Better Help Guide for Therapists

A Quick Guide to get you up and running, helping other, and earning money on the largest virtual therapy platform

Inside you will find out what you need for getting started so you can see clients as quickly as possible and feel confident.

You’ll find an example intake form and informed consent. You’ll find ideas for session agenda, session length, newsletters, and worksheets.

Plus additional tips and some frequently asked questions.

Interested in a PDF version of this guide? You can download that here https://thinkandfeel.gumroad.com/l/BHFTguide

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Contents

Getting Started

Intake Form (example)

Informed Consent (example)

Newsletter (idea)

Session Agenda

Session Length

Tips

FAQ

I plan to make this a “living” document as much as is possible. That means I’ll update it as needed so that it remains as relevant as possible.

Reminder: This is merely a guide. This does not constitute legal information or advice. It is only meant to provide a framework for providing quality care to clients through virtual therapy. Please consult with your local licensing board and appropriate supervisor to ensure you are practicing within your scope.

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Getting Started

What do I need to get started?

Liability Insurance

Liability insurance is also known as malpractice insurance. If you’re already practicing independently, there’s a good chance you have this already. If someone is in private practice then this is a necessity. Betterhelp offers some liability coverage but it’s only secondary to your own and is always subject to change.

You also want to make sure that whatever insurance you choose provides coverage for practicing telehealth. It’s likely it will but it’s worth double checking. Some providers may charge an extra fee for this.

Some options for coverage:

• HPSO
• CPH & Associates
• Berxi — I personally use Berxi. It offers a quarterly payment plan so you don’t have to pay for it all upfront.
• You can also check with your licensing organization for recommendations.

Informed Consent

By now, you may have learned that Betterhelp has their own sort of “informed consent.” This is great (for them) but does not take the place of your own informed consent. This is where you want to outline therapy protocols, expectations, risks, etc. You can include a no-show policy and termination policy here.

Note-taking Plan

Have a plan for how you’re doing to do this. Some people still write their notes. Some people type them.

There are EHRs that people use with betterhelp. This is an option if you don’t mind paying the extra fee. SimplePractice is a popular one. These are helpful if you’re also doing therapy outside of Betterhelp, like those in private practice.

Some people write their notes within Betterhelp. I see no problem with this but you should decide for yourself. In case you never need to refer to them OR produce them, do now what will be easier later.

Everything Else

It goes without saying but make sure you have a working, internet-connected device.

A laptop is best but tablets also work.

Make sure you’re using Google Chrome or Firefox for the best settings. Video only works through those browsers.

Your phone will work only if you’re doing a phone session.

Pay attention to your lightning. You want this to be conducive to the session, not a distraction.

Plan ahead for tax purposes (refer to FAQ section for more on this).

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Intake Form

This is very first message I send clients. I put this together with some help from examples from other therapists so feel free to tweak this to make it sound like you!

Sometimes I add a message at the top because I want to acknowledge something specifically that a client mentioned in a message. You’ll notice that their answers to Betterhelp’s intake questions always appear at the top. I may respond to something in those answers. Other times, a client may send a message before I’ve had a chance to send my intro/intake message. In those cases, I also like to acknowledge their message before launching into my “intake” message.

Sometimes clients will not respond to this message prior to their first session. I used to nudge clients to complete it or send reminders. I even encouraged some to cancel the session if they had not completed it. I eased up on that pretty quickly. Instead, I would send a reminder that they could complete the questions prior to the session or we could go over the questions together in the first session. Some people preferred the latter option and it worked fine. They understood it would be like an intake session and that was their choice. Regardless, I always highlight certain things in their responses or ask for clarification around their answers when we meet, especially those around safety.

