Remember when you didn’t even use cellular phones in your therapy practice? (If you started recently, then you probably don’t. But you can likely imagine such a time!) Now you’re probably looking to work with clients over a secure and high-quality Internet video connection. Oh how times change.
If you’re like most of our mental health colleagues, you’d like to know if there are free-yet-appropriate software options for connecting with clients online.
Fortunately, the answer is a resounding “Yes.” And those options aren’t Skype or Facetime, either!
Skype and Facetime are not good options for delivering telemental health services (not sure why that is? See our article on How Skype Became Software Non-Grata→.) Yet, many people wish to use them because they’re free and are often already there when we get our computers. This makes it easier on both clinician and client to use them. Luckily, the options we’ll explore in this article are just about as easy to acquire and use.
What Do We Need From Our Software?
There are a large number of things we need for our HIPAA compliance when we get a company’s software involved in our therapy services. The most obvious and concrete need is to execute a HIPAA Business Associate Agreement with that company (not sure what that is? See our article, What Is a HIPAA Business Associate?→)
In this article, we will review and compare online therapy software options that:
- Provide a Business Associate Agreement to health care customers for the free version of the software.
- Pass muster when we do an informal, non-rigorous but still much-deeper-than-just-reading-the-website audit/review of the software’s security; and of the company’s attitude towards both security and the usefulness of their product(s) to mental health clinicians.
What products are on our list for review? Colleagues of mine, I give you (in alphabetical order):
- Regroup Therapy
Free Online Therapy Software With All the HIPAA Fixin’s? How?
Each product on our list has its own reasons for being willing to do a BAA for no cost. So I’ll just list what each company says about the subject and what you need to do to get that BAA executed with them:
In 2016, Roy had a lovely conversation with Dylan Turner at Doxy.me in which Roy asked a lot of pointed questions for which Dylan had satisfactory answers. His story, and the one described on their website, is that Doxy.me arose out of a grant-funded project to fill a gap in telehealth software services at the university where Doxy.me was born.
Since 2016, Roy has had further contact with the company that reconfirmed their stability and trustability.
They state that the free version is for solo and small practices, and larger clinics can pay for a version with a lot more bells and whistles. Turner says that this business model is supporting Doxy.me, which is more important than it may sound at first — if a company can’t survive financially, it will disappear from under you. Turner indicated that there is little risk of Doxy.me going under in the near future.
Executing a Business Associate Agreement with Doxy.me is a part of the initial setup process. We have verified that no special process is required.
We performed a HIPAApropriateness review for Regroup Therapy in late 2016. A member of ours requested the review when they learned that Regroup Therapy not only offers free video software to behavioral health clinicians, but they also can connect those clinicians with work doing telemental health!
In our review, we found the company to be responsive and straightforward about what they offer and how they work with clinicians. Their CTO was highly responsive to our questions.
What’s more, Regroup uses a popular, high-quality video service called Zoom. If you haven’t heard of Zoom, ask a colleague about it. Chances are good that they know what its.
The Regroup team tells us that they offer their video service for free because it’s part of how they attract clinicians to work with them. The same video software is used to provide services to Regroup’s customers, as well. Based on our review of the company, there is good reason to trust that the platform is both secure and stable.
Make sure you contact Regroup to get your Business Associate Agreement after you sign up with them. It is not executed automatically.
Long-time readers know VSee well, as we have long-touted it as a good video software option that was designed specifically for telemedicine. Some disclosure: Roy uses VSee for his own online therapy practice.
In 2016, we announced that the environment around HIPAA is such that even solo providers making light use of video software should not use VSee without a HIPAA Business Associate agreement. Quite happily for us, the company responded to that by making a free BAA available.
The process is not as simple as signing up. To get a free VSee Pro account, with the BAA, follow these instructions:
Please contact VSee. Email firstname.lastname@example.org. Do not use the word “free” in your subject line. Your email will end up going to spam and VSee won’t see it.
- Let them know that you are a solo mental health practitioner. The free Pro account offer is only for solo practices.
- Make sure to tell VSee that you are a Person-Centered Tech reader and you are requesting the free Pro account offer.
Three Types of Video
Interestingly, the three different services also happen to represent the three major video software applications in use across the USA for telemental health services.
Doxy.me, along with many other non-free online therapy platforms, uses a free open-source software package called WebRTC to deliver video, audio, and chat for you and your clients.
WebRTC is interesting to us because you already have it on your computer. If you and your clients use a “standards-compliant” browser, e.g. Chrome or Firefox, then you already have WebRTC and you both can use Doxy.me without downloading any new software. That’s pretty nice.
If you want to use it on a mobile device like a smartphone or tablet, then there is a Doxy.me app that also works just fine. (Please bear in mind, however, that we don’t recommend performing online therapy services with small screens when there is a significant need to be able to visually observe a client’s behaviors.)
The upside is that you don’t need to download new software and the low costs for Doxy.me can be passed on to you in the form of free service.
Zoom (Regroup Therapy)
Zoom is a very high quality — but also expensive — video service that is popular for a wide variety of applications. If you’ve ever attended a webinar online, there’s a decent chance that the webinar was run via Zoom. Many therapists really like Zoom, but the healthcare-friendly version is targeted at clinics and hospitals and costs hundreds of dollars per month. The free version of Zoom uses different servers and really should not be used for online therapy, even by clinicians who are not HIPAA covered entities.
Luckily, Regroup Therapy licenses the HIPAA-secure version of Zoom for use by their therapists. Because they invite any clinician to use their software for their own clients, as well, Regroup’s service is an opportunity to use Zoom in your own practice.
The main upside is Zoom’s high quality of service.
VSee is, itself, a video application that was developed specifically for telemedicine. Many online therapy platforms use the VSee software under the hood. Getting the VSee Pro service with the BAA will allow you to do the same for your clients.
VSee was developed to be optimized for telemedicine in a number of different contexts. The most notable context is that of delivering telemedicine to areas with poor Internet service. VSee is capable of keeping up a good video and audio connection with nothing but 3G cellular service to work with. In other words, it’s great for working with people who are far away and/or are in remote areas with lower-quality Internet service.
The main upside is that VSee will likely work the best when your clients are far away or in rural areas where they may have to rely on cellular service for Internet. If working internationally, it is likely to work the most efficiently of the three options.
Conclusions About Free Online Therapy Software
We see no obviously superior free online therapy software application, but we can see how for individual practices one option may be clearly superior to the other. We hope we’ve given enough information to choose.
And lastly, some links to help you find these lovely free, HIPAA-friendly options (once again, in alphabetical order):
An Important Note
The primary mission of this article is to guide therapists away from Skype and Facetime by providing appropriate options that are similarly easy to access and use (i.e. free and simple.)
The fact is, there is a multitude of options out there for performing online therapy, including a number of platforms that provide much more than just the simple video connection provided by the options in this article.
For those who are seriously thinking about getting into telemental health, you owe it to yourself to also check out the options at Telemental Health Comparisons. Also see our HIPAApropriateness reviews of different options for getting HIPAA-secure videoconferencing.