We provide PRIVATE psychiatric services online. These are NOT covered or refundable by provincial health care plans. Contact us for a SKYPE appointment today!

FAQs

What about payment and billing?
What about privacy?
What computer facilities are required to access our services?
What if my doctor is concerned that I am at risk of imminently harming myself or others?
Can online care be done anywhere?
Is consent required?
Is mental health care effective if provided online?
What are the expectations regarding contact between sessions?
How will the doctor’s and patient’s identity, contact information and location be verified?
Are their parts of Canada that are excluded from the service?
Can we access a psychiatrist through your service and then see them in person under the public health care system in an expedited basis?
What is the number of sessions and cost you might expect in a course of marital therapy?
What are the questions you should ask a marital therapist before engaging in therapy?
What is hypnosis?
What is the difference between a psychologist, a psychiatrist and a GP psychotherapist?
How do I know the service is secure?
How do I arrange a Skype appointment?
Is there a cost to the service?
Do I need a referral from my family doctor / GP?
What are the pros and cons of Online psychiatry?
What is this website’s privacy policy?

What about payment and billing?

Prior to the commencement of initial services, the patient shall be made aware of all financial charges that may arise from the services to be provided. Arrangement for payment must be completed prior to the commencement of services.

Sessions must be pre-paid before they occur. Notes, letters and reports must also be paid for prior to their release.

What about privacy?

Efforts shall be made to ensure privacy so clinical discussion cannot be overheard by others outside of the room where the service is provided. If other people are in either the patient or the professional’s room, both the professional and patient shall be made aware of the other person and agree to their presence.

Videoconference software shall not allow multiple concurrent sessions to be opened by a single user.

What computer facilities are required to access our services?

When using a personal computer, both the professional device for video-transmission and the patient’s site should, when feasible, use professional grade or high quality cameras and audio equipment now widely available for personal computers. Personal computers shall have up-to-date antivirus software and a personal firewall installed. Both the doctor and patient should ensure their personal computer or mobile device has the latest security patches and updates applied to the operating system and third party applications that may be utilized for this purpose.

In the event of a technology breakdown, causing a disruption of the session, the professional shall have a backup plan in place. The plan shall be communicated to the patient prior to commencement of treatment. The professional may review the technology backup plan on a routine basis.

The plan may include calling the patient via telephone and attempting to troubleshoot the issue together. The plan may also include providing the patient with access to other mental healthcare. If the technical issue cannot be resolved, the professional may elect to complete the session via a voice-based telecommunication system.

What if my doctor is concerned that I am at risk of imminently harming myself or others?

Your online doctor will take steps to ensure your safety just as he would if you attended in person. Your doctor may contact other health professionals or emergency personnel in your geographic area. The online mental health doctor may also call upon a family or community member who has previously been designated to be called upon for support in the case of an emergency. This person will be called “the Patient Support Person” is an individual selected by the patient. In the case of an emergency, the professional may contact the Patient Support Person to request assistance in evaluating the nature of the emergency and/or initiating 9-1-1 from the patient’s home telephone.

Can online care be done anywhere?

Both the professional and the patient’s room/environment should aim to provide comparable professional specifications of a professional office setting. Efforts shall be made to ensure privacy so clinical discussion cannot be overheard by others outside of the room where the service is provided. If other people are in either the patient or the professional’s room, both the professional and patient shall be made aware of the other person and agree to their presence. Seating and lighting should be tailored to allow maximum comfort to the participants. Both professional and patient should maximize clarity and visibility of the person at the other end of the video services. For example, patients receiving care at the home setting should be informed of the importance of reducing light from windows or light emanating from behind them. Both provider and patient cameras should be on a secure, stable platform to avoid wobbling and shaking during the videoconferencing session.

Is consent required?

Yes.

A thorough informed consent at the start of services shall be performed. The provider shall document the provision of consent in the medical record.