Example intake message:

Hi Client Name,

I’m excited to work with you and walk with you on this journey! I am *Therapist Name*, a licensed professional counselor (LPC). I have worked with individuals and couples seeking counseling for over 9 years, both online and in various face-to-face settings. You can read more about my background, education, experience and counseling approach by clicking on my name above our messages. To help us get started, I’d like some additional information. I mentioned some of this in the informed consent you agreed to but I always remind everyone to be sure.

Your well-being is my number one priority. BetterHelp does not provide me with your personal or billing information that you provided when you signed up for your subscription. In order for me to maintain compliance with my licensing board and ethical code, I am required to gather some basic personal information. I also ask that you provide an emergency contact so that someone can be reached in the event of an emergency.

**Your Personal Information**

Full Name:

Date of Birth:

Current Home Address:

Phone Number:

Email Address:

I’m responsible for verifying a clients identity when engaging in virtual counseling, so it’s helpful for me to have that on file.

**Your Emergency Contact**

Full Name:

Home Address:

Phone Number:

Relationship to you:

I appreciate you providing this information, and please know that this information is confidential and will only be used if I am concerned for your safety or the safety of others. If I believe you or someone’s life is in danger, I will contact your emergency contact person and/or local emergency services to check on your well-being. You can read more about confidentiality in my informed consent/information form.

**Here are those emergency/crisis numbers again:**

Call 911 or go to the nearest emergency room for in-person help for an immediate crisis

TEXT: You can text the Crisis Text line by texting “Help” to 741–741

PHONE/VOICE: Call the Crisis Hotline via phone at (800) 273–8255

(Update — 988 is now active and can be called for mental health related crises)

At the beginning of each session, I will ask you for location address if we are having a live session and you are not at home. Currently some states allow for counseling to occur across state lines. I am physically located in Georgia but I understand you may not be. If you are traveling outside of your home state, please let me know as we will need to reschedule our appointment for when you return.

I appreciate you letting me know what brought you here! I’d also like to ask some of the following questions which are a part of my intake process. These may be duplicates of questions you already answered, but bear with me! I understand some of these questions may bring up some difficult or old feelings, so please let me know if you feel triggered by any of these questions.

• What brings you here?
• - How long have you been experiencing this?
• - What are your symptoms? (These may be physical, emotional, or mental).
• - [When] have you been in counseling before?
• - What was the most helpful, and the least helpful, thing about your previous counseling experiences?
• - Are you currently employed?
• - If so, what type of work do you do?
• - If you are currently taking medications for a mental health related concern, which medications do you take?
• - Have you ever had thoughts of suicide?
• - If so, when was the last time?
• - Have you ever engaged in self- harm?
• - If so, when was the last time?
• - What are some things that you do in order to try and feel better?
• - Who do you live with?
• - Which people in your life would you include in your support network?
• - What are some of your strengths?
• - What are some of your weaknesses?
• - Anything else I should know about you that will help me understand you better?

I would also like to know, do you have any relevant health diagnoses from any medical or mental health provider?

When was your last physical with your primary care doctor?

It’s very important to keep your physical wellness in mind while we work on mental wellness.

I look forward to speaking with you soon! My working hours are typically 9am-5pm EST, Monday-Friday. I try to reply to messages at least a couple of times per day as my professional/personal obligations allow. I try to practice healthy boundaries and encourage everyone to do the same. Live sessions tend to be the best use of our collective time (either through video or on the phone) but messaging can also be very helpful. Once you’ve answered the questions above and provided the important contact information, feel free to request a live session on my calendar! Please let me know if you have any questions or concerns. I appreciate your patience during this initial onboarding process!

— Therapist Name, LPC

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Informed Consent

Remember that Betterhelp has their own informed consent but I recommend therapists have their own. Betterhelp is not the therapist, you are! You will copy and paste this (or your version of it) into the template section. This is shared with clients when they are matched with you and it asks them to agree/consent. Remember to revisit this during your first session to confirm client’s understanding.

