and enroll! We are preparing for our Winter Fast-Track Series! Our Specialist Certificate for the Therapeutic Use of Technology is Endorsed by BACP. Read more and ENROLL!

In other training news... Kate and DeeAnna presented at the 4th Virtual Conference on Counseling (4VCC) on September 12th, interviewing the director of talhotblond, a documentary about murder and the internet. To read more, visit: http://onlinetherapyinstitute. com/talhotblond/ DeeAnna and Kate were delighted to be contacted by Clinton Power, a relationship counsellor and TILT’s new Associate Editor for Marketing and Practice Building, based in Sydney, Australia. Therapy Without Borders: A Beginners Guide to Online Therapy was the resulting interview for Australian counsellors and therapists thinking about introducing technology into their practice. The interview can be viewed here: http:// onlinetherapyinstitute.com/2012/08/meetingof-three-colleagues-across-three-continents-noproblem/ Kate and DeeAnna conducted a workshop, Introduction to Online Therapy via OnlinEvents live video feed for the EAPA-South Africa 14th Annual Conference on September 12th. 8

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DeeAnna conducted a workshop, Legal and Ethical Considerations of Online Therapy for the EAPA Kansas City Chapter. Kate conducted a workshop, Carefully Managing Your Online Presence for the Psychologists Protection Society Trust in Edinburgh, Scotland on October 26th. Kate and TILT’s Associate Editor for Research Stephen Goss linked live to Kosovo via Skype on 21st October to speak at the Foundation Together Kosovo annual conference of their online team for Nuk Je Vet!, an asynchronous forum based support service for young people. Kate spoke on Online Counselling and Support: Context and Rationale, and Stephen spoke on Online Counselling and Support: Text-based Communication.


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Kate and DeeAnna are teaching their “Introduction to Online Coaching” course at the Institute for Life Coach Training (ILCT). ILCT is a Verified member of Online Coach Institute. For details check out http://onlinetherapyinstitute. ning.com/events/introduc tion-to - online coaching. For more information contact Ellen at ellen@lifecoachtraining.com

Online Interventions to Victims of Domestic Violence. To increase awareness about domestic violence, Online Therapy Institute/Online Coach Institute partnered with Impact Publications, publishers of the Employee Assistance Report (EAR). Read the article and more here: http:// onlinetherapyinstitute.com/2012/10/octobernational-domestic-violence-awareness-month/

DeeAnna is facilitating Distance Credentialed Counselor trainings in Georgia, Maryland, Texas, Philadelphia and Arkansas! For details check out http://www.readyminds.com/training/dcc_event. asp or email lisa@readyminds.com

October 10th was World Mental Health Day and once again we joined Psychcentral’s blogging party to bring awareness to mental health issues. Our blog post, Enhancing Mental Health by Understanding Cyberculture can be read here: http://onlinetherapyinstitute.com/2012/10/ enhancing-mental-health-understandingcyberculture/

OPEN OFFICE HOURS Join us each month for our Open Office Hour and ask your questions about online therapy and online coaching! Upcoming Open Office Hour Dates! Time is 2pm EST/7pm GMT November 29 December 20

Clara Lang, the fictitious therapist featured in our book, Therapy Online: A Practical Guide, is now featured at www.claralang.com. Her blog features posts by Online Therapy Institute’s Specialist Certificate students. Check out her website and blog!

Join our community Find out all the ways to join our community by checking out our community page! http://onlinetherapyinstitute.com/community/

Sign up here http://therapistsandcoachesopentotechnology. com/

Publications and Blogs October was National Domestic Violence Awareness Month in the U.S. In preparation, DeeAnna and Kate wrote an article, Offering T I L T M A G A Z I N E fall 2 0 1 2

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TILT – Therapeutic Innovations in Light of Technology

Research Revie

INTERA

Numerous dissertations and theses receive relatively little attention and here we highlight a few on the subject of online education, across a range of fields. A study at North Central University (Bordelon, 2012) has reported that the level of interaction between students and staff, between students and their peers and between students and their course content, all have a significant impact on students’ achievements and their levels of satisfaction in online training services. A purposive sample of 155 participants in online courses showed marked increases in both variables (p=<0.05 for each). Interaction with staff and with course content seemed to be the most important factors, with the level of interaction between students themselves having less of an impact. Insofar as these findings are generalizable, they carry a clear implication that those trainings that do not offer high levels of interaction will be less valued by their participants than those who do. The author of the study recommend that “institutions implement requirements and guidelines for student-instructor interaction and the incorporation of meaningful studentcontent interaction” (Bordelon, 2012). Perceptions of online learning in comparison with face to face instruction are known to show very few differences, including those in the health care arena (e.g. Ayars, 2012). Elsewhere, program format and length - allowing students to study alongside their current jobs and to

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is the Key to Online maintain their family routines - were found to be the major factors in choosing online learning (Gratz, 2012). A separate study, looking at online tools from the instructors’ perspective, found variations in the degree to which staff take to online methods, however. Those whose style was facilitative were clearly more likely to integrate online resources into their courses but that the level of available resourcing, the instructors’ familiarity with computers and the kind of class were all influential, as were the gender and title under which the instructor worked (Thomas, 2012). Online professional development in the use of computer mediated communication has been supported in another study (Lundstrem, 2012) that showed confidence and experience as key outcomes while also stressing the need for subject-specific training through online mentorship, underscoring the importance of interaction between staff and students in online learning noted above. A third perspective on online education – that of prospective employers – was separately investigated (Bailey, 2012) with tentative results based on a small sample (n = 20) suggesting that those who decide who gets which job do put very little emphasis on whether the qualification was obtained online or not, or whether the training provider operated for profit – although it should be noted that the research was undertaken at an


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ew S t e p h e n G o ss

ACTION

e Training Success institution that is itself a major online, for profit provider. Increasing numbers of courses, especially for post-qualification Continuing Professional Development, are being made available online. It is quite possible that although still relatively new to many professionals at the time of writing, many professional organisations already offer online CPD and this seems set to increase, quite possibly becoming the norm for any elements of training that do not absolutely require face to face work, such as initial practitioner trainings. Blending online therapy into such core trainings with an experiential online module seems a strong possibility, however, as offline and online ways of working become ever more integrated. That the key is ensuring interactivity and student engagement underscores that not all online trainings are equal â&#x20AC;&#x201C; some clearly achieve much better results than others. But when courses are offered by experienced online trainers, who are themselves trained and temperamentally well suited to the task, it is clear that such work is set only to increase. Those responsible for core curricula should take note, perhaps, that this will be an automatic expectation from the students of the future, as it is already becoming now. Please send reports of research studies, planned, in progress or completed, to the TILT Editor at editor@onlinetherapymagazine.com

ABOUT THE AUTHOR Stephen Goss, Ph.D. is Principal Lecturer at the Metanoia Institute, and also an Independent Consultant in counselling, psychotherapy, research and therapeutic technology based in Scotland, UK (http:// about.me/stephengoss).

REFERENCES Ayars, V. D. (2012) A comparison of perceptions of online and face-to-face learners in the same associate degree nursing program. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.73(2-A),2012, pp. 488. Dissertation: Northcentral University, US. Bailey, J. S. (2012) Hiring managers' perceptions of the value of an online MBA. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.73(2-A),2012, pp. 452. Walden University, US. Bordelon, K. L. (2012) Perceptions of achievement and satisfaction as related to interactions in online courses. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.73(2-A), pp. 580. Dissertation: Northcentral University, US. Gratz, S. D. (2012) Online learners and their choice of institution. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.73(2-A),2012, pp. 494. Dissertation: Lincoln Memorial University, US. Lundstrem, K. A. (2012) Exploring the effectiveness of online professional development in developing skills in computer-mediated communication technologies. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.73(2-A),2012, pp. 585. Dissertation: Northcentral University, US. Thomas, C. D. (2012) Factors affecting faculty use of technology-enhanced instruction at research universities. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.73(2-A), pp. 508. Dissertation: University of Texas at Austin, US.

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Research Call Study into attitudes and perception of etherapy Alyx MacTernan, M.S, is a doctoral candidate at Argosy University completing her dissertation on the attitudes/perceptions of etherapy. She welcomes any and all participation in her study. The survey link is https://www.surveymonkey.com/s/ EtherapyAttitudeSurvey

Study intending to explore the processes involved in online text-based therapy from the counsellor's perspective. Required: Clinicians (MA, MFT, MSW) who have engaged in online text-based therapy in the past 12 months.

Rowena Jopling is conducting research into understanding clients’ views on therapy as part of her Doctorate at the University of Surrey. In particular, she is interested in experiences of tension or breakdown in the working relationship with a therapist which may have been resolved or unresolved. The difficulties may have occurred in just one session or over several sessions.

As a participant, you will be asked to complete a brief (5-10 minute) demographic questionnaire that we will send to you via email. You will then be requested to participate in an (approximately) 90-minute interview session via text-based chat or Skype. After this, I will contact you to present to you my summary of our interviews for your review and feedback. Your participation in this study is completely voluntary and confidential. No names or personal information will be linked to the outcomes of this study.

If you wish to be entered into a prize draw of five £20 Amazon vouchers you will be asked to send an email to the researcher to request this. Your email address will be treated confidentially. Your questionnaire responses will remain anonymous, as it will not be possible to link them with your email address.

Being involved in this study will help researchers and practitioners better understand the online counseling processes and help establish better guidelines for engaging in online therapy and developing therapeutic relationship.

Study intending to explore the breakdown of the therapeutic relationship

The therapeutic breakdown must have occurred within the last five years. To TAKe part in the REsearch, contact jopling@surrey.ac.uk

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Must be 19 years or older to participate in the study. FOR MORE DETAILS, CONTACT Shereen Kahn shereenk@mail.ubc.ca


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The Use of Technology in Mental Health Applications, Ethics and Practice Edited by

Kate Anthony, MSc, FBACP

Online Therapy Institute

DeeAnna Merz Nagel, LPC, DCC

Online Therapy Institute

Stephen Goss, PH.D., MBACP

Independent Consultant in Counselling, Research, Supervision and Technology in Mental Health 2010, 354 pp., 7 x 10, 6 il., 5 tables • $74.95 hard, $49.95 paper (hard) ISBN 978-0-398-07953-6 • (paper) ISBN 978-0-398-07954-3 • (eBook) ISBN 978-0-398-08447-9

Technology is revolutionizing the delivery of mental health services. In this book, the reader is introduced to the broadest possible sampling of technologies used by mental health professionals today. It contains 30 chapters on different aspects of technological innovation in mental health care from 43 expert contributors from all over the globe, appropriate for a subject that holds such promise for a worldwide clientele and that applies to professionals in every country. A wide range of styles is offered, from the individual practitioner exploring a new technology and writing anecdotally about their personal experience, to some of the world’s most experienced practitioners writing a thorough overview of a technology and its uses in the profession. In each chapter, you will find introductions to the technology and discussion of its application to the therapeutic intervention being discussed, in each case brought to life through vivid case material that shows its use in practice. Each chapter also contains an examination of the ethical implications – and cautions – of the possibilities these technologies offer, now and in the future. Technological terms are explained in each chapter for those not already familiar with the field, while the content should stimulate even the most seasoned and technologically minded practitioner. Psychotherapists, counsellors, psychiatrists, life coaches, social workers, nurses – in fact, every professional in the field of mental health care – can make use of the exciting opportunities technology presents. Whether you have been a therapist for a long time, are a student or are simply new to the field, The Use of Technology in Mental Health will be an important tool for better understanding the psychological struggles of your clients and the impact that technology will have on your practice. Further information on ethics, training and practical exploration of online therapy can be found at: www.onlinetherapyinstitute.com, whose work extends and deepens the resources made available in this volume.

