Therapy, Coaching & Distant Healing via Technology

We offer articles from TILT Magazine and information related to online therapy, online coaching, online complementary and alternative modalities and cyberpsychology.

What is Crowd Funding and Why Should You Get In On It?

December 18th, 2014   •   no comments   

replacement piggyThe new hot topic for entrepreneurs these days is crowd funding, which is anticipated to at least supplement, if not replace, the slow and mysterious process of current Angel and venture capital investors. “Crowd Funding,” or “Crowd Sourcing” is a way to get start-up equity for your business (or any venture for that matter). This model allows “regular” people to get start-up funding from $5,000 on up by getting other “regular” people to invest small amounts of money online. It is not a “get-rich-quick” scheme, nor is it a “network marketing” scheme. It’s a great idea, especially since in most cases, after you receive your funding goal, you do not have to pay it back.

I will attempt to outline this model in simple terms for you and offer some practical advice on how YOU can get some start-up money for your venture. Congratulations to DeeAnna Merz Nagel and Kate Anthony with Online Therapy Institute for recently completing their goal for $5,000 on Kickstarter to fund this fabulous online magazine TILT: Therapeutic Innovations In Light of Technology! Sign up for your subscription here: if you don’t already have one!

In fact, I’m so excited about this new possibility, I will be starting MY OWN funding program to promote my book Bad Dick, Good Jane next month – watch out for it! I will be doing much more research on crowd funding before I actually engage in it, and I recommend you do the same. There are many different types of crowd funding, and things are changing very rapidly. You can learn more about it on the most popular websites such as, and

There are also many different types and models of crowd funding. Some of the main ones are listed below. As far as I can tell, here is how the basic crowd funding works. You sign up with one of the sites. With Kickstarter, you create your project and determine how much money you will need to start it up or get it going, and within what time frame you want to receive it (OTI started with $5,000 within 3 months). You then send emails, calls, or social media posts to everyone you think would be interested in getting your project going, asking for pledges for donations. They can pledge as little as $1, and do not have to pay out money when they make a pledge. They only pay out IF the project receives enough pledges to meet their goal, such as $5,000. If the project meets their goal, they will receive the $5,000 (less the crowd funder’s percentage which is usually 3% – 10%). You do not have to pay the money back, but you do have to use the money for the project you stated you would. You do not have to share what you are doing specifically with the donations – it is largely based on trust. Therefore, you need to have a trusting audience. The larger and more passionate your audience is, obviously the better. Along the way, during the 3 month campaign, you will want to provide your audience with updates on your funding, such as, “We’ve raised 72% of our funding goal with 16 days left!” Once your project time period has ended, you need to send an update to your audience with how you did, and thank them for their pledges. After that you can send updates to them on how your new project is taking off if you like. It’s a good idea to stay in touch with your audience, as you never know when you may want to ask them for a pledge for a future project.

IndieGoGo has a slightly different platform. It is much like Kickstarter, except that if you don’t reach your funding goal you still get whatever money you were able to get pledged, less a higher fee %. For example, if your goal is $5,000 and you reach your $5,000, the fee might be something like 5%. If your goal is $5,000 and you only receive pledges of $3,000, the fee might be something like 9%. Here are some different types of crowd funding:

Good-cause crowd funding. This model is a good thing, and has been around for years. Example sites include StartSomeGood and the Facebook Cause page. People can invest (donate) money to a project which has good moral/ethical value. Contributors can enjoy the feeling of doing good.

Pre-order crowd funding. Here people make online pledges with their credit cards during a campaign, to pre-buy the product for later delivery, if it is ever built. Kickstarter is the big player in this space. It has had some notable successes for entrepreneurs (over $1M in funding), as well as non-starters. Kickstarter also allows you to receive funding for a product or service that is not associated with ordering a product or service for later delivery, rather helping the entrepreneur get their product or service going.

Rewards-based crowd funding. This is a variation on the two previous ones, where investors get the satisfaction of helping, and immediately get a pre-determined reward or perk of value, such as a t-shirt, or other recognition, but no equity or finished product. For example, OTI (as mentioned above) offered a free subscription to TILT Magazine with a $20 pledge. You could pledge less or more than $20 but if you pledged at least $20 you would get a free one year subscription, which was a great incentive. A good example site, and one of the earliest in this category, is IndieGoGo.