Informed Consent Example:

Client Information Form

I understand that the service provided through BetterHelp is not intended for crisis situations and urgent needs. While my therapist, *Therapist Name, LPC (NY LPC #00000)* is a licensed therapist in the state of *State*, Better Help services and/or online or text-based services may not be the best avenue for me to receive mental health care. If the use of this site or online services are not appropriate for my situation, I understand that my therapist will assist in providing me with additional options of in-person referrals where I can obtain care.

Verification of Identity and Location at the time of session:

I understand and agree that my therapist needs to verify my identity and may request to see a form of photo ID at the start of our work together. This is to verify my identity including legal name, date of birth and home address.

If my address on the submitted ID is not included or not current, I will provide my clinician with my current correct address.

I agree to provide my clinician with a phone number to reach me in an emergency. I agree to provide an emergency contact name and number as well.

I also agree to provide my therapist with my current location, vehicle make/model/color, and license plate number if I am meeting from inside of a car (some clients do this for privacy.) I understand that, for safety reasons, my therapist will NOT meet with clients in a moving vehicle, and that failure to provide this information at the start of my session will result in the session being cancelled.

In a crisis situation, I agree that I will either:

• Call 911 or go to the nearest emergency room for in-person help for an immediate crisis
• - Call 988 for mental health related crises *(Newly added)*
• - TEXT: You can text the Crisis Text line by texting “Help” to 741–741
• - PHONE/VOICE: Call the Crisis Hotline via phone at (800) 273–8255
• - You can also call your psychiatrist or prescriber for assistance

I understand that my confidentiality is fully protected by law with the exceptions of these FOUR circumstances:

• If my therapist has concerns or suspicions of abuse or neglect of a child, elderly person, someone with a disability, or someone otherwise unable to care for themselves
• - If I present as a risk of harm to myself or others in the professional judgment of my therapist
• - If my therapist is legally compelled through subpoena or court order in any court proceedings regarding my care (This is extremely rare, and if it were to happen, we would discuss it thoroughly.)
• - If I choose to sign a Release of Information form

I have read, understand, and agree to the Client Terms of Service at https://www.betterhelp.com/terms/

This includes understanding and agreeing that:

My Better Help clinician cannot provide, verify, or produce reports related to clinical diagnosis of a mental health condition. While trained to do so, services of this nature must be provided outside of the Better Help site/services at the discretion of my provider.

My Better Help clinician cannot provide proof of attendance at, or reports regarding progress in, use of the site or services provided through the site. This includes documentation for court, custody agreements, employers, or any other party.

My Better Help clinician cannot provide letters of support for Emotional Support Animal designations (or ESA’s.)

I understand that I can seek out online therapy with *Therapist Name, LPC* or another clinician OUTSIDE of Better Help if I have needs for clinical diagnosis, biopsychosocial assessment with diagnosis (including psychological testing), or referrals for treatment that come from the legal system, child welfare services, or my employer, and may require documentation or proof of attendance.

Privacy of Sessions:

If having a “live” session with my clinician, my clinician will ensure my privacy by using headphones and being alone at the time of sessions. I understand that I am solely fully responsible for the privacy in my own environment for meetings. To ensure the greatest privacy, my clinician recommends:

• Ensuring that I am alone in the room I am meeting
• - Using headphones for phone and video sessions whenever possible (this also helps reduce audio feedback or echo)
• - Muting the microphone (or turning off apps) that listen to my environment, such as Amazon Alexa, Google Home, Siri on Mac devices, or Bixby on Samsung devices
• - If possible, placing a Bluetooth speaker or device outside of the space I am in that plays “white” noise or music to mute any options of hearing me speak during sessions.

Risks and Benefits of Counseling:

First and foremost, I can’t help if you aren’t here! In making an appointment, you are committing to that time for yourself to the exclusion of others. If you must cancel an appointment, you must provide no less than 24 hours’ notice. Failure to cancel in advance may result in changes to the type or frequency of sessions your clinician is able to offer.