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Barb Veder, Stephanie Torino and Kelly Beaudoin

FIRST CHAT

Attracting New EAP Users Through Online Text-Based Chat Services

As consumers adapt to an ever-changing technological world, they expect their service providers to keep pace and offer new and innovative experiences.

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TILT – Therapeutic Innovations in Light of Technology

Many of today’s services have transitioned online to meet the increasing demand of customers who want instant gratification, to access them when and how they’d like. They expect to shop, bank, and book a vacation via the Internet, 24/7/365, using only a few keystrokes. Social media innovations like live chat tools are being developed to provide clients with immediate and private counselling support in a secure setting. This type of environment provides individuals with a level of anonymity which can appeal to those who are looking for an alternative to in-person counselling. Shepell•fgi, the leading provider of integrated health and productivity solutions supported by a full range of programs and services to address the mental, social and physical health issues that impact employee and organizational health, offers a product called First Chat in the synchronous text-based clinical counselling space.

The benefits In text-based counseling, the client and counsellor communicate in writing, so that the

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information can be reviewed at a later point by the client and kept as a reminder of a course of action to follow. Essentially, the client receives real-time support at the moment that they need it most. It is an immediate, engaging, and positive experience that draws upon a person’s strengths to explore options for moving forward. As the individual makes decisions or investigates options to resolve a situation, they have a counsellor at their fingertips to help guide them along the way. Morneau Shepell’s First Chat provides individuals with professional counselling through chat services. Individuals correspond via text with a qualified counsellor for immediate clinical support regarding their work, health, or life issue, 24 hours a day. Issues can include such things as work-life stress, parenting, or relationship-related concerns.

The research Research was conducted on First Chat via post-chat surveys to measure the overall level of client satisfaction with the service. Data was also randomly sampled from 407 chats taken from December 5, 2011 to January 31, 2012, and was compared against utilization data from the company’s suite of Employee Assistance Program (EAP) support services for 2011.

The results Results indicated the following:


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• 94% of First Chat users reported feeling comfortable using chat as a clinical counselling service, indicating that textbased communication is an attractive and accessible method for clinical support. • Young adults under the age of 39 accounted for 57% of the First Chat user community, and users in their 20s access First Chat two times more than other EAP access options. (First Chat users must be a minimum of 18 years of age.) • 65% of the user population was female. This remains consistent with all other forms of counselling support. • Feeling supported and provided with immediate relevant information to address their issues, 87% of users would recommend First Chat to other potential clients.

altogether removed due to the freedom that technology offers. These include obstacles such as: • perceived stigma, • fear of loss of privacy, • access issues such as lack of mobility or transportation, • verbal communication challenges, and/or • social phobias A client can now travel and still have a constant link to clinical support. The concept of mobility coupled with privacy is fostering the emergent success of this new form of support. Other elements of end-to-end intake services are also going online. Users can now book,

Another interesting finding was that 65% of First Chat users were new clients that had not previously reached out for EAP support services. No longer deterred by waiting for appointment times in a brick-and-mortar office, individuals now have more choice as to how and when they receive the support they require.

Improving access Barriers that previously prevented some individuals from seeking clinical counselling for themselves or their family members have been greatly reduced or

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TILT – Therapeutic Innovations in Light of Technology

confirm, and/or change appointment times via the Internet. In fact, the telephone is being increasingly replaced by text and/or online tools and the convenience and immediacy that it provides.

Quality Delivery is very important in the online environment. Best-in-class online clinical practices ensure you have a user-friendly platform that is secure, protecting both the confidentiality and privacy of the individual. The platform should support the needs of the user while also being adaptable. Online users are notorious for moving on to another provider if an application is cumbersome, expensive to access, or somehow violates their privacy rights. Another important factor is the standard of clinical quality. While a clinical support company needs to be constantly developing and innovating to keep sustained user interest in their services, the core principles of clinical counselling should remain the driving force. When the client accesses the provider’s services online, they expect to receive the same type of issue identification, risk assessment, support, and solution suggestions as they would inperson. A clinical counsellor who transitions to the online space requires targeted training and must develop a technology-enriched skill set to deliver counselling in this non-traditional

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realm. They must have reliable computer hardware with a secure operating system and high-speed access to the Internet. They also need to remain current with technology (i.e., tablets, smartphones, etc.) and the applications that run on them. By having a solid understanding of technology, the online counsellor can troubleshoot issues that may arise during an online session to prevent these issues from dominating the therapy session. In addition to developing trust and mutual respect between themselves and the client, the online counsellor needs to be able to use the written word and netiquette (a way of talking in shorthand and using symbols to indicate emotion) to communicate warmth, openness, and genuineness and to deliver a clinically-appropriate message. The ability to accurately interpret the client’s mood from plain text and respond accordingly to foster a supportive environment in the technological space is an acquired skill.

Qualitative Results – Client Feedback “With today's office environment moving towards cubicles without any privacy, the internet chat is great for being able to discuss things and get info without the whole floor knowing” “It is very good way to communicate, especially for those whose English is second language, who is shy, or nervous, is more comfortable this way


“Thank you, I needed the service immediately and you were there, thanks” “Much easier to communicate online rather than phone”

Outcome Based on the growing presence of online technology and devices in our lives, online clinical counselling services are expected to continue to increase in popularity and daily usage. The potential for service providers to expand and diversify their client base and to assist these users with new and innovative methods is just a click away. Reaching out to a counsellor for immediate support should be as simple as reaching out to a friend through chat.

ABOUT THE AUTHORS

to start conversation. Thank you”

Stephanie Torino, MA Counselling Psychology First Chat Supervisor and Client Care Counsellor for Shepell•fgi Stephanie has over 20 years’ experience in the counseling field, and has been with Shepell•fgi since 2010 when she signed on as Bilingual Client Care Counsellor in the Montreal Care Access Centre. Stephanie has been involved in the development and supervision of First Chat since August of 2011. Stephanie began her clinical career creating and leading parenting workshops for community centers, and transitioned into giving anti-bullying workshops to adolescents and young adults. In the past 10 years she has created and led workshops for the First Nation’s population that specifically address family and youth issues in private practice setting and founded the MMFCA- Montreal Multicultural Family Counselling Association (January 2009). Stephanie specializes in working with clients with suicidal tendencies and alcohol and drug dependency, and received special training in Mental Health Disaster Response Counselling regarding Post Traumatic Stress Disorder and trauma related to natural and man-made disasters.

Barb Veder, MSW RSW Director of Clinical Services for Shepell•fgi Barb Veder has spent 17 years working in the EAP field, including 15 years as Clinical Director with Shepell•fgi. Barb has extensive experience in addictions counselling and a strong interest in research and counsellor education. She is also committed to contributing to the development of resources and support for individuals struggling with depression, anxiety and other mental health issues. She is a past President of the Board of Directors for both the Mood Disorder Association of Ontario and the Employee Assistance Society of North America. She was also the 2011recipient of EASNA’s Contribution to the Field Award. Barb is also the clinical leader of Shepell•fgi’s Digital Management team, which has launched North America’s first EAP Smartphone application (My EAP).

Kelly Beaudoin Clinical Communications for Shepell•fgi Kelly Beaudoin has been part of the Clinical Services Team for over 11 years as the key writer/editor and manager of the Clinical Communications team. As the editor of Shepellfgi’s WorkHealthLife blog, she is a prime example of why an Honours English degree (from Ottawa U) isn’t as useless as some may think! Kelly thoroughly enjoys working with her counsellor and clinical management colleagues, and is in grave danger of exploring an MSW herself one day!


TILT â&#x20AC;&#x201C; Therapeutic Innovations in Light of Technology

Social Media vs. Social Anxiety In the last issue of TILT, I wrote about how clients can use their smartphones and tablets to cognitively avoid their discomfort during exposure therapy for anxiety. In this article, I want to talk about how to integrate social media when you are helping clients overcome social anxiety.

Christine Korol

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According to the Pew Research Institute, approximately 66% of Americans use various social media channels (mostly Facebook). People who are shy or socially anxious may spend more time observing their news feeds, rather than actively commenting, posting, retweeting, or liking what they see. I take full advantage of this fact

when designing behavioural experiments with my clients who are working on meeting new people or developing deeper connections with their friends and family. First, it is important to use a technique called Assertive Defense of the Self developed by Christine Padesky, where we generate and then role play a list of possible assertive responses to feared critical remarks. Once clients feel confident that they could cope with criticism or negative remarks, then we develop a plan to connect with others both off and online. Hereâ&#x20AC;&#x2122;s a sample social anxiety hierarchy: 10 - Post a video on Youtube.


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9 - Friend someone on Facebook.

1 - Share someone’s funny photo.

8 - Post a status update on Facebook.

0 - Read through one’s newsfeed.

7 - Checking in on Facebook to tell people where you are having coffee.

You follow the same basic rules as you would with any anxiety hierarchy, letting the client tell you how anxious they would feel from 0-10 and then planning behavioral experiments around the easier items. In the beginning, I usually stick to situations that are rated less than 4 out of 10 on an anxiety scale to ensure success and build confidence.

6 - Comment on an acquaintance’s status update. 5 - Comment on a friend’s status update. 4 - Post on someone’s wall. 3 - Retweet a tweet. 2 - Like someone’s post.

As a therapist, I love the extra options that using social media gives me when helping my anxious clients feel less anxious.