Debt-based crowd funding. In this model, sometimes called micro-financing or peer-to-peer (P2P) lending, you borrow money from a number of people online and pay them back after the project is finished. This has been popular in many countries for years via sites like LendingClub and Kiva. The allure is fat returns, but they come with a huge risk.

Ideas crowd sourcing. Technically, this model is not involved with funding at all, but “crowd sourcing” and “crowd funding” are often used interchangeably. Sites like GeniusCrowd get your ideas off the shelf, and give you the wisdom of the crowds. Of course, this might also lead to investors, partners, and licensing opportunities.

Don’t confuse any of these models with other popular funding sites for start-ups, like FundingUniverse and GoBigNetwork. These are primarily matchmaking sites between entrepreneurs and professional investors or banks. Often they do sponsor pitch contests with small cash prizes for funding, as well as other valuable services to support entrepreneurs.

So it’s easy to see that whether you are a new entrepreneur or a new potential investor, the Internet has opened several new options for the crowd to help you. These also open new concerns about lost intellectual property, Internet scams, and long-term return on investment. Most of the information I am sharing here was found at:

What makes for a good Crowd Funding project? Just like the TV shows Shark Tank and Dragon’s Den, you need to make a great “pitch.” The most important thing is to make sure you’re actually giving something to people. Either you are giving them a physical object or you are giving them the satisfaction of “helping” you create a good thing. The next most important thing is to make sure you are targeting a passionate crowd at the right time. Your “crowd” is people you know, or people in your social media and business media networks. They should be people who LOVE the idea of your project and WANT to see it get off the ground. It also helps to give people incentives to pledge. You can give everyone who pledges some sort of gift, or those who pledge $25 or more a nicer gift, and those who pledge $50 or more a nicer gift, and so on. I will give you some examples of successful Kickstarter projects here.

“Save Blue Like Jazz” raised more money than any other project on Kickstarter — $345,992 to save a movie project that was going to be cancelled. The book “Blue Like Jazz,” was turned into a film, but ran out of funding before it could hit the big screen. Supporters started a Kickstarter project to get it going and created what they call, “the largest crowd-sourced creative project ever.” What was the key? It appears the key here was that it was a project with millions of fans already built in. They also gave donation incentives. The minimal donation landed you some goodies like posters, and script pages. The director of the movie is calling people to personally thank them for donating.

Dan Provost and Tom Gerhardt are two friends that decided to make a little contraption that could put your iPhone in a tripod. They wanted $10,000. They got $137,417. This is probably because they gave away a free tripod gadget to people who pledged a certain amount, and it looks like a LOT of people wanted one of those gadgets!

Punk Mathematics is a project from improv comedian and math professor Tom Henderson to make an accessible, punk math book. He raised $28,701 which is 10X is original goal of $2,400.

If you would like more information, do a “Google” search for “crowd funding” and/or check out the websites and resources I’ve listed here. Sign up for my newsletter and I will share my own experience with you as it unfolds!

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the What is Crowd Funding and Why Should You Get In On It article.

Lyn Kelley is a Practice Building Coach at who helps colleagues increase their practice growth and success. She is also faculty at Online Therapy Institute/Online Coach Institute.

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What is good SEO anyway?

December 12th, 2014   •   no comments   

marketing toolboxSearch engine optimisation (SEO) is the process of ensuring a website is not only visible to search engines, but appears as high in the resulting ranked list of results as possible when users input a search term. Good SEO results in more potential customers finding your website.

Over the past few years, Google has been advancing its search algorithms in favour of good, ‘white hat’ SEO. It has also applied rules that specifically penalise ‘black hat’ SEO; deceptive techniques to improve rankings, such as hidden text and link spamming across the web.

White hat developers and content producers should aim for a well-built website with high quality, original content, social integration and good links to other relevant sites. Recent search engine developments have demonstrated that any black hat methods for artificially raising search engine ranking will quickly backfire, resulting in a site ban.
“Rule one: If your users love your site, so will the search engines.”

Creating a website optimised for search engines

Search engines send out small programmes, called spiders or crawlers, which constantly search the web and index its content. New websites can be registered with the main search engines; Google, Bing, and Yahoo! to ensure they are found and indexed quickly.