The consent should include all information contained in the consent process for in-person care including discussion of the structure and timing of services, record keeping, scheduling, privacy, potential risks, confidentiality, mandatory reporting, and billing. In addition, the informed consent process should include information specific to the nature of videoconferencing. The information shall be provided in language that can be easily understood by the patient. This is particularly important when discussing technical issues like encryption or the potential for technical failure.

Part of obtaining consent from the patient is the evaluation of the appropriateness of videoconferencing care for the patient as well as assessing patient cooperativeness in assuming the responsibilities inherent in remote care. The consent process shall include discussion of conditions of participation around session management so that if a professional decides a patient can no longer be managed through distance technology, the patient is aware that services may be discontinued if no longer appropriate.

Is mental health care effective if provided online?

Randomized controlled trials have demonstrated the effectiveness of telemental health care:

1. O’Reilly R, Bishop J, Maddox K, Hutchinson L, Fisman M, Takhar J. Is telepsychiatry equivalent to face-to-face psychiatry? Results from a randomized controlled equivalence trial.
Psychiatr Serv. 2007;58(6):836-43.

2. Ruskin PE, Silver-Aylaian M, Kling MA, Reed SA, Bradham DD, Hebel JR, et al. Treatment outcomes in depression: comparison of remote treatment through telepsychiatry to in-person treatment. The American journal of psychiatry. 2004;161(8):1471-6.

What are the expectations regarding contact between sessions?

Reasonable expectations about contact between sessions shall be discussed and verified with the patient. At the start of the treatment, the patient and provider should discuss whether or not the psychiatrist / GP psychotherapist will be available for electronic contact (through our service) between sessions and the conditions under which such contact is appropriate. The provider should provide a specific time frame for expected response between session contacts. This should also include a discussion of emergency management between sessions.

How will the doctor’s and patient’s identity, contact information and location be verified?

The name and credentials of the physician and the name of the patient shall be verified. When providing professional mental health services to a patient in a home setting, the telehealth provider shall provide the patient (or legal representative) with his or her qualifications, licensure information, current location, and, when applicable, registration number and where the patient can verify this information. Patients shall provide their full name, address, current location, healthcare number, family doctors name and contact information of a family or community member who could be called upon for support in the case of an emergency. The doctor may ask patients to verify their identity more formally by showing a government issued photo ID on the video screen or through a scanned copy sent through email. The contact information for both provider and patient shall be verified. This shall include gathering telephone and mail contact information for both the provider and patient and may also include contact information through electronic sources such as email. The location where the patient will be receiving services by videoconferencing shall be confirmed ad documented by the doctor. For legal reasons, both the doctor and the patient must be in Canada at the time of Videoconferencing. Our services cannot be accessed while travelling through the United States or other countries.

Are their parts of Canada that are excluded from the service?

Currently Saskatchewan, Northwest Territories and PEI are excluded due to their provincial college restrictions. If you feel you have been harmed by this restriction, please contact your provincial legislative government representative as this is the only way change is possible. New Brunswick and Newfoundland may have delays in access due to extra bureaucratic rules by their respective colleges. Again, if you feel you have been harmed by these bureaucratic delays, please contact your provincial legislative government representative.

Can we access a psychiatrist through your service and then see them in person under the public health care system in an expedited basis?

No. While you are welcome to get on the Psychiatrist’s public health care list, you would be required to wait for public service at least as long as any other patient for public access.

What is the number of sessions and cost you might expect in a course of marital therapy?

This varies from couple to couple and depends upon the circumstances. Factors that can prolong a course of marital therapy include:

• Past history of trauma
• Presence of a mental health disorder
• Substance abuse
• Significant attachment injury (e.g. affairs)

Your doctor will assess your situation on an individual basis, and provide you with an estimate of time and financial cost.

What are the questions you should ask a marital therapist before engaging in therapy?