ABOUT THE AUTHOR/ ILLUSTRATOR: Christine Korol, Ph.D. is a cartoonist, psychologist in private practice in Calgary, Canada and the host/producer of a podcast on WiredToWorry. com that provides free online anxiety and stress reduction education videos. T I L T M A G A Z I N E fall 2 0 1 2

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TILT â&#x20AC;&#x201C; Therapeutic Innovations in Light of Technology

Insights for Growing Your Practice Julie Hanks 22

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nventional ll Matters

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Several weeks ago, as I was walking out of my therapy office, my receptionist motioned for me not to leave. She was on a phone call and whispered to me, “It’s the Dr. Phil Show asking for you.” Thinking she was joking, I rolled my eyes and turned to walk toward the door. She replied, “I’m not kidding!” I told her I’d take the call. After a few days of phone and email exchanges with Dr. Phil staff, I ended up not being selected to appear as an expert on that particular episode, but the show booker said they would keep me in mind for future shows. Whether you’re a fan or Dr. Phil or not, it’s still amazing to me that a private therapist in Salt Lake City, Utah is on the radar of a national TV show. Upon becoming a licensed therapist, my initial plans for starting and growing my practice did not include appearing on local or national television in the USA (Discovery Health, TLC, Fox News Channel), 24

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or being regularly quoted in national publications like The Wall Street Journal, Cosmopolitan, Parenting, or Women’s Health as an “expert”. However, I made a few key decisions in that first month of practice that helped me get to the point where I felt that conventional media would make a significant difference in growing a thriving practice that is reputable, effective, and trustworthy. What’s in a Name? One of the first key decisions was about me and my practice—that is to say I made a choice to not use my name as my official practice name. I had a vision of eventually growing my practice beyond a solo practice so I wanted to find a name that sounded large and established. I felt that the best way to serve my community was to create a family-friendly service that would be inviting to a broader range of clientele. Rather than using my personal name, I went with one that would be regionally recognized: Wasatch Family Therapy (Salt Lake City and the extended metropolitan area stretch approximately 100 miles along the Wasatch mountain range; nearly 80% of Utah’s population lives in this region).

Early Technology Adopter. As with many of those who saw an early opportunity with the Internet, I created and maintained a static web page for my practice. I am including the Internet in my discussion of “conventional” media here because of the way it was first used by many businesses and professions (and perhaps still is). It initially served about the same purpose as a print advertisement, but reached out to those who used the Internet in addition to other conventional media. What is your value? There is enormous potential value in every therapist, and it is vital to work on your perceived value individually in face-toface interactions. But have you ever thought about the “value of perceived value”? Many professionals believe, and my personal experience supports this belief, that therapists should focus more on their perceived value. There is perceived value in the fact that I do not work with insurance companies; clients believe that I must be good enough to “go it alone.” This perception by potential clients must be backed up by the real value you provide face-to-face; this is the way to get genuine referrals


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There is enormous potential value in every therapist, and it is vital to work on your perceived value individually in face-to-face interactions. from trusted sources. I believe that our thinking about face-to face trustworthiness can be expanded. By this I mean you have to put the time and effort into a “grassroots” approach to extending your personal reach and the name recognition of your practice into your immediate and surrounding communities. This is where conventional media really matters. These key decisions allowed me work more effectively with a broader range of conventional media to build a thriving fee-for-service practice of 14 therapists in an uncertain economy because I can build trust directly to potential clients by the hundreds or thousands rather than by word-of-mouth alone. The Media is Calling for You. As my practice began to become

more established, I felt as though if media was calling for me. I realize that the notion of using conventional media might not dawn on everyone. I would say if the media’s not calling you then you should call them. I was presented with a unique opportunity to develop the concept for a local TV show and, in a media baptism-by-fire experience; I ended up hosting and producing a weekly hourlong live television show for several months. In addition to hosting the show I selected the show topics, wrote up the script, and managed guests. This experience opened my eyes to the power of conventional media to build a broader and deeper relationship of trust, character reference, and recognition in my community. And while there may have been an element of luck involved here, much of what I did initially came about because

of ingenuity and hard work; this is perhaps more true of the networking I did (and still do) and what snowballed into greater media opportunities later.

How Media Interviews Can Benefit Your Practice Conventional Media (TV, Radio, Print, Newspaper, Website) interviews help build awareness of your practice and services; provide opportunity for community service & education; create public trust and adds credibility to your practice; help transition you from a provider to an expert in your field; provide potential multiple income streams; and can help provide fresh consistent content for website, blog, and social media channels.

Increasing Awareness Of Your Practice and Services “If you build it, they will come” doesn’t necessarily apply to opening a private practice. Most private practitioners initially struggle to get clients in the door of their practice because few people are aware of their business. Media interviews increase the exposure of your practice and allow you to get in front of more potential clients. Continued exposure makes it T I L T M A G A Z I N E fall 2 0 1 2

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more likely that potential clients will remember your name and will eventually call you if they need help.

Opportunity For Community Service and Education Media interviews provide volunteer opportunities to educate your community, increasing awareness about issues that matter to you and to them. In addition to making a living doing something I love, I want to make a difference for as many people as possible and media interviews allow me to make a positive impact for people well beyond the therapy office.

Engender Public Trust and Increase Credibility Television stations, radio stations, newspapers, and websites spend a lot of time connecting with their readers and viewers and building their “brand”. When you are featured in the media you get to borrow their credibility and trust as they put you in front of their audience. Regular media appearances have allowed a large number of people to hear my therapeutic philosophy, and get a feel for my approach, and see me as a resource.

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Helps Transition You From Provider to Expert Regular media appearances help position you us as more than a potential counseling or coaching provider. Interviews allow the general public to view you as an “expert” in your field or specialty area. The role of expert adds value to you and your services and makes it more likely that clients will pay out of pocket for your services.

Provides Potential Multiple Income Streams Surprisingly, in my experience, some media appearances have transitioned into additional income streams. I’ve been invited to be a regular contributor on television or to write for magazines and blogs. What could be better for your practice than getting paid to educate the public and to create awareness of your practice?

Helps Provide Fresh Consistent Content For Website, Blog, and Social Media Media interviews help provide new content for your practice website and resources to your social media followers. Sharing video of on-camera interviews, links to print or web interviews extend your reach beyond your

location, provide more traffic to your website, boost SEO, and solidify your professional online presence.

How To Get Media Interview Opportunities What do you think of when you think of professional networking? Private practice therapists who I’ve worked with in business consultations usually consider networking to be meeting with other likeminded professionals for lunch or handing out business cards to physicians offices. While those are important ways to make connections that build your therapy practice, there are other ways to get the word to thousands and thousands of people in one shot, instead of just a few folks at a time. Rarely do therapists think of networking with producers, reporters and journalists. Over the last few years I’ve focused on developing relationships with producers, journalists, and reporters in various media platforms. There are a few who now contact me for quotes when they need expert quotes or interviews for upcoming stories. Here are some things I’ve learned about what works when building relationships with reporters, journalists and producers.


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#1 Seek out opportunities Keep an eye out for opportunities to interview with local and national reporters. Sign up for services that notify you of reporters looking for interviews, like Reporter Connection, ProfNet Connection, Expert Engine. Contact local radio, television, and newspaper companies and offer your expertise on newsworthy topics. #2 Know what is ‘newsworthy’ When pitching stories or interview topics to local journalists and reporters it’s crucial to know what they’re looking for. Sorry, but the fact that you’re going into private practice specializing in family therapy is not newsworthy; however, news and other TV programs might be interested in getting your thoughts on a new study showing how cultivating self-compassion helps individuals manage divorce. I suggest getting into some “media-minded” habits: • Watch national news headlines. Pitch a local spin on those stories to local TV producers. • Suggest seasonal topics. Pitch interviews around managing holiday stress, or Halloween safety tips for children in October. T I L T M A G A Z I N E fall 2 0 1 2

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What could be better for your practice than getting paid to educate the public and to create awareness of your practice? • New research is “news.” Keep an eye out for interesting research that’s relevant to your practice and offer to interview. While what counts as newsworthy must be modified to your particular practice and community, MediaCollege.com generally defines a story as newsworthy if it has the following characteristics: • Timing – News is all about stories that are current and new • Significance – Something that affects large numbers of people • Proximity – An event happening close to home • Prominence – Involves someone famous or wellknown • Human Interest – Appeals to emotion, novel, off-beat, interesting 28

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#3 Know how to write a press release When pitching to media you need to speak their language, which means learning how to write a press release. • A press release needs to be in a specific press release format. Here’s an excellent example: EReleases.com. • Read other releases. Here’s a release I helped one of my therapists at Wasatch Family Therapy, LLC write recently based on her dissertation research: Mean Girls Get Married: Teens Don’t Always Grow Out of Mean Girl Behavior and End Up Using Emotional Manipulation On Spouse. • Don’t send attachments. When you email a press release (or a pitch/proposal) to local news and TV producers, cut and paste it in

the body of the email, do not send as an attachment (it is one more thing that makes their job more difficult). #4 Respond to requests ASAP I’ve come to realize that journalistic deadlines are incredibly tight, and the sooner I respond, the better. I’ve interviewed one afternoon for an E! Online article and it posted that same evening. When I get an email request for an interview I will respond right then on my smart phone with comments off the top of my head. I’ve been known to pull over on the side of the road while driving carpool to respond to an interview request. If a reporter or producer contacts you, respond immediately or the opportunity will pass you by. Decide ahead that you’ll say “yes” (and think about how you can make it a positive and confident “yes”). #5 Avoid psychobabble Talking with the popular media is different than talking with colleagues. Fellow shrinks can talk in short hand with acronyms like DBT, CBT and EFT; we know what transference and countertransference are, but most people don’t know and don’t care. In pitches and in correspondence always use


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layman’s terms that can be easily understood even if someone’s never taken Psychology 101. #6 Let your passion show I think part of why I’ve been successful in getting quoted in national publications is because I show my passion for the work and for the topic of the story or article. Even in email correspondence, don’t be afraid to show your personality and to be approachable. I also openly share my gratitude for the interview opportunity and how much I enjoy media interviews. #7 Make your contact info easy to find In all correspondence make sure that your name and credentials (the way you’d like them to appear if you’re quoted), your email address, and your cell phone number are highlighted and easy to find. Reporters don’t have time to hunt you down. #8 Know how to make their job easier Reporters, producers, and journalists are extremely busy and always on multiple deadlines. They don’t have time to calm your anxiety or to walk you through the interview process.

• Send only relevant information. Highlight the most important information you’d like to talk about and a brief line or two about you and your practice or your “basic professional practice message” (see my elevator speech post). Through that brief stint as a producer and host of a local TV show mentioned earlier, I learned what makes an easy and a difficult interviewee. One of the hardest parts of screening potential guests was skimming through too much information hunting for the relevant points. You can always add more information as needed. • Limit your correspondence. Respect the reporter’s, journalist’s or producer’s time. Though getting an interview might be a big deal

for us as the therapist, it’s just one of many details they are trying to juggle. • Know their demographics. Understand the demographic for a given newscast TV show, newspaper, or magazine so you can pitch relevant and helpful topics (have some “audience awareness”; if you don’t know the primary audience, ask). #9 Ask them to contact you again At the end of each interview or correspondence, whether you interview or not, be sure to ask them to keep you in mind as a resource in the future and to keep your contact information should they need your expertise in the future. If you’re an easy expert to work with and you are eager to interview,

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my experience is that many journalists will take you up on your offer to interview again.