When building a website and creating content for it, developers should focus on several factors to ensure good SEO is supported from the outset. A search engine assesses each website for usability and usefulness using sophisticated algorithms that function by checking for specifics, which include:

Structure; search engines do not crawl pages more than three ‘deep’ from the site’s root directory. Good use of navigation will ensure all pages are indexed and can be found by both real users and crawlers. Page size and structure is also relevant. Content higher up each page has more weight than content further down.
Technical accuracy; good quality coding is essential, and 301 redirect pages and a site map are required to ensure visitors always reach their intended destination on content pages. Broken links and overuse of frames are penalised. Server downtime and the page response time also have high SEO impact, so a reliable web host is important.
Meta Tags; these hidden text elements provide important information to search engines. Both the site itself and each web page should include a title, a description and keywords.
Keywords; a set of words or phrases that are most likely to be input by users into a search engine to find the specific content on each page. The more specific these are, the better SEO they will deliver. It is important to ensure that keywords in meta data do indeed match the content on the page or the site will be considered spam. Using keywords in the headings and page URL also adds to positive SEO.
Headings and highlighted text; search engines seek out terms of emphasis that give weight to the words within them. Including an H1 header, sub headers and bolded text helps readers make sense of a piece of copy more rapidly. Headings should use keywords were possible and faithfully describe the content.
Content; the content must be original and discuss the subject which the page and the web site claims to be about. Search engine crawlers assess keyword density, proximity and placement and have the ability to recognise and penalise unnatural or irrelevant copy.
Inbound links; links on a page pointing to other pages or external content should use descriptive anchor text. So, rather than using a word such as ‘Link’, describe what that link leads to, preferably using keywords, then stretch the link across the phrase.
Back links; the number and quality of links on other websites pointing to your site add positive SEO. However, spam linking is a well-known ‘black hat’ method that is heavily penalised by Google. Make sure any links back to your site are from legitimate, relevant or popular websites and, if at all possible, create reciprocal links.
Accessibility; to ensure a site is accessible to blind readers it is important to include descriptive ‘Alt’ text to all images. This also allows Googles Image Search to find and catalogue each image.
Freshness; recently updated pages and links add positive SEO to a site. So, the more often you add new content, the better. Social content such as blogs and twitter feeds are a popular method for ensuring a regular flow of both new content and fresh links.
Popularity; increasing the number of visitors to your site, how long they stay, and how many links they click, will also improve your search engine ranking.
Location and contact information; Google maps looks for place names in headers, keywords and site descriptions so including geographical details can increase your search engine visibility. Email details included on a web page should be domain specific or they may be considered by search engine crawlers to be spam. For example, my website is so it is important that my email address uses the same domain;

Measuring the success of SEO

Attempting to track page ranks to assess SEO success is rather futile. Ultimately, you are not interested in how well your page ranks. You are looking for increased traffic to your site. You are hoping that visitors are interested in your products or services. You want their buy in. Site traffic and sales leads are therefore key performance indicators for good SEO.

Use Google Analytics and Webmaster Tools to measure, record and analyse site traffic. Segment incoming traffic using the built-in advanced segmenting reports, then compare non-paid search traffic with another time period (year on year, or month on month). Filter out branded phrases, such as company and product names, using Webmaster Tools as these are unique, so searches based around brand names have no reflection on SEO. You are looking to measure organic visits.

Organic Search Image

Understanding Google zoology

As Google evolved, new updates were released which have changed the landscape of search engine performance. In February 2011, Google introduced the Panda update penalising sites with content copied from other sites. April 2012 saw the launch of Penguin, which penalised sites using black hat ranking techniques. More recently, in September 2013, Google Hummingbird improved Google’s natural language processing and semantic understanding. This also gave social signals greater impact on search results.

Quality content and social integration for customer contentment

These updates mean that Google is now sophisticated enough to be difficult to fool. As a search engine’s ultimate aim is to find the best quality content that most accurately matches the search terms input by users, it is now simple common sense to aim to produce just that.

Priority number one should be to write content that people, and in particular your customers, want to read. By making content easy to find, quick to assess, enjoyable to read, visually pleasing and within an environment that offers both additional information (in the form of quality links) and social context and commentary, you will automatically be increasing your search engine ranking. More to the point, your reputation for providing useful or interesting information will increase return visits and enhance site popularity, which will not just increase your SEO, but will ultimately bring you more customers.

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the What is good SEO anyway article.

