This is the second post of our "voice of telemedicine" blog series. An opportunity for telemedicine practitioners to share their experiences with telemedicine. Today’s guest blogger is Dr. John Silver:
A Retrospective of my 20 Year Voyage through Cyberspace
FREE SEX THERAPY! That was how my psychotherapy practice was listed on AOL if you were on the Information Superhighway in 1995 searching for “Therapy in Los Angeles.” Thus began my trip through Cyberspace 20 years ago. I had just sold The Counseling Center of West Los Angeles, which we created in 1979, and was casting about for a new source of patient referrals. My practice was now called Counseling Until Midnight, since I keep nocturnal hours. I turned to the Internet to augment client referrals, driving up the onramp at snail-like speeds with a personal computer, Windows 3.1 and a dial-up modem.
This little old computer brought back memories of 20 years before while working at the RAND Corporation where we did some of the early work in the integration of computers and psychology, in those days computers took up entire walls and the Internet was called the Arpanet and was used to link the government and universities together (in case of nuclear attack). In 1991 the Arpanet became the World Wide Web (or the Wild Wild Web as it was called) and was accessible by anyone with a personal computer and a telephone line. Webcams were not in use yet and Internet pages took sometimes 2 minutes to load. Communication was by email and chat (Instant Messages they were called). There would be no Skype until 2003. I decided to try the World Wide Web as a vehicle to advertise my services. I learned about the new Internet and taught myself how to build and code websites for maximum exposure (now called search engine optimization ). In designing my website, I thought free email advice was a good way to get my name out there. One of my certifications was as a Sex Therapist. AOL (the main ISP and search engine at the time) serendipitously combined Free Email Advice with Sex Therapist on my Website, resulting in the listing FREE SEX THERAPY. That shot me to the top of most searches having to do with Therapy in Los Angeles. I played upon this fortuitous event and got myself listed on every mental health directory or listing service possible. For almost 10 years the little one-page website I had created kept my practice filled.
Online Therapy And Counseling Until Midnight
During my private practice years with Counseling Until Midnight, I had learned all I could about Telemedicine. I had obtained Certification in Online Therapy in 2001. I studied what minimal information was available regarding the integration of law and ethics at it applied to online therapy. I developed my own telemedicine informed consent forms, contracts and other documents in order to protect the client and myself. Cable Internet and Skype had evolved so that Webconferencing was available, though the audio and video were primitive at best. There were no clear cut guidelines on the practice of online therapy. Laws were vague or non-existent. Psychological associations were maintaining their distance and would not take a position on the ethics involved. Was Online Therapy even under the purview of my California MFCC license? Since the Internet is accessible world wide, what about counseling across state and national boundaries? What about malpractice? How does one even practice online therapy? How is it similar or different than other modalities?
John Silver, Voyage
Through a consistent and diligent approach of researching best practices in this new world of technology, I spent the next 5 years taking every online course offered, reading all the latest articles on telemedicine and refining my online therapy practice to ensure it met all clinical, ethical and legal standards. At the same time, I became certified in psychoanalysis and cognitive behavioral therapy (CBT). My combination of clinical skills, coupled with my experience in online therapy, moved my practice forward, and I was able to expand it further by answering hundreds of email questions from around the world. I felt I was qualified to make clinical decisions as to what type of patient and what type of therapy would work for online therapy.
About 5 years ago I noticed that my placement in searches was falling further and further behind. It was time to evolve. I learned the new SEO as it related to Google’s ranking of websites and rebuilt my website. At the same time I was thinking of (semi) retirement. It occurred to me that having an online therapy practice would allow me to practice virtually world wide from wherever I settled. Of course the caveat was to invest the time, energy and resources required to become licensed, certified and compliant with the evolving Laws and Ethics in telebehavioral health.
Since “Counseling Until Midnight” was still coming up in search results, I attached Online Therapy to the name and became ‘”Online Therapy and Counseling Until Midnight”. It took about 2 years of intensive work doing SEO and website composition. As a result of my efforts to monitor my traffic and fine tune my outreach tactics, my company has migrated back to the top in most searches for Online Therapy (in Los Angeles and elsewhere). I had begun during the Wild West of Online Therapy, evolved with the times and now am practicing the art and science of Telemedicine.
Online Therapy and Counseling Until Midnight http://www.DrJohnSilver.Com ~ (310) 268-8282 ~ FAX (978) 268-8286 ~ Email@DrJohnSilver.Com 2100 Sawtelle Boulevard Suite #204 ~ Los Angeles, CA 90025 Marriage, Family and Child Counselor, M14943 Certified Modern Psychoanalyst, P90366 Certified Online Therapist, #00663