#10 Be a resource

Preparing For On Camera Interviews

I’ve learned that offering myself as a resource is a great way to build bridges with the media. I often tell reporters, producers, and journalists to contact me whenever they need someone to interview on a mental health or family relationship topic, and that if I can’t do it, or don’t feel qualified, I will find them someone who would do an excellent job.

If you got an email today from a local or national television station asking to interview you as an expert on camera about one of your specialty areas for a story, how would you respond? Surprisingly, many therapists let the opportunity to speak on camera and reach a large audience pass them by because of their own anxieties and insecurities about being on camera. Landing interviews on local news and talk shows allows thousands of people to “get to know you,” hear about your areas of expertise, and become aware of your private practice. In my experience, the most effective marketing and public relations opportunities for my private practice are the ones I don’t have to pay for, where someone else is featuring me as an expert, where I can reach thousands and thousands of people in one shot with accurate information, and where I can let them know that I am in private practice. Several years ago I decided I wanted to not just accept invitations to interview on TV but to actively seek them out and gain media experience. Over the past few years I’ve become a regular contributor on Utah’s #1 women’s lifestyle show KSL TV’s Studio 5, as well as

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being interviewed frequently for various news stories. Here are a few things I’ve learned in the process to help you land local TV interviews in your area in order to educate your community and to draw potential clients to your private practice. Thanks to newer social media, TV interviews can reach far beyond the viewership of the live broadcast to a larger audience. Complete segments or clips from your appearances can be linked to from your website, be featured on YouTube or distributed through other social media channels. One example is this short, live interview for a local Utah TV lifestyle program. “How To Handle A Narcissistic Mother” has had over 41,000 views on YouTube (and yes, I’m still working on not saying ,”um”). This video was the one that prompted the Dr. Phil Show booker to contact me about a possible appearance. In my own experience, and in researching and speaking with other therapists about their television experiences, I’ve noted some important advice on preparing for TV interviews and how these interviews can impact your practice. Here are 10 Tips to help you look and sound like an expert when TV interviews come your way.

Thanks to newer social media, TV interviews can reach far beyond the viewership of the live broadcast to a larger audience.

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Know the show Find out who is interviewing you, how long the interview will be, and who watches the show so you can tailor your interview to fit the format and show yourself in your best light. As suggested above, research the show’s demographics, audience, and format so you can tailor the interview to the show’s viewers. Watch the show on TV or go online and find clips of the newscaster who will be interviewing you to get familiar with his or her interview style.

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Develop talking points Mapping out 5-6 talking points is crucial to building my confidence, producers’ trust, and in contributing to an atmosphere of comfortable direction which interviewers will appreciate. I have found that the TV world is very fast-

paced and prepared talking points help me to stay focused. Your talking points might also help some TV anchors stick to the messages you want to highlight, as some anchors tend to go off on tangents. That said, if the interviewer asks a good question that goes a different direction than planned, be flexible and prepared to follow them off topic momentarily before steering your way back to the main issues.

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Add visuals and examples The old adage, “show it, don’t just say it” is certainly true when you have a few precious minutes in the spotlight. Working visual elements into your TV segments provides your audience with an additional mode of “learning” that can empower your message. When using examples or visuals of any

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kind, being as specific and clear as possible will make you and your message more compelling. Even stories or narratives about you and your practice are more effective than boring clinical descriptions because they demonstrate your point more vividly.

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Prepare and practice When preparing for a TV interview, don’t just develop clear taking points; develop an ability to deliver them effectively and confidently. Some people find it useful to memorize talking points and then preparing to expand or extend your point with solid examples. Likewise, you should be prepared to deliver your talking points smoothly if your time is cut short. In the television world, there’s always a bit of uncertainty, and a big part of that can be time. You never know if your five-minute segment will be cut short or extended by five minutes. Practicing and over-preparing for interviews will ensure that you make the most of your appearance.

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Remember that you’re the expert If you’re feeling a bit anxious about an upcoming TV interview (which is perfectly natural), remember that you are the expert and they are coming

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to you for the specialized knowledge that you can provide. Find comfort in the fact that you are knowledgeable about the breadth and depth of your field in ways that they are not. That said, I would advise that you avoid sounding defensive, overly confident, or too argumentative.

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Speak in sound bites A sound bite is a short phrase or a few phrases of information and, increasingly, it is what people expect from most forms of media. Speaking in sound bites requires therapists to use skills that aren’t often practiced. Good therapists often speak slowly, reflect back, pause often, and go deeper; most of us are really good listeners. However, good TV interview skills require the opposite: speak quickly, don’t reflect back, keep the interview moving at a good tempo, and stay on target. For

taped TV interviews that will be edited afterward, remember to pause at the end of each thought or phrase to allow for clean editing.

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Wear comfortable and flattering clothing From my own TV experience, I find it’s important to wear something comfortable that reflects my professional personality and my practice. If something you’re wearing feels awkward or out of place it will detract your focus from the interview. Here are a few “what to wear” tips: • Bright solid colors generally look better than prints or white. • Wear colors that have elicited the most compliments in the past. • Accessorize close to your face, drawing the eye upward.

Marketing experts say that it generally takes 7 exposures to your business brand before a client will actually try your products or services.


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• Women should wear more makeup than usual; men should also wear some makeup, especially a foundation, because men often have oily skin and are more likely to sweat which can look shiny on screen.

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Look at the interviewer Unless instructed otherwise, look at the interviewer. If the show is filming with several cameras, it can be confusing to track which camera to look at. For the record, the camera with the red light is the one currently filming. When the interview is over, unless instructed otherwise, also continue looking at the TV host.

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Be yourself I find it very useful to think of the interview and the filming set (albeit new or unfamiliar) as a comfortable and friendly place. Be glad that you are there. If you can, try to achieve a degree of professional intimacy with your host. Most importantly, relax and be yourself; let your personality show. When it is appropriate, use some humor (though, if in doubt, leave it out). People often make mistakes on camera because they are so worried about making one. Don’t worry about making mistakes, everyone does; if you misstate something, just simply restate it more clearly.

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Don’t Expect Immediate Results Media Psychiatrist Carole Lieberman M.D. says: “Therapists often think that this will grow their practice, but unless you offer some very specific niche therapy that the public may not be familiar with, and patients with this need happen to see your appearance, it is not the most efficient way to get patients. I do not do it to grow my practice. In fact, TV appearances interfere with practice because you often have to reschedule patients at the last minute to do a TV show.” While your TV interview experience might not have an immediate impact, it can give you a lot of credibility, especially the kind of “grassroots” publicity I mentioned earlier. Your TV appearance is more about building your name recognition and about your credibility as an expert.

Maximizing Media Interviews To Build Your Practice While conventional media interviews and appearances rarely lead to an immediate increase in new clients, they do raise awareness of your private practice and your specialty areas, expose thousands of people to your practice, and set

you up as a credible expert in your field. Marketing experts say that it generally takes 7 exposures to your business brand before a client will actually try your products or services. Thanks to social media, your media interviews can have a life well beyond their publication date or airdate. Here are some tips for getting the most mileage out of media interviews to build your credibility and increase referrals to your practice. 1) Be explicit about how you’d like to be introduced Reporters aren’t worried about your branding; they’re concerned about their story. It is your responsibility to protect your practice name and brand by being explicit about how the interviewer should refer to you on camera, on air, or in print. After having a few interviews where they say my practice name incorrectly, or didn’t mention it at all, I’ve learned to clearly spell out how I want to be introduced. In email correspondence with media contact I request something like this: Please refer to me on camera as “Therapist Julie Hanks LCSW, Director of Wasatch Family.”

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Is Conventional Media less normal than New Media?

I also request a lower-third banner (the text box graphic that pops up at the bottom of the screen during interviews) with my name, credential, practice name, and website during the interview. Here’s what I ask for: “Julie Hanks LCSW, Director of Wasatch Family Therapy, WasatchFamilyTherapy. com”.

3) Capture the video or audio to post on your website

2) Always request a link to your website

4) Post on social media

Always request that the reporter or interviewer mention your website address during the interview and if you’re on camera, show your website address on a lower-third banner. You want to make it as easy as possible for potential clients to find your practice website, and ultimately, set an appointment. Having large websites link to your website improves your visibility Google searches. 34

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I suggest keeping an archive of all TV, radio, and print interviews so you can use them on your own practice website. If the interview is not available online, you can request a DVD copy of the segment from the TV station or an mp3 of the audio interview.

The editors of TILT magazine are planning an article in the pipeline where I will address the effective use of social media for therapists, but it is worth mentioning here that social media sites, like YouTube, Facebook, and Twitter allow interviews to have a much greater reach than the live TV viewership or readership of a periodical.

While we know that some forms of mass media are limited in their reach and effectiveness in today’s high-tech world, there’s no denying that the general population still gets the majority of their information from TV, radio, and news sources (print or online). Make a change in your approach to conventional media for your good, the growth of your practice, and your ability to help more people in need.

About the Author Julie Hanks, LCSW has over 20 years in the mental health field & 10 years in private practice as owner of Wasatch Family Therapy. She consults with therapists on how to build a fulfilling and profitable therapy business and attract clients through technology and social media. Follow Julie on Twitter & Facebook. She also writes for PsychCentral.com’s Ask the Therapist and Private Practice Toolbox. Have you been interviewed on local or national TV? I’d love to hear about your experience. How did it go? What do you wish you’d known beforehand? If you have any questions for me feel free to ask me on Twitter @Julie_ Hanks or contact me directly here.