The following are guidelines and you should feel free to bring any other questions to a potential marital therapist:

a) What training do you have in treating couples specifically? When and where did you acquire this training?

b) For how long have you been treating couples?

c) What percentage of your practice involves treating couples?

d) What is your bias when it comes to divorce?

Responses may vary from:

i) “Divorce is like the amputation of a limb and should only be considered after all other options have been exhausted”.

ii) “God does not make marriages, people do, and if a couple is not getting along an early option is amicable divorce”.

iii) “I have no bias.”

If your potential marital therapist chooses iii) it is indicative of a lack of insight on his or her part, as therapists are human and invariably have biases. If these are not recognized, they cannot be dealt with appropriately.

If these are not recognized, they cannot be dealt with appropriately.

If your potential marital therapist chooses ii) and your ultimate goal is amicable divorce, then this therapist may be for you.

If your goal is to heal the wounds in your marriage, strengthen the marital bond and restore, and even improve, loving connection including levels of intimacy that you never imagined were possible with your partner, then we suggest that a therapist with the attitude in response i) would be your best choice.

e) What approach do you use in couples’ therapy?

If you are going to put your relationship and your money in the hands of a professional, then you deserve for that professional to be working from a clinical approach that is scientifically validated. The two couples’ therapy approaches that have achieved strong research support are Emotionally Focused Therapy (EFT as developed by Dr. Susan Johnson) and Behavioural Marital Therapy (as developed by Dr John Gottman).

f) What do you do if one or both partners is on the verge of divorce?

g) Is there hope for a marriage if there has been sexual infidelity?

h) Under what circumstances should couples break up?

While ethically, this is the couple’s decision and not the therapist’s, your potential therapist should be able to talk with you about situations where marital therapy is not worth the time, effort and money. These include: situations of domestic violence where one spouse and/or children are at significant risk, and when there are destructive patterns of addiction (substance, sexual, gambling) where a partner refuses to make the kind of changes that might save the marriage and the family.

i) Approximately what percentage of the couples that you have treated would say you helped improve their relationship?

Judging this type of success can be difficult as many factors can influence treatment outcomes. However, we think you should expect an improvement rate of 90% and a success rate of about 70%. Notably, in studies of EFT, with highly supervised therapists, such rates are quoted in the literature.

j) What is your own marital or relationship history?

This may seem like an intimate and inappropriate question, but we think that you have every right to ask it of the person with whom you are entrusting with your marriage.

We thank Brent Bradley et al. for inspiring some of the above questions.

What is hypnosis?

Hypnosis involves a focusing process. The client is encouraged to focus on something, for example,

• the breath,
• the voice of the person guiding them through the process,
• a bodily sensation,
• a thought,
• an emotion,
• a spiritual experience,
or
• a specific idea, image, or symbol.

This focusing is used as a means of getting the client absorbed in a particular experience.

Hypnosis often involves relaxation, but this is not a necessary or even essential aspect of a successful hypnotic experience.

Hypnosis can help you control your
• thoughts,
• feelings,
• behavior,
and even
• level of pain you experience in your body.

People do only what they want to and choose to do under hypnosis. The client is an active participant in the process and always remains in complete control.

Hypnosis is about building frames of mind, absorbing new ideas and expanding one’s ability to consider various possibilities.

When performed by a qualified clinician, hypnosis can teach skills that can reduce anxiety and depression.
Hypnosis is one of the most impressive tools by which people can be helped to develop greater self-mastery.

What is the difference between a psychologist, a psychiatrist and a GP psychotherapist?

First, not all Psychologists are able to treat clients. Only “Clinical Psychologists” have a license to treat, and these vary in their level of education. Typically, Psychologists are specialized in one or sometimes two aspects of mental health care. Some Ph.D. Psychologists are highly trained and skilled in their specialty field of study.

Psychiatrists are Medical Doctors. They have been through medical school followed by a 5 year residency program during which they are trained in all aspects of mental health. They can prescribe medications. Some Psychiatrists further subspecialize in child, adolescent, family and marital, geriatrics, substance use disorders, forensics, and so on. Psychiatrists must undergo ongoing continuing medical education to meet their Royal College requirements.