Sarah Lawton is a UK based content marketer and social media expert. With a passion for communication, new technologies and top quality content, Sarah encourages SMEs to make the best use of both traditional and online solutions. For further information or advice, please contact:

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The latest edition of TILT Magazine is here! Fall 2014

December 11th, 2014   •   no comments   

TILT Magazine Fall 2014Welcome (or welcome back!) to Therapeutic Innovations in Light of Technology.  We are so pleased to bring you the first issue in Volume Five – our 20th issue, funded by you our readers through our Kickstarter campaign!

Our main feature article in this issue is a topic dear to Kate’s heart – how social gaming has implications for the world of therapy and why we should be worried about it.  We spend a lot of our business days immersed in how technology can help us and our clients function better and work towards improved mental health, and our features show you these innovations in issue after issue – but what do we need to know about the “fun” side of our client’s lives?  Are their leisure pursuits something that gives them joy in life, or are there more sinister machinations at work?  Kate teamed up with Professor Mark Griffiths to unpick the seemingly innocent world of gaming on social media, to discuss how online social gaming has implications for our clients by tapping into a behavioural reward system that often leads to addictive behaviour, the closest cousin being harmful gambling.

We also welcome Catherine Knibbs, a UK specialist in CyberHarm and Young People.  She examines the links between adolescent development and the peer pressure young people experience in cyberspace, often leading to negative behaviour or, in turn, negative results.  Cath also highlights the importance of what we can do as adults – moving away from shielding young people from the darker side of the Internet and towards ensuring their resilience in facing them. By understanding the motivation behind online interaction, our young people of the future will find a happier way of living with the outcomes.

Finally, Mark Shields – the CAM Coach – talks us through how his business embraces many different technologies to make a success of it, and gives us his insight into some of the tools needed in running a thriving clinic online.  Mark’s book is featured in our Love of Books section, so make sure you check that out as well!

As always, our regular columnists are here, and we say a very fond farewell to Anne Stokes for her final CyberSupervision column.  Anne has been with TILT since Issue One, and it is hard to lose such a stalwart member of the team!  Our best wishes go to her as she frees up her time to work on other projects, and her insights into Online Supervision will be sorely missed.  Her shoes will be filled by Cedric Speyer in the future, who has a challenging role to take on!

Best wishes to all our readers for the holiday period and happy reading!

Kate and DeeAnna

PDF Download: TILT Magazine~ Therapeutic Innovations in Light of Technology, Fall 2014


For the Love of Books

December 4th, 2014   •   no comments   

Love of books 19 image 1Distant Healing: A Complete Guide Paperback

Most of us have prayed for someone facing a health challenge, only to wonder if it actually helped. What if there were a set of skills you could use to dramatically increase your ability to aid in the healing process?

With Distant Healing, you will join esteemed teacher Jack Angelo to learn dozens of simple ways to draw on the power of spiritual intention and send healing energy wherever it is needed.

Explore the Rainbow Breath to balance your energy field; Distant Healing techniques for plants and animals; “etheric gateways” and the body’s subtle energy centers; and Astral-Level healing and other advanced techniques designed for solo or group practice.

Psychoanalysis Online: Mental Health, Teletherapy, and Training

Love of books 19 image 2 Psychoanalysis Online: Mental Health, Teletherapy and Training, edited by Jill Savege Scharff, MD, is an international collaboration by psychotherapists and psychoanalysts who consider the impact of virtual reality on our society and the uses of communications technology for analytic treatment and professional training. Having examined the impact of communications technology on mental health and relationships, the authors explore its use in analytical treatment conducted on the telephone and over the internet, and review its problems and possibilities. They provide a multi-faceted view of it, an ethical stance in relation to it, and evidence from which to judge its effectiveness.

Looking into the future they imagine a time when technology-supported analytic treatment may be not only convenient as a supplement to in-person treatment but also preferable for some patients and therapists in various circumstances. Psychoanalysis Online: Mental Health, Teletherapy and Training invigorates the debate about technology and its responsible use in psychotherapy and psychoanalysis and in distance learning programs for mental health professionals.

Look out for Kate’s book review of Psychoanalysis Online in a forthcoming edition of the British Journal of Guidance and Counselling!

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the For the Love of Books article.