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REEL CULTURE Jean-Anne Sutherland

The Tenacity of Spirit in Beasts of the Southern Wild Every now and then a movie like Beasts of the Southern Wild comes along. Not very often, but every now and then a movie comes along that slams us into questions about strength, faith, fortitude, survival and community. This is one of those films that works on every level. It is visually stunning. The actors are raw and authentic. The story is rich and complex. It’s poetry without pretension. It’s more of an emotional event than it is a movie. In the film, 6 year-old Hushpuppy faces the unraveling of the Universe. She and her father live in an impoverished region of southern Louisiana called The Bathtub. While the community is poor (and I mean poor, the kind of poverty we rarely see in film), they delight in the sense of community they’ve created far away from malls and shops and, well, civilization. As she tells us, The Bathtub “has more holidays than the whole rest of the world.” But the community is shattered when a violent storm wreaks havoc. Several of the folk who refuse to abandon their home band together

to make shelter, find food and rebuild their lives, so very far apart from the rest of the world. Hushpuppy observes, “The whole universe depends on everything fitting together just right. If one piece busts, even the smallest piece... the whole universe will get busted.” When Wink, her father, falls ill, the universe shifts and those things that were once aligned are no longer holding together the whole. Ice caps melt, storms rage, and prehistoric animals roam the land. In the midst of survival, she and her community literally cling to floating, makeshift homes. This is a story of hope and healing, of determination and will. Wink knows that soon he won’t be there for his little girl and she needs to know how to survive. It’s a wrenching story about a parent’s love for his child, albeit a quicktempered, beerswilling dad. Love and strength don’t look as we are used to them looking. It at times looks mad, irresponsible, life -threatening.

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will let you talk about loss and survival, tenacity and re-building a life out of what seems like ruin. It reminds us that even the smallest of us matter. It makes us question what we think we know about love and living. Rarely does a film tell such poignant tales. Take advantage of the opportunity to explore this one.

But the film forces us to see dimensions of love outside of our comfort zone. These people are poor! They “should” evacuate and be relieved to land in the bright, white, sanitary hospital where they can be fed and medicated. They should curtail their drinking. They should better clothe the kids. The genius of this film is that it makes their choices look like wisdom while the “shoulds” feel like a kind of prison. And it does so without preaching or reliance on tired stereotypes. This film can be used to explore myriad issues from family to death and dying. It’s a film that

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Not very often, but every now and then a movie comes along that slams us into questions about strength, faith, fortitude, survival and community. Jean-Anne Sutherland, Ph.D. is assistant professor of sociology at University of North Carolina Wilmington, USA with one of her research focuses being sociology through film.


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The

Internet-license Connection What if you’re already licensed as a counselor, and you’re taking an online education course to brush up on your skills? Do those hours count toward license renewal? With online counseling and education programs booming, you need to know the answers so you can meet the legal requirements for licensure.

Range of regulations When it comes to obtaining your license, some state laws either don’t address the issue of accepting online hours or use vague terminology. For example, if you live in Virginia, state regulations require you to have “direct client contact” for 240 of the 600 hours of intern experience to become a marriage and family therapist. But, the regulation doesn’t define whether that contact must be faceto-face in an office setting or if online counseling with a video camera is acceptable. Other states may allow online counseling hours.

LEGAL BRIEFS

You’re a marriage and family therapist intern working under supervision. You roll your chair up to your computer and log onto the Internet to conduct some online counseling sessions. Does this “telemedicine” time count towards the experience you need to obtain your license as a counselor?

Licensing boards may be reluctant to accept online counseling experience because of concern that candidates for licensure would submit all online hours to meet the requirement. Would that truly be in the best interest of the public? States need to clarify what’s acceptable—and what’s not. Keep in mind that you still need to obtain informed consent even when the counseling is online. A new set of issues arises when the therapist is licensed in one state and provides online counseling to a client in another state. Therapist state boards may take a page from the National Council of State Boards of Nursing’s interstate compact, which provides for mutual recognition of licensure in different states. The Federation of State Medical Boards developed a model so T I LT TI L M T AMGAAGZ AI NZ IEN fall E fall2 021021 2 37 37


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that physicians can go through an abbreviated licensure process to practice in other states. Several states have also adopted this model.

Some clarification in California? California may have helped clarify the muddy waters of online counseling and licensure. As of January 2008, applicants for a marriage and family therapist license can receive credit for “providing personal psychotherapy services via telemedicine.” The California Association of Marriage and Family Therapists and the (California) Board of Behavioral Sciences supported the change. Online counseling time is limited to 125 hours to avoid a situation where a licensure candidate obtains all of his or her client contact hours online.

Log on for CE The license situation is clearer when it comes to continuing education requirements. Some states don’t specify how many hours of education credit may be earned online. In other states, you may be limited to a certain percentage of online courses you can take in order to meet licensure requirements. It’s important to keep current on the requirements. For example, a proposed change to the regulations in California would increase the number of self-study courses allowed (most of which are taken online) from one-third to one-half. Don’t forget to check for any specific topics for which you are required to obtain credit so you can receive your license renewal. Ohio, for example, requires 3 hours of ethics training as part of the 30 hours of continuing education credit that marriage and family therapists must earn every 2 years.

Protect yourself Your state association is one of the best places to find more information related to licensure and online counseling. By taking the time to become informed about this new form of obtaining hours, you can protect yourself from liability in the future.

Reprinted with permission from Healthcare Providers Service Organization (HPSO); 159 E. County Line Road, Hatboro,PA 19040 1-800-9829491 HPSO Risk Advisor 2011-2012.

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DeeAnna Nagel

TECHNOLOGY ENHANCED COACHING

Vision Boards Go Digital A vision board is a simple yet powerful visualization tool that activates the universal law of attraction to begin manifesting your dreams into reality. Many people attribute the concept of a vision board to the concept of law of attraction but a vision board can also be a way of demonstrating what is important in your future in a visual display. Coaches have long been fans of vision boards and the use of vision boards with coach clients can enhance the coach practitioner’s practice. Vision boards can be created with a poster board, magazines, a pair of scissors and glue- or a cork board and thumbtacks. The process involves cutting and pasting or tacking images that represent what a person wants to manifest in their future. The process of searching and cutting

out images can be seen as a focusing activity as a person envisions with intention. Now with technology, vision boards can be created online using a formal vision board program like StepOne Vision Boards or Catalog of Dreams . Marcia Turner has written a book, The Complete Idiot's Guide to Vision Boards (see For the Love of Books column in this issue) and offers a chapter on online vision boards. She says, Although you can see your online vision board only on a screen—computer, Blackberry, or phone, for example—the process required to prepare it mirrors that of a physical board. In both cases, you contemplate your priorities and set goals, gather images that reflect the life you aim

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TECHNOLOGY ENHANCED COACHING to create for yourself, couple them with inspiring quotes and sayings, place the components on a board of some type, and then hang or place it somewhere you will regularly see it and reflect on it. With technology everywhere and becoming an integral part of our lives, coming up with new ways to offer tried and true coaching techniques becomes more and more necessary. Translating vision boards from poster board and magazine cut outs to the digital screen is one such example. We must also keep in mind that our clients may already be creating something akin to a vision board through their own creative avenues online like Polyvore and MyScrapNook. Finding out how clients are using websites such as those mentioned here can help us coach our clients to success.

Many people are also using online programs to create collages that contain emotional content both positive and negative. It is important not to confuse collage images or pictures that a person might place in an online scrapbook or pictures with positive affirmations and quotes on their Facebook wall with a vision board. Even though these efforts may be a way for someone to view the world from a positive lens, a vision board is a dedicated process- one that is even mindful and contemplative for some. A vision board can help our clients find focus, establish goals, name their dreams and clarify what is important. A vision board is intended to be a positive and uplifting reminder to the person about what they are working toward. REFERENCE Turner, M. (2009). The complete idiotâ&#x20AC;&#x2122;s guide to vision boards. Alpha Books: NY, NY.

ABOUT THE AUTHOR DeeAnna Nagel is Co-Editor of TILT Magazine and is a Board Certified Coach and a Certified Professional Coach.

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Intergrated

Mental Health SUpport

Eoin Oâ&#x20AC;&#x2122;Shea

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The internet provides unique opportunities as well as challenges for effectively engaging those experiencing psychological distress, including suicidality (Shah, 2010). Barak et al. (2008) have conducted one of the largest reviews and meta-analyses examining the effectiveness of online mental health interventions. This study found, among other results, that online methods are broadly comparable to face-to-face therapy on a range of measures. Furthermore, research (e.g. Cook & Doyle, 2002) suggests that measures relating to factors such as therapeutic relationship/alliance – so often assumed to be more amenable to development through face-to-face sessions – are comparable through online contact. Turn2me’s own user survey responses posit us as an already-successful organisation in this regard with 75% of our members suggesting they are

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either satisfied or very satisfied with the site (O’Reilly & Scollard, 2012).

The Development of Turn2me Turn2me was founded for very personal reasons by those directly affected by what some might consider to be the ultimate consequence of mental health difficulties: suicide. Two Irish brothers, Oisin and Diarmuid Scollard, suffered the unthinkable in 2003 when their brother, Cormac, took his own life. For a number of years, ideas about how to make some sense, and difference, in the wake of Cormac’s loss percolated. In 2009, the two brothers came together from their respective legal, business,

and web design backgrounds to launch Turn2me. What started off as a small group of site users regularly chatting and posting online grew rapidly into a multiservice organisation. Initially, interaction on the site was not moderated but the sense of community among such a small number of people was strong. As time went on, the importance of training moderators to ensure safety of communications and adherence to emerging policies and procedures developed. Turn2me’s appeal to a broad range of people with mental health problems did not go unnoticed externally. The


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organisation has been awarded funding by Diageo, Vodafone, Nua Healthcare, and a generous ‘Adwords’ grant from Google. As of today, the site employs no fewer than six professional staff including counselling psychologists, a psychotherapist, and fundraising staff. A Board of Directors meet with the operations and fundraising managers on a quarterly basis to guide the organisation’s development. Furthermore, Turn2me utilises the voluntary efforts of between 15-25 moderators who oversee the day-to-day interactions of members on our support forums.

A closer look at Turn2me’s range and integration of services reveals an attempt to combine the ‘best of both worlds’ in terms of the peer-supportive and cost-effectiveness features of volunteer involvement with the professional rigour and supervision of mental health professionals. This combination seems advisable given two strands of research supporting both approaches. For instance, some research suggests the importance of support provided by trained volunteers, even in working with otherwise challenging client groups (e.g. Verinis, 1970). In some instances, such volunteer input has demonstrated comparable effectiveness to that of professionals (e.g. Castro et al. 2011). Other research, however, points to ways in which both the administration of volunteer programs as well as some of the more complex/challenging duties, e.g. supervision of volunteers, would best be handled by professional staff (Vinton, 2012; Abdel-Monem & Bulling, 2005). In any event, it is likely that we can view volunteer efforts in initiatives such as suicide prevention as being complementary to those of professionals (Eldrid, 1993).

Turn2me’s Services and Research Rationale Whilst the present article forbids a comprehensive review of research underlying the provision of Turn2me’s full complement of services, what follows is a description of these different site features with mention being made of research examples supporting the same. An attempt is made to provide service-focused discussion of how these can be provided in a safe, ethical, and workable way.