To gain the most from the therapy process, it’s helpful if you are honest about your commitments to self-examination, understanding, and our relationship. This includes any concerns you may have regarding services or with me. I want to serve you well and appreciate any feedback you may have that will help me to do so.

Unwise applications of new learning are a common risk in therapy (e.g. being too harsh when learning to assert yourself) as well feeling as though you are regressing when feeling vulnerable. Therapy is a process that is often like taking three steps forward and one step back at times, but the overall momentum should be forward. Talking openly about this can help minimize stress about this process.

You are responsible for maintaining the confidentiality of others that participate in your counseling sessions, such as in family therapy sessions. In marital therapy, secrets between spouses works against successful outcome; in this regard, your counselor is not obliged to keep secrets of one spouse from the other spouse.

It is best to avoid abrupt terminations from counseling and to honestly discuss, preferably by video or phone, the reasons for your desire to end care or transfer to a different clinician. This method can maximize growth and health at these times.

Termination of Services:

If you do not interact with me for a period of time (either through appointments or messaging back and forth), I cannot ethically continue a treatment relationship with you. Sometimes I am not the best fit to work with a client for a variety of reasons (personal fit, clinical experience, schedule availability, cost, etc.) Clients can decide to end services or change counselors at any time, however it is in your best interests to let your therapist know you are doing so in advance . If you’d like to switch counselors within Better Help, you can do so by clicking on the icon in the top right corner of the “Counseling” page, and choosing “Change counselor” from the drop-down menu. Make sure you specify in the feedback to support what you are looking for that is different. If you have any trouble with this, please reach out to Support at Contact@betterhelp.com. Know that if you decide to take this action, you will lose all written correspondence with me at that time on your client dashboard.

To cancel your BetterHelp subscription, contact Customer Service via email (contact@betterhelp.com) or online at https://www.betterhelp.com/contact/ and ask them to cancel your account altogether. If you cancel your account and decide to return at a later date, Better Help will prompt you upon logging in about whether you would like to return to working with me, or find a different therapist. Please know that while I am happy to resume working with you at a later time, this is subject to my availability to see new or returning clients at that time.

If you do not cancel your account or request a new therapist, you will continue to show as an “inactive” client on my caseload whether or not you are logging in to the site or participating in services or not. Please note that your agreement for counseling services with me is considered no longer valid once you have not been in contact with me here for a period of 30 (thirty) calendar days. Exceptions to this are only made in discussion of clear dates and plans between us on a case-by-case basis. On the Better Help site/app, I will continue to send you this same message regularly until you either: (1) respond and resume contact with me, (2) change therapists, or (3) cancel your account. Thank you.

**BY CLICKING AGREE/CONFIRM, I AGREE TO THE CONDITIONS AND BOUNDARIES LISTED IN THIS CLIENT INFORMATION FORM. I ALSO AGREE TO NOTIFY MY CLINICIAN OF ANY CHANGES PERTAINING TO THIS INFORMATION, AND UNDERSTAND THAT MY CLINICIAN WILL DO THE SAME.**

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Newsletter

An idea for engaging clients…

You may find it helpful to send out a newsletter to your clients. You can call it whatever you want, of course. It’s a way to share helpful information with them and ideas they can put into practice.

It could be a “Mindful Mondays” message if you promote mindfulness.

It could be a “Tool Tuesday” message with a new tool for them to use that week.

“Wellness Wednesday”

“Thoughtful Thursday”

… you get the idea.

You can be as creative as you want.

If you personalize it for each client, then you can be compensated for the messages. If not, then you can write it once for compensation but then paste it to other clients as a template or resource.

Client responses to the newsletter will be compensated.

This can also be a helpful to engage clients outside of therapy sessions.

Oftentimes, clients will sign up for BetterHelp because they want the added interaction of messaging. This can be a good way to increase that connection.

Another idea is to use therapy card decks to help formulate newsletters or quick thoughts to share.