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Beginnings and endings- the latest news from Kate and DeeAnna

December 2nd, 2014   •   no comments   

As diverse as topics can get and yet not really…


DeeAnna talks about transitioning one’s work focus to embrace essential oils. Many healing practitioners are doing just that.

Kate talks about another transition- the end of an online therapy session.

Sometimes our weekly blog topics converge and other times they are seemingly worlds apart. We always find the common thread.


Retooled and Updated: Certified Aroma Coach

I love essential oils. So much so that I devote a good bit of my vocation to educating and sharing about essential oils. I became a Young Living Essential Oils wholesale member so that I could receive a discount on products and it wasn’t long before I knew I had to share my love of…  Read more





No, YOU hang up!

Ending conversations can sometimes be awkward, particularly if we are online.  If we are in the physical presence of someone, there are clues from our body language that we are about to move away – sometimes a kiss on the cheek, a handshake, or a facial expression that denotes a cheery farewell or that the… Read more




From Starting a Blog to landing a Movie Deal ~ all on the WWW

November 27th, 2014   •   no comments   

oimet 1When I overcame dissociative issues and chronic depressions by seeing where they originated in the first place and how the false understandings of how relationships worked were stuck in my belief system, I found myself with a massive passion and desire to share my new found freedom and wholeness with the world.

In the beginning I started speaking in mental health seminars and I noticed that almost everyone in the room could relate to what I was speaking about when I talked about this ‘root belief system stuff’ that had resulted from the messages that I got from the actions of adults in my childhood. I was seeing people’s eyes pop open and they were mobbing me on the breaks. It was really validating to have so many people interested in talking to me in order to learn more about how I found this new freedom from depression and how I recovered my self-esteem.

I was in my mid-forties at this time and although I considered going back to school to become a therapist, I still had 3 kids at home and I lived way out in the country and couldn’t figure out how I would attend school if I did go back, so I decided to become a professional coach. Since I was already working in the mental health arena, I chose a well-known American psychiatrist who was the dean of a reputable coaching institute, as my coaching instructor, so I could learn how to coach without crossing over into therapy.

Through coach training I learned about internet marketing and began to read about how to get known through the internet. The prospect of reaching a worldwide audience was really exciting to me and armed with the confidence in my message that I was receiving as a mental health advocate and inspirational speaker, I started to take a few courses on how to get set up on the world wide web. I am not very techie. I barely knew how to cut and paste!

I was overwhelmed with all the possibilities but I worked hard every day and downloaded every free training that I came across until I found the people that I really wanted to learn from and then I took a few actual internet marketing courses. I determined from my studies that having a professional blog was the most effective way to present content and I took an online course with step by step instruction on starting a WordPress blog and I set up my website “Emerging from”.

Although I had never considered myself “a writer” I started writing about my journey to wholeness: I wrote small consumable bite sized stories about how I discovered the false messages that were stuck in my brain because of the damage and trauma I had endured in my childhood. I wrote about sexual abuse, dissociative identity disorder, trauma and depression. I wrote about my life and the solutions that I had found that helped me overcome the trauma in my own life. I learned about key words, and facebook and a few other social media mediums and learned how to get my content found and how to share it and how to get it shared and I started to get comments on my blog!

That was four and a half years ago now. My blog grew and grew and within two years I was averaging 1000 legit comments a month and many of the comments were and still are over 2000 words. I invited some experts to guest post and I have invited people to share their own personal stories of healing. I have guest posted on other sites, and commented on other blogs related to my blog topics, all of which helped me to increase my reach, which was my primary goal in the beginning!

I also built a very successful private coaching practice through my blog. I have never advertised, or posted that I had an opening (not even in facebook) because I usually have a waiting list. I coach on the phone in Canada and the USA and on Skype in all other countries. 50% of my clients are American and the other 50% are from all over the world.

Today the blog itself has over 400 posts and over 33,000 comments! When Emerging from Broken was about 4 months old I started a facebook fan page and I have organically grown the following there to over 50,000 people, and the Emerging from Broken facebook page attracts an average of 100 new followers a day. I have become known as an expert on emotional healing and my website is read in 156 countries.