Support Forums The benefits derived from participation in support forums may be explicable in terms of Reissman’s (1965) ‘Helper Therapy Principle’; the view that those who help others indirectly help themselves as well. Greidanus and Everall (2010) further suggest that this same principle may account for such helpers achieving an enhanced commitment to recovery, increased perception of importance to others and social status, and a greater sense of independence. Furthermore, studies such as that conducted by Roberts et al. (1999) have empirically demonstrated

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support of the ‘Helper Therapy Principle’. This study found that, among those in a ‘mutual help’, mental health concerns forum, those communications characterised by help offered to others were more predictive of a positive psychosocial outcome than help received. This potential mechanism of change of an online mental health community seems important in the provision of Turn2me’s service to date. The forums at Turn2me are peer-moderated by volunteers who have undergone a total of between 18-27 hours of direct training and ‘shadowing’ – the latter term indicating a period over which trainees observe and are guided by experienced moderators (or ‘mods’) in responding to members on the site. (The range of hours indicated above reflects the fact that our training has lengthened over time to a point where recently-trained mods will have undergone a

Certificate in Online Mental Health Support). Forums are open to posting between the hours of 12pm-12am; outside of these times, members are free to read others’ posts but cannot post themselves because of the premium which Turn2me places on providing a safe and moderated environment for all members. The role of mods has changed over the course of Turn2me’s development. Initially, they were present only to edit and advise regarding breaches in our policy as deemed necessary. Nowadays, however, mods are encouraged through training and on-site duties to intervene, comment, provide support, and facilitate further engagement and deeper exploration of material by members on the site. Support of mods – other than through training and shadowing provision – occurs through two different

resources. One involves weekly moderator-online support groups (M-OSGs). These are support groups for and by mods, led by one of two experienced volunteers. This is a forum in which (a) support from each other can be provided in relation to the strains of the role, (b) information and guidance on issues like policy application on-site can be discussed, and (c) a method of feedback by M-OSGs facilitators exists whereby the Director of Services is informed through a standard Feedback Form of anything which needs to be addressed. A second support in this regard is provided through monthly online supervision. This is provided by a fully qualified counselling psychologist and focuses more on clinical issues which may arise for mods when dealing with certain members, either specific individuals or


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broader groups characterised by varied presenting issues.

Online Support Groups (OSGs) One of the largest reviews to date has been conducted by Barak et al. (2008). The authors found that: â&#x20AC;&#x153;Personal and interpersonal dynamics, which are central in producing effects in these groups, are induced and accelerated by the powerful online disinhibition effect. These factors, including the very impact of writing, expressions of emotions, collecting information and thereby improving understanding and knowledge, developing social relationships, and enhancing decision-making skills and consequent behavioral actions all serve as possible generators of a sense of personal empowerment for people in distress.â&#x20AC;? (p.1867).

OSGs at Turn2me provide support in relation to three different presenting issues; those of depression, anxiety, and suicidal thoughts and feelings. The addition of this latter group was deemed appropriate following an event to mark World Suicide Prevention Day 2012 on the 10th of September. This involved 24 hours of support group provision for those affected by suicide, the majority of whom were themselves suicidally distressed. The OSGs are facilitated by mental health professionals and last an hour and a half. They are of an open format, are free of charge, and can be accessed by booking in advance or coming along on the night in question. Our

chat system allows for any challenging or abusive members (a very rare occurrence indeed) to be removed from the group for an hour whilst provision is made, in the group for those who may be suicidal, to be contacted for 1-to-1 support as/ when deemed necessary by the facilitator. Anecdotal evidence from our groups suggests that they have occasionally been viewed by attendees as having saved their lives or otherwise kept them going through a particularly tough period in their lives. Attendance is unlimited, meaning that those who are depressed, anxious, and/or suicidal can attend as many groups as they like.

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Information and Services Directory One of the more common uses of the internet to date in relation to mental health support has been the provision of information and various non-staffed resources for site visitors. Turn2me offers its own 24-hour accessible resource in this regard. The Information service includes a Directory of Services, articles, blogs, and other informational resources so that those who visit the site can gain access to other services/information of relevance to them. Only those sites/resources which have been screened by our professional staff are included here under the assumption that incorrect information can be worse than no information at all when it comes to mental health issues.

1-to-1 Online Counselling Online counselling has shown promising results to date (e.g. Barak et al., 2008) in areas as varied as child psychiatry, depression, dementia, schizophrenia, suicide prevention, posttraumatic stress, panic disorders, substance abuse, eating

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disorders, and smoking prevention (Hailey et al., 2008). However, it has also been plagued by doubts concerning safety and effectiveness (compared with face-to-face), especially in relation to factors concerning visual and paraverbal cues in communication and limitations regarding the therapeutic relationship online (e.g. Rochlen et al., 2004). The latter point seems widely-accepted in a manner not consistently supported by research concerning the online therapeutic relationship/ alliance specifically. At the very least, it has been suggested that any negative effects of absent visual and para-verbal cues may be offset by disinhibition and a range of other benefits of online contact (Leibert et al., 2006). The Turn2me online counselling offering is provided by fully qualified counselling psychologists (all are members of the Psychological Society of Ireland). Sessions are reasonably priced and last for 50 minutes. They can be booked by contacting the service by email and every effort is made to revert to that member within two working days to schedule an appointment with him/ her. We are careful to screen clients in terms of presenting

issues and level of distress – it is made clear from an early point in time that the counselling service at Turn2me is not a crisis service or for those who are acutely suicidal. If this seems to be the case, every effort is made to provide that member with information and encouragement to contact a local mental health service or their usual healthcare provider, e.g. GP or psychiatrist. Furthermore, we do not work with clients who state that they are already in some form of counselling/psychotherapy elsewhere, such is our conviction that this might cause ‘mixed messages’ or possible confusion for such clients.


– and also better ways of coping and responding to life’s challenges.

Thought Catcher: Tracking one’s progress over time A more recent and also interesting feature at Turn2me – and one which can be used in combination with any other service on offer, both internally and externally – is our Thought Catcher. This is basically a thought-, mood-, situation-, and behaviour-tracking tool which is available free of charge to all members. Individuals can submit one entry per day, communicating a certain thought they have in mind, linking this to a feeling which seems to be associated with this

thought, detailing the current scenario implicated in both, and finally commenting on how he/ she seems to have responded to all three. The Thought Catcher is based broadly on the cognitive behavioural therapy theoretical underpinning which highlights the extent to which our appraisals of various thoughts, feelings, and events maintain or alter any suffering experienced as a result (Beck, 1976). The Thought Catcher can be used by members either solely or in addition to any other intervention/support in which they are currently engaged. If presently receiving professional therapeutic support, the tool can be used to help clinicians and clients to monitor patterns underpinning their problems

A View to the Future at Turn2me At a present membership of almost 17,000 individuals, Turn2me’s service seems a welcome addition to mental health support received elsewhere, both online as well as through other modalities. Plans for the future include further research to evaluate and compare our services to others available. Furthermore, a new 1-to-1 offering is being developed which will see our organisation offer a larger range of specific methods on online counselling interaction including synchronous and asynchronous, textual, audio-visual, and telephonic components. Our vision is one in which every individual is entitled, and has access to,

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a seamless range of free and low-cost mental health support options characterised by the cost effective but safe and ethical combination of volunteer and professional support.

REFERENCES

Abdel-Monem, T., & Bulling, D. (2005) ‘Liability of pro Sciences and the Law, Vol: 23: 573–590.

Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (200 Technology in Human Services, Vol: 26 (2/4): 109-160.

About the Author

Barak, A., Hen, L., Boniel-Nissim, M., & Suler, J. (2008)

Eoin O'Shea is Director of Services at Turn2me. Trained as a counselling psychologist, he has worked in various teaching, research, and therapeutic settings. His work at Turn2me will focus on providing online mental health solutions to both the general population as well as specific groups for whom the online modality may represent greater accessibility and effectiveness of service.

Castro, C. M., Pruitt, L. A., Buman, M. P., & King, A. C. (2 285-294.

Beck, A. T. (1976) Cognitive therapy and the emotional

Cook, J. E., & Doyle, C. (2002) ‘Working alliance in onl

Eldrid, J. (1993) ‘The complimentary roles of voluntee

Greidanus, E., & Everall, R. D. (2010) ‘Helper therapy in

Hailey, H., Roine, R., & Ohinmaa, A. (2008) ‘The effecti

Leibert, T., Archer, J. Jr., Munson, J., & York, G. (2006) ‘A Vol: 28: 69–83.

O’Reilly, G. & Scollard, O. (2012) ‘Turn2me.org: An aud

Reissman, F. (1965) ‘The ‘helper’ therapy principle’, So

Roberts, L. J., Salem, D., Rappaport, J., Toro, P. A., Luke adjustment of members’. American Journal of Commu

Rochlen, A. B., Zack, J. S., & Speyer, C. (2004) ‘Online t

Shah, A. (2010) ‘The relationship between general po

Verinis, J. S. (1970) ‘Therapeutic effectiveness of untra

Vinton, L. (2012) ‘Professional administration of volun

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ofessional and volunteer mental health practitioners in the wake of disasters: A framework for further considerations’. Behavioral

08) ‘A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions’. Journal of ‘Fostering empowerment in online support groups’. Computers in Human Behavior, Vol: 24: 1867–1883.

l disorders. New York: International University Press.

2011) ‘Physical activity program delivery by professionals versus volunteers: The TEAM randomized trial’. Health Psychology, Vol: 30 (3):

line therapy as compared to face-to-face therapy: Preliminary Results’. CyberPsychology & Behavior, Vol: 5: 95-105.

ers and professionals in suicide prevention’. Italian Journal of Suicidology, Vol: 3 (2): 107-109.

n an online suicide prevention community’. British Journal of Guidance & Counselling, Vol: 38 (2): 191-204.

iveness of telemental health applications: A review’. The Canadian Journal of Psychiatry, Vol: 53 (11): 769-778.

An exploratory study of client perceptions of Internet counseling and the therapeutic alliance’, Journal of Mental Health Counseling,

dit of service use November 2011 – January 2012’. (Contact author of present article for copy of report).

ocial Work, Vol: 10 (27): 32.

e, D. A., & Seidman, E. (1999) ‘Giving and receiving help: Interpersonal transactions in mutual-help meetings and psychosocial unity Psychology, Vol: 27 (6): 841.

therapy: Review of relevant definitions, debates, and current empirical support’. Journal of Clinical Psychology, Vol: 60: 269-283.

opulation suicide rates and the Internet: A cross-national study’. Suicide and Life-Threatening Behavior, Vol: 40 (2): 146-150.

ained volunteers with chronic patients’. Journal of Consulting and Clinical Psychology, Vol: 34 (2): 152-155.

nteer programs now more than ever: A case example’. Administration in Social Work, Vol: 36: 133-148.