GP Psychotherapist are Family Doctors. They have a two year residency in Family Medicine. Additionally, they have extensive continuing education in psychotherapy after completing their residency. They must also meet their College requirements for continuing medical education.

How do I know the service is secure?

Skype calls are encrypted, but it is important to use a location which is secure such as a home high speed internet connection which is not shared. An internet café or a free public Wi-Fi would not be secure locations. That said, it is also crucial that your computer’s operating system, Skype and anti-viral software be up-to-date.

How do I arrange a Skype appointment?

By contacting us at PsychiatryOnlineCanada@gmail.com. We will do our utmost to arrange an appointment at a mutually convenient time.

Is there a cost to the service?

Yes. This service is not covered by any provincial health care plan. You must pay out of pocket for the service. You should, however be able to use the receipt for this service as a legitimate health expenditure on your income tax return form. As to the hourly rate, please contact us at PsychiatryOnlineCanada@gmail.com for current pricing and availability.

Do I need a referral from my Family Doctor / GP?

No. You can self refer. However, please consider that it may be to your advantage to open the lines of communication between your Family Doctor and your Psychiatrist / GP Psychotherapist so that they can work together toward improving your mental health.

What are the pros and cons of Online Psychiatry?

Pros:

• No long wait list.
• Convenience (comfort of your own home).
• No travel time.

Cons:

• The service is not covered by provincial health care plans.
• Some nuances of facial expression may be lost in transmission over Skype.

What is this website’s privacy policy?

This privacy policy sets out how we use and protect the information that you provide to us when you use this website.

We are committed to ensuring that your privacy is protected. Should we ask you to provide certain information by which you can be identified when using this website, then you can be assured that it will only be used in accordance with this privacy statement.

We may change this policy by updating this page. You should check this page from time to time to ensure that you are happy with any changes. This policy is effective from July 15, 2014.

Here’s what we collect

We may collect the following information:

• Name
• Contact information including email address

Here’s what we’ll do with the information we gather:

We require this information to understand your needs and provide you with a better service. In particular, we may use the information for:

• Internal record keeping.
• Contacting you for feedback and service quality improvement purposes.
• Customizing the website according to your interests.
• Provide your contact information to the agreed upon mental health care professional.

Here’s what we won’t do with the information we gather:

• We will never provide your information to third-party partners.
• We will never sell your information.

Handling security

We are committed to ensuring that your information is secure. In order to prevent unauthorized access, or disclosure, we have put in place suitable physical, electronic, and managerial procedures to safeguard and secure the information we collect online.

Links to other websites Our website may contain links to enable you to easily visit other websites of interest. However, once you have used these links to leave our site, you should note that we do not have any control over other website. Therefore, we cannot be responsible for the protection and privacy of any information you provide whilst visiting such sites and this privacy statement does not govern such sites. You should exercise caution and look at the privacy statement applicable to the website in question.

Controlling your personal information

You may choose to restrict the collection or use of your personal information.

If you believe that any information we are holding on you is incorrect or incomplete, please email us as soon as possible. We will promptly correct any information found to be incorrect.

You may request details of personal information we hold about you under the Data Protection Act 1998. You may be asked to pay a small fee. If you would like a copy of the information held on you, please contact us by email.

Please note: We will not sell, distribute, or lease your personal information to third parties. Medical information sent to us is treated the same way as in any medical practice in Canada in accordance to provincial laws and college requirements.

Is there a question we did not answer? Contact us and we will endeavor to answer all other questions regarding our service.

We have discussed the contents of this website with professional colleges who have made suggestions to the content of the site. We thank them sincerely for their suggestions.

We also want to thank the American Telemedecine Association for their permission in using parts of their Practice Guidelines for Video-Based Online Mental Health Services for some of the above FAQs. These Guidelines are available in their entirety on their website.