Buy several card decks or just get one that is in line with your therapeutic approach if you want.

Card deck ideas:

(*linked cards will take you to Amazon)

• ACT cards https://amzn.to/3j3cAB1
• CBT cards https://amzn.to/3HpbQ2u
• DBT cards https://amzn.to/3iSwteh
• Mindfulness cards https://amzn.to/3XSVSTF
• Values cards https://amzn.to/3J9uHQz
• Activities cards

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Session Agenda

Another way to increase engagement and streamline sessions is to create a session agenda. One way to do this is to send a list of questions to your client before the session. You can do this 24 hours in advance or send them out on Sunday evenings — do what works best for you and your clients. These can also be personalized to each client and you can be compensated for the messages. Although, even sending out the generic questions can be helpful. Keep in mind, your agenda can reflect your therapeutic approach.

What progress have you made toward your goals this week?

What do you want to focus on in our next session?

What automatic thoughts have come up for you (in regard to insert goal)?

Any questions you have that we should make sure are addressed?

Again, these can be tweaked to your liking and are just a foundation for setting an agenda. Depending on your therapeutic approach, these could look very different.

The idea is to increase engagement. Setting an agenda can also help with client progress as sessions are more focused. It encourages the client to do some of their own preparation before a session.

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Session Length

How long should your sessions be?

BetterHelp allows providers to choose between 30 minute and 45 minute sessions.

At the time of writing this, BetterHelp only pays providers up to the 45 minute mark of a session. This means a provider can go past 45 minutes with a client but they will not be reimbursed for the added time.

There’s more than one way to approach this…

I landed on doing 30 minute sessions. I left a 15 minute buffer between my sessions. This allows me to go past the 30 minute mark if I needed to (and I usually did). My sessions are typically 40 minutes in length.

I like for clients to plan for 30 minutes. Not every therapist will work this way. I just think it helps clients to be more focused.

If you’re sending an agenda (see agenda example) before the session then that can help keep the session focused also.

Some therapists do 30 minute sessions back to back. That can be tough for therapists who are used to doing a “therapy hour” or 50 minutes of therapy.

I like the 45 minutes because it can allow time to type notes in-between. This approach is preferable to having to write notes at the end of the day.

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Tips

On eye-contact, headphones, note-taking, and session length

Eye-contact…

• I make the client’s video small (but not uncomfortably small) and move it to the top of my screen close to the webcam. This mimicks eye-contact as much as possible and is important for rapport-building and communication in general

Headphones…

• Like most things, it’s a personal preference. For me, it ensures that what a client is saying is going straight into my ears only. This reinforces privacy since it is a virtual setting. It also eliminates the echo! No one like the echo.

On Note-taking…

• Type your notes in vivo — as in, during the session
• You can place the client video close to your webcam (this is best practice anyway for eye contact) and also place your note-taking app right next to it
• This allows you to glance at the note if needed and not drastically divert your eyes
• This is time-saving and you’ll be glad you did

On session length…

• I recommend scheduling in 30 minute blocks but allowing up to 45 minutes. Totally a personal preference. For me, it’s a mental thing. If I’m close to 30 minutes but I know we need to stay on something then I can do that. If I had a 45 minute block, I would be more likely to fill that time and then spill over. Again, a personal preference (some might call it boundary issue ;) ).

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FAQ

Frequently Asked Questions…

Do I need to see the client’s photo ID or driver license?

I have not been able to confirm that viewing or retaining a copy of someone’s photo ID is necessary for providing services. If you’ve been to some sort of doctor appointment before, they may have asked you for this. While it can be used to verify someone’s identity, it is not necessary. It can be helpful to verify someone’s residence but you should always obtain location information prior to every session. I like to know a client’s main residence in case I need to contact emergency services. Most ethical codes and best practices recommend verifying a client’s identity every session. This is done to ensure you’re talking to the correct person.