TILT â&#x20AC;&#x201C; Therapeutic Innovations in Light of Technology

an Online Therapist

A Day in the Life of

I love my job. Itâ&#x20AC;&#x2122;s strange to say that out loud, but my job is exciting, new and part of the digital revolution that is our world. I am a tech-savvy clinician, and this is right up my alley!!!

Stephanie Torino

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I begin my day at 7:45am, sitting at my desk with a large tea and bagel in hand. I check email, get my First Chat profile up and running, open up all the documentation I will need, and make myself ready to accept the first clinical consult of the day. It is now 8 AM, and I am ready to tackle the day head-on! Chat, you say? Chat, I say! I am a First Chat clinical counsellor for Shepell•fgi. By “chatting” I mean online instant messaging using secure encrypted chatting software that allows clients from all over the country to access services 24 hours a day. First Chat offers clients a solution-focused clinical consultation through which they can confidentially address their issues, be they financial concerns, relationship issues, or anything in between, under the guidance of a trained clinical counsellor. First Chat is also a wonderful gateway through which clients can be connected to more specialized Shepell•fgi resources or other referrals as appropriate. I need to be open-minded, flexible and well-versed in netiquette and internet jargon. I am challenged on a daily basis to deliver the best counselling possible because we all know that one wrong word can result in the client taking offence where none was meant. I have always been a stronger writer than speaker, and it pleases me to know I am providing writing support to those who also feel more comfortable in the virtual world. Clients tend to get to the point more quickly, speak their minds without fear of judgement, and will share things they would not normally share because chatting gives the impression of intimacy without having to look someone in the eye while bearing your soul to a complete stranger.

Seeing as I do not get any visual or audio cues from my client, I have to pay extra attention not only to what is typed, but to the tone of the conversation, the delivery and structure of the phrases, how long it takes for the client to finish their train of thoughts, what they are not saying, the grammar, spelling and punctuation they use. I have to depend on my skills and experience to tell me when something is appropriate, when I am touching on a sensitive subject, how to engage the client, how to focus them, and how to let them guide their own experience as well. It’s like driving a car: you have to multi-task and concentrate on the present, but also anticipate the possible route the other driver may take. As for the client experience, First Chat has exceeded expectations. From what the clients have said, it is a tool that provides “instant gratification”. Client comments include “thank you so much!”, “I feel fortunate to have this service available to me”, “given that I work in a cubicle, with so many ears around me, this discrete service is incredibly valuable to me”, “service was fast and no wait time for a counsellor, keep up the great service!” and “great and accessible service”. As the modality allows clients more time to reflect and articulate their thoughts before making their final comments, more so than they may at the end of a final face to face or telephonic session, I practically receive this kind of feedback on daily basis. Although traditional-minded professionals might suggest that “chatting” is not a clinically viable way of dealing with mental health issues, as we saw when we first launched e-counselling over a decade ago, I am here to say not only is chat an extremely effective and sound clinical practice, it is a natural evolution of writing therapy and e-counselling. It takes the power of the written

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word and offers clients the opportunity to seek counselling outside of conventional means, such as face-to-face or telephone counselling. In today’s day and age, people are communicating more through the written word than any other modality. This is the natural result of our technological advancements and is an extension of the new social media trend. If you know how to BBM, IM, tweet, or text then chatting is the modality for you. It appeals to those who wouldn’t

normally seek professional help for many reasons, such as social stigma, privacy & confidentiality concerns, access issues due to lack of mobility or transportation, verbal communication challenges and social phobias. I am offering a valid and valued service that is paving the way for unique and effective counselling. I am proud to say I am part of this new virtual era where we have combined old world communication with the new technology of today.

about the author Stephanie Torino, MA Counselling Psychology First Chat Supervisor and Client Care Counsellor for Shepell•fgi For Stephanie’s full biography, please see our feature “First Chat: Attracting New EAP Users through Online TextBased Chat Services”

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an Online Coach A Day in the Life of

by Sheevaun Oâ&#x20AC;&#x2122;Connor Moran

About 15 years ago I founded Energetic Solutions, Inc., to work with clients who want breakthroughs, shifts and transformation. The clients that came to me were ones that had tried many many other modalities to achieve a result in their business or in their life. About six years ago I started to move my clients to the virtual model

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because I wanted to travel and have more freedom when teaching and traveling to continue to serve the clients. Today 90% of my work is done via technology. I remember when I first started working with clients over the phone and had to have a conversation with the cell phone company about my bill. They looked at the minutes and were astounded by the number of minutes I was using. That conversation resulted in my getting a program that only a few people had at the time – unlimited. I could always tell the success of my business by the volume of my cell phone minutes. Yes, this was a strange way but it indicated what was happening in my business and how I was able to serve as many people as possible. Today my days are mostly fixed with a very regular schedule. I work with clients three very full days a week until around 6 pm, and the other two I set aside for speaking, running the business and connecting with my team. I am truly grateful to have a woman that started as my assistant 12 years ago and who now runs the left brain stuff of on-line marketing,

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coordinating the shipping of our transformational CDs, books, or DVDs, autoresponders, teleseminar set-up, and pushing me to continually do videos. My favorite day starter is to get up around 5:30 am, as that’s when I find it quiet and I’m able to write blog posts, articles and respond to emails. But I first take a giant glass of water to stop the dehydration that occurs from sleep and then get to the kitchen to get my juice and tea going. I have a custom blend that I love that has flowers and green leaves that is very cleansing as well as energizing. Most days during the week I walk on the beach for 35 to 55 minutes so I can be ready physically, mentally and energetically for what’s ahead. The amount of time that I walk depends on the volume of clients I see on a particular day or if I have a networking meeting. It is my preference to walk alone and although I do see many of the same people, there is only one I stop for. She is a woman from Egypt whose name is Yvonne and she is dealing with Parkinsons. I love chatting with her as she is so interested in feeling better and

improving herself, which I of course love to share. Once I get back from the walk I allot 45 minutes to respond to my emails, client issues that have been sent to me and partnership opportunities. My emails are often situations from clients who are part of either my email membership program or one of my Diamond Level coaching clients. What I have discovered is that the 45 minute allotment for emails presses me to get them all handled before I move on to the rest of my day. I love to work with time chunks because it gives me a beginning, middle and an end. I allot 35 minutes of my morning for meditation and goal setting. It is my goal to serve as many people as I can and for that I need to be clear. Clarity is what I get for my clients and if I’m not clear then how can I share those gifts? My next chunk of time is allotted to making my green smoothie and preparing what I will have for lunch as I work back to back with scheduling. The smoothie is filled with lots of fruit and vegetables for the most energizing effect throughout the day.


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I drive to my center, which is called the Tree of Life Center, around 10:30 and set up my room for the day of clients. There are a few specific things I do to ensure the space is clear from anything that could be left from previous days

or clients. Most of my clients who are entrepreneurs and CEO’s are most accustomed to working in a meeting setting via technology. Some of my clients like to meet in person and I enjoy having a center as I hold group meetings regularly.

Usually I have lunch on the fly from what I brought with me and end my day around 6 or 7 pm. Once I get home I’ve got a routine of clearing my energy and taking a salt bath before I do anything else.

ABOUT THE AUTHOR Sheevaun O’Connor Moran, author of several books and Master Energy Coach, is the founder of the Energetic Solutions, Inc.® Success System and is devoted to teaching entrepreneurs and leaders deep Universal Transformation Principles with practical step-by-step “How-To’s” to live abundantly. Through her Conscious Conversations for CEO’s or Energetic Solutions, Inc.® Boot Camps, Private Mentor Coaching Programs, and products, Sheevaun shares how to transcend lower level energies into the life of your dreams.

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Cyber Supervision Anne Stokes

Recently, attempting to create some order in my life – or rather my loft room – I went through 27 years of journals, removing articles worth keeping, and binning the rest. I came across ‘Relationship Serenity’ by Michael Neill, looking at relationships between clients and coaches in faceto-face work. He quoted that wonderful prayer of Niebuhr, commonly called ‘The Serenity Prayer’. A friend had just given me a bookmark with it on, so I began to be curious about its application to Online Supervision.

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The starting point was acknowledging that I’m at my best as an online supervisor when we’ve co-created a good relationship. This isn’t as easy online as it is f2f, as perhaps more time is spent f2f paying attention to relationship building. In synchronous supervision, there can be pressure to ‘get on with it’, or asynchronously, a feeling that boundaries may be crossed if I make enquiries that appear more personal in an email response. Yet if I don’t do this, how do I really get to know my supervisees, support and hold them, or know when there may be ‘buttons’ touched? So I need to have the ‘wisdom to know the difference’ between what is purely ‘nosey-ness’ on my part and what is

genuine relationship building, enhancing online supervision and therefore benefit the client. I also then need to have the courage to change aspects of our relationship where necessary. Neill talks about the possible desire of a coach to control the ‘coachee’. This can also be true in online supervision. As supervisors, we can be so sure that we can see what the supervisee’s ‘problem’ is with this client, or have a useful bit of theory to inform the process, that we thrust this on to the supervisee! In other words we’re attempting to control the other. Now, I am not suggesting that we shouldn’t use our insights, hunches, and knowledge. If we don’t, we are being withholding, which can


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Serenity in Relationships in Online Supervision also be a way of controlling the other. All I am thinking is about changing the way we make the intervention – is it from a position of trying to control, or is it an ‘offering’ for you both to consider to see if it fits? If it’s the former and happens repeatedly, it will sour the relationship very quickly. It’s particularly important in the relationship for supervisors to be tentative in ‘sharing their wisdom’ in the online environment. We haven’t got the luxury in asynchronous work to moderate, to temper, our remarks to suit the supervisee’s reactions – to know when to say more or less. Even in synchronous sessions, we need to be alert to pick up whether we’re overstepping

the mark. An obvious, but sometimes overlooked, way of avoiding controlling, or inadvertently being seen as seeking to control, is to ask! This ability to be open to feedback both strengthens the relationship and models good practice for the supervisees in terms of how they work with online clients. Sometimes it does take courage, as we can’t be sure we will like the feedback! What about ‘accepting the things I cannot change’? In fact I cannot change anything about another, as we know from our client work! They have to want to change and I can solely offer an environment in which that might be possible. It’s the

same in supervision. So maybe what needs concentrating on is not ‘what do I want from them?’ (i.e. what have they got to change to do/be as I want) to what do I want for them? If I do this, I’m more likely to be guided by genuineness and empathy, rather than by my own needs! Then maybe I am providing that online atmosphere where a supervisee might choose to change. Once again, I think that this aspect of the relationship may take more concentration and awareness to achieve online, since it takes time, and has to be spelt out literally, rather than being picked up from non-verbal cues. Neill also mentions the concept of starting each session

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with a ‘clean slate’. Silly idea I thought… surely the idea is to build up relationships from previous sessions/emails? However, if I carry into today’s supervision the things that have not been good about the last one, I taint the relationship. You know the old saying during a marital dispute ‘And in October 1975, you said….’ Whew, either deal with it in the next online contact, or let it go! That way we might get to serenity in our relationship. Reference Neill, M. (2006). Relationship Serenity. Counselling at Work, pp 24-25. Summer. BACP Rugby

ABOUT THE AUTHOR Anne Stokes is based in Hampshire, UK, and is a well-known online therapist, supervisor and trainer and Director of Online Training ltd. She can be contacted at anne.stokes4@ btinternet.com.

