Chapter 2
Key Protocols and Strategies for High-Risk Online Therapy:
Providing virtual therapy to clients experiencing suicidality, domestic violence, psychosis, or other high-risk behaviors presents unique challenges. However, with thoughtful preparation and proper protocols, virtual work can be just as effective—if not more so—than in-person therapy, especially when clients feel more comfortable in their own environment.
It is crucial to have a comprehensive crisis management plan and the appropriate tools in place to effectively support clients at high risk. Online therapy requires an even higher level of proactive safety planning and risk assessment because of the physical distance between therapist and client.
Why This Matters:
Increased Accessibility, Increased Responsibility: While telehealth provides greater access to therapy, it also requires therapists to be especially proactive in identifying risks and responding quickly to signs of distress.
Adapting to Remote Challenges: Working with high-risk clients online means therapists may need to be more creative and communicative in finding alternative ways to check in and assess safety. Clients who may feel isolated at home often benefit from frequent, supportive contact.
Enhancing Emergency Readiness: Preparing for the worst-case scenario—while still maintaining a compassionate, supportive framework—ensures that clients feel heard and safe even in the most challenging moments.
Reflection Prompt:
How can you integrate high-risk protocols more seamlessly into your virtual sessions to ensure clients feel supported and safe at all times?