What about scheduling?

See here for scheduling ideas. Whether you schedule clients or you allow your clients to schedule their own appointments is up to you. There are therapists on both sides of this. I prefer to let clients schedule themselves rather than try to coordinate a day and time. If needed I still have the option scheduling the client myself. For instance, I could schedule a client outside of the available time slots if I wanted.

What if there’s an emergency?

Stuff happens. You should already have your client’s contact info and info for an emergency contact. Do not rely on betterhelp to provide you with emergency contact. They say they obtain this info from the client, which is great. I believe it’s better and makes more sense to have this information for yourself. You do not want any delays. Also, the client may not have provided accurate info to betterhelp. The client is more likely to give you accurate info as a therapist anyway.

What about overdue actions?

This is almost guaranteed to happen. This is because of betterhelp’s internal policies regarding action timelines. It’s no big deal so don’t sweat it but DO take action. Try not to let it become overdue if you can help it. It’s easy to send a quick message to clients to check in. And you’re being compensated for messages so it’s worth it. Some therapists explain to their clients the reason for the outreach (action timelines) but you don’t have to do that. For some, they may just send a period (”.”). If your client is aware of why you’re doing it, then that may be fine.

Where should I store my notes?

This is a personal preference. My advice is store it in a way that is easily accessible later on if needed. And when I say easily accessible, it’s also understood that you’re keeping note properly secure.

Some therapists use an EHR, some use the notes section in Betterhelp, while others use handwritten notes that they retain.

How long should my sessions be?

Refer to section on Section Length.

What about self-employment taxes?

Great question! I’m not an expert in this so this is for entertainment purposes only 😉 You’re a 1099 contractor, therefore…

Self-employment taxes can be a tricky thing to manage, but with the right information, it is possible to do so successfully. First, it’s important to understand the difference between self-employment taxes and regular taxes. Self-employment taxes are taxes specifically for people who are self-employed, such as freelancers, contractors, and small business owners. These taxes are the Social Security and Medicare taxes that are typically taken out of an employee’s salary.

When you are self-employed, you are responsible for paying the full amount of these taxes, both the employer’s and the employee’s share. This means you must pay a total of 15.3% of your net self-employment income. You can deduct half of this amount from your regular tax return, which can help reduce the amount you owe the IRS.

In addition to the 15.3% self-employment tax, you will also need to pay your regular income tax. Your income tax rate depends on the amount of money you make and your filing status. It is important to determine your income tax rate before filing your taxes so you can get an accurate picture of how much you will owe.

In order to pay your taxes, you will need to set aside money each quarter to cover your self-employment tax. To do this, you can use an estimated tax calculator to help you figure out how much you should set aside each quarter. You can also set up an automatic payment plan with the IRS so that you are sure to make your payments on time.

Finally, it is important to keep detailed records of your income and expenses. Keeping accurate records of all your income and expenses will help make filing taxes easier and help you to avoid any potential penalties. Additionally, you may be able to deduct certain business expenses, such as office supplies and travel expenses, from your income. This can help to lower your overall tax burden.

By understanding the basics of self-employment taxes and keeping accurate records, you can successfully manage your taxes as a self-employed individual. Doing so will help you stay in compliance with federal tax laws and save you money in the long run.

Thanks for reading. I hope this is helpful!

If you believe anything in this to be erroneous, please let me know!

You can find a contact form on the website: https://betterhelpfortherapists.simple.ink

Any feedback is welcome!

If you’re not yet signed up to be a therapist on Betterhelp and you’d like to try it, you can sign up here https://www.betterhelp.com/cref/c3b1a3529d687c274fd7844301c7ab79

We both receive a bonus if you sign up and begin working with a client within two weeks.

Also, you may have noticed I linked some things (like the card decks) to Amazon items. If you make a purchase I receive a commission. It costs nothing extra if you use those links. It does help compensate me for the time I put into this though.