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Serenity Prayer God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.


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TILT – Therapeutic Innovations in Light of Technology

Ne wInnovations

Innovative Online Counseling Referral Programs (Part 1) Jay Ostrowski Her eye was first drawn to the beautiful image on the card and the headline that fit her deep desire for relief. Feeling hope and a bit of excitement from the bold declaration on the card, the professionally dressed woman decided that it couldn’t hurt to text the number on the card for more information. In this crowded doctor’s lobby, no one would know that she was inquiring into mental health services. Connect offline Clients with Online Resources One of the most common problems faced in starting an online counseling practice is the question of how to market or advertise the practice to acquire clients. An ad, leading to a text-base interaction, is just

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one of many innovative ways you can get clients to see you online. Many online counseling marketing programs have some of these same elements. But, more often, they have a link or two missing in the chain of events that get clients to go online. Maybe their marketing is only web based. Those who use websites as their sole referral source can tell you that the referral process often gets stalled there. A website alone will not bring in enough referrals for a full-time practice. Maybe it is time to try something more interactive that meets clients at their point of need. Counselors should use their considerable problem solving skills to help clients adopt online counseling services. Consider again the example.

The response to the woman’s text was immediate. She’s one of the 68% (Pew, 2012) of young Americans who have fallen in love with the smart phone. The return text she received provided some options. No, she didn’t want to call the number on the screen and talk to someone, not now surrounded by strangers. Yes, she wanted to know about the services, but was drawn to the survey she could take right then on her small screen. After


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a few more clicks, she agreed with the results of the screening. She really did need some help. Her private problem, she knew, was growing. She hadn’t really known how to get help. She’d been too embarrassed to discuss it with her friends. However, this survey seemed to be accurate and made getting help pretty easy. She hadn’t considered online counseling to this point, but now she was curious and open. Ever since she picked up that ad in the lobby, everything seemed to line up. It was encouraging. The Combination is the Key The combination of several key ingredients makes a program like the one illustrated work: an eye catching “ad” with a bold and encouraging claim (something counselors are often reluctant to make), placement in a high-traffic area where re-enforcement will

likely take place, ease of client engagement (text messaging), immediate response, a validating survey, etc. Remember to keep the client’s point of view in mind. At each step of the client’s decision-making process, educate the client, build trust, and provide options leading them to online counseling services. The ad in the illustration didn’t talk about the details of the service. That comes later. The ad gave the woman hope and engaged her in a process that built awareness of the severity of her issues and of the online counseling resources to meet that need. Encouragement, validation and ease of connection were essential ingredients that made the self-referral process work. However, connection and advocacy by referral sources would move the potential client

to schedule and follow through with an online counseling appointment. Interface with Referral Sources As she was moved along from room to room in the doctor’s check-in process, she wondered what to tell her doctor about her problem. Looking again at the results of her screening on her smartphone, she found what she was looking for “What to tell your doctor.” Well, it doesn’t get any more clear than that! Clicking the link, she saw the list of symptoms that fit her to a tee and treatment options and discussion points with her doctor. So, when she saw the doctor, she handed over her phone.

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After reviewing the symptom list on her smartphone, her doctor agreed that she needed some professional assistance. They discussed the local and online options and she was a little surprised that the doctor knew about the online counseling center in the ad and had many other patients who had very positive experiences with these services. The idea of receiving help from home was really appealing to her and since her doctor had a high opinion, she decided to give it a try. In the office, the doctor pointed out that with a few clicks she would have the appointment time she needed. With her consent, her doctor even sent the online counselor a note to coordinate care. A few minutes later, she began feeling rather nervous. She had a lot of questions. What if she couldn’t figure out the technology? Will the counseling sessions end up on YouTube or Facebook? The hope was being taken over by fear and doubt. She wasn’t sure if she could do this anymore. Sensing her hesitation, the doctor reassured her that this was secure and that the online counseling center was very good at helping clients set up the sessions and would answer all of her questions. The most prestigious counseling, medical, and government agencies support

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online counseling. Her doctor reassured her that she was in good hands. Her sessions would begin the next day. Driving home, she glanced at the little ad and marveled at the new way of getting help. She felt hopeful for the first time in a long time. Create a Client Acquisition Process Online counseling has a bigger barrier to entry simply because it is new and not yet the norm in the general population. In order to grow a steady flow of online counseling referrals, online counselors need to create more than an advertising campaign or marketing brochure or website. They need a client adoption process that meets the needs of their target market at each decision point. Your referral flow may start with client education on an issue that leads to your online help. In this case it started with a topic and was reinforced by the relationship with a local doctor who converted the woman to a scheduled client. Clients come to online counseling in many different ways. They typically need several reinforcements before the commit to therapy of any kind. The combination of different marketing efforts will be the key to client adoption online

counseling services. Obtaining referrals for an online counseling practice will take more than simply posting a website, making a brochure or other common marketing practices. Addressing each potential barrier and decision point in your referral process will help you plug the leaks in your referral process. Consider ways to address the needs of the client at different entry points and how you might lead them down a path to start online services. REFERENCE Smartphones Particularly Popular With Young Adults, High Earners. Pew Internet & American Life Project, September 11, 2012, accessed on September 12, 2012.

If you would like to share your innovative idea on gaining clients for online practice, email ideas and comments to jay@ behavioralhealthinnovation.com.

Jay Ostrowski is a Telemental health and marketing innovator with www. BehavioralHealthInnovation. com. BHI created www. telementalhealthcomparisons. com to help professionals choose technology. He lives in Grand Rapids, Michigan, USA.


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Marketing Toolbox

Clinton Power

When I first came across Pinterest.com, I thought it was a website to share pictures and information about weddings, recipes and home decor. I admit it, I was pretty closed to the idea of joining yet another social media network, as I was already struggling to keep up with my Twitter, Facebook, LinkedIn and Google+ accounts. After my initial reaction, I've recently circled back to Pinterest to spend a little more time on the site and really investigate the possibilities it might offer the therapy or coach professional who wants to add another channel to their marketing efforts. What is Pinterest and why should you care? Pinterest is a relatively new social media network that allows you to create virtual pinboards where you can pin images and videos. It's social because people can follow your virtual boards, and you can follow other people's boards. You can also 'like' a pin (similar to a Facebook 'like') as well as 'repin' an image you like from someone else's board to one of your boards. Sound simple right? Well it is.

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So this is where I got hooked. After spending about 20 minutes on the site, I found that it's very intuitive and simple to use. And because everything you're viewing, liking and repining is visual, it has an engaging quality that makes it different from the other social media networks. A real-life therapist success story on Pinterest As I explored Pinterest, I came across St. Louis play therapist Pam Dyson, MA, LPC, who is a prolific ‘pinner’. It was in talking to Pam that I realised there is enormous potential for using Pinterest in marketing your private practice. As a play therapist, Pam works creatively and has used Pinterest to share lots of images of sand trays, information about play therapy and videos of her speaking about her work and upcoming workshops. You can see what she’s doing on Pinterest here. Another way that Pam uses Pinterest is that she creates specific boards related to the issues some of her clients have, and then creates lots of resources related to that topic. For example, of her 44 boards she has topics on parenting,


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Can Pinterest Help You Grow Your Therapy Business? ADHD, adoption, autism and Asperger's and many other topics related to child mental health and parenting. These boards then become a great resource library where she can send her clients to get more information or ask them to follow her to stay updated on a particular topic. I was curious to know what benefits Pam had seen for her own therapy practice, and there were several. These included: â&#x20AC;˘ A significant increase in the amount of website visitors to her website, which had been helpful in local people finding her services.

You can see the full 25-minute video I recorded with Pam where she shares lots of tips about how to use Pinterest here. How can you use Pinterest effectively for your therapy or coaching business? Pinterest is similar to Twitter or Facebook in that you ideally want to be a curator of quality content and you post this content onto your pinboards. The main point of difference is you are posting images or videos contained in the article or post, not just the URL of the content.

â&#x20AC;˘ Attracting therapists to her play therapy workshops where in some cases, therapists have travelled for many hours to come to one of her workshops, based on the connection they had developed with her through her Pinterest profile. â&#x20AC;˘ Overwhelmingly positive feedback from her clients that they could access lots of information on their issues, or the issues their child was struggling with.

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If you’re not on Pinterest but come across content that you find interesting and you want to post, the easiest way is to install a simple plugin in your browser that allows you to directly share to Pinterest from your browser. When you click on the Pinterest button in your browser, it will automatically grab all the images and videos from that page and give you a choice as to which one you want to share on Pinterest. You can then choose the board you want to pin it to, or you can create a new board. You can also give it a title or add a comment that others will be able to read. There are a few simple tips to follow to get your Pinterest profile working for you. Here’s what to consider if you’re interested in starting: 1. Open a Pinterest account at www. pinterest.com 2. Install the Pinterest plugin for the browser you most frequently use 3. Create specific boards for separate topics- the more specific the better 4. Share your own images and videos in your blog posts and articles to your related boards 5. Follow other boards and pinners and start to like and repin their content to your own boards 6. As you browse the web, get into the habit of sharing interesting and engaging content to your boards 7. Rinse and repeat

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So after spending the last few weeks on Pinterest, I’m convinced that it offers a number of benefits for your therapy or coaching business, which include: • Driving more traffic to your website to increase your rankings and build your email list. • Raising your profile as an authority in your niche through sharing your expertise. • Providing an online resource library for your clients to easily find information about their particular issues and problems. • Connecting with other therapists or coaches that may be looking for consultations, supervision or your workshops and products. Aside from the business benefits, it’s a really fun social media network that engages you through the power of images. I encourage you to experiment with it and see if it can assist you in marketing your therapy or coaching business.

ABOUT THE AUTHOR Clinton Power is a passionate marketing coach and consultant who provides online marketing and business development ideas for healthcare professionals.


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TILT â&#x20AC;&#x201C; Therapeutic Innovations in Light of Technology

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TILT Magazine (Issue 12)