Recently I was contacted by award winning producer Robin Jay, with an invitation to be in her next self-help movie “The Secrets of the Keys” which is a prequel to her first movie “The Keeper of the Keys” staring Jack Canfield (co-creator of “Chicken Soup for the Soul” and author of “The Success Principles”), Marci Shimoff (author of “Happy for No Reason”), and Dr. John Gray (author of “Men are from Mars, Women are from Venus”). “The Keeper of the Keys” was the first funny self-help film. It won the Las Vegas International Film Festival Award for Best Independent Film and The INDIE Fest Award for Best Documentary.

Robin Jay signed me to co-star in the next “Key” movie “The Secrets of the Keys” as a featured “Key Expert”. I will be presenting on the key of Harmony. I will be co-staring in this film with icons of the personal development industry including Brian Tracy, Michael Beckwith, Dannion Brinkley (Author of “Saved by the Light”) John Assaraf, Gloria Loring, and will feature special guest don Miguel Ruiz, author of “The Four Agreements”. I am so excited and extremely honored to co-star with these amazing messengers in the field of self-help and personal development. I never imagined that my passion for reaching the world with my message of hope and healing would land me a movie deal!

Most Coaches and Therapists have a passion to help people. That’s why we do what we do and who doesn’t want to reach a wider audience? I saw a problem in the world and I believed I could contribute to the solution. I believed that I had unique information and I found a way to share it. I researched the best way to deliver this information and I learned how to do it. I celebrated the milestones along the way and I persevered through the tough times. There was a time when I thought that building this whole thing took too long but when stop and think about it honestly, it’s only been 4 and a half years and in that time have built a really high traffic website with hundreds of thousands of readers, I built a successful business, I have just published my first e-book “Emerging from Broken ~ The Beginning of Hope for Emotional Healing” and I have a movie deal. I think that is pretty awesome! Hope and persistence mixed with passion plus courage and the willingness to share information has been the recipe that got me on the road to the where I am today.

There is beauty (and success) on the other side of broken.

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the From Starting a Blog to landing a Movie Deal ~ all on the WWW article.

Darlene Ouimet is a certified international coach, inspirational speaker and author of high traffic emotional healing blog ‘Emerging from Broken’. Darlene empowers readers to break through their false belief systems in order to gain higher self-esteem, increased ambition and confidence.

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“Tech Support”- Using Technology to Support Ongoing Recovery

November 20th, 2014   •   no comments   

mullensMost clinicians have experienced the vibration or ring of a cell phone during session. Depending upon whether we are “digital immigrants”, “digital natives” or those who would like to seek “digital asylum” our responses might be very different (Prensky, 2001). Many clients are technologically connected in ways that counselors may not have traditionally experienced in the clinical setting. Most addiction counselors pride themselves on “meeting clients where they are,” yet many find it difficult to embrace our client’s connectedness or attachment to their devices. Untangling the mystery and fear of technology for “digital immigrants” doesn’t have to be scary; the clinician need only be willing and open to working within the digital culture using websites and smartphone applications to enhance recovery.

First Choice Services Inc. and its sister corporation First Choice Health Systems Inc. have embraced technology for many years using the original modality of providing telehealth – the telephone. Its two phone-based programs, the West Virginia Prescription Drug Abuse Solutions program and Problem Gamblers Help Network of West Virginia (PGHNWV) program, provide information and referral services across West Virginia, with PGHNWV having provided therapeutic interventions for more than 11,000 problem gamblers and their loved ones since 2000. Additionally, both programs provide a “Chat” option on their websites to engage those who are seeking help and who are more comfortable utilizing computers or mobile devices.

In 2012, First Choice Services, Inc. was awarded a Technology Assisted Care (TAC) grant from SAMHSA to further incorporate technology into treatment services in West Virginia, and as a result developed the Appalachian Technology Assisted Recovery Innovations (ATARI) program. The ATARI program’s objectives include: introducing technology into treatment and recovery support programs in West Virginia; maintaining and increasing client engagement; preventing relapse and developing community partnerships. To help achieve its objectives, ATARI contracted with the University of Wisconsin to utilize the A-CHESS (Addiction-Center for Health Enhancement System Studies) smartphone application, which has been nationally recognized and showcased in the Journal of American Medical Association Psychiatry, TIME magazine, WebMD and Yahoo News.

A-CHESS is comprised of many features to help those in recovery and is currently being vetted as an evidence-based practice. A-CHESS is theoretically based in Self Determination Theory (SDT), which focuses on how social and cultural factors facilitate or undermine people’s sense of volition and initiative, in addition to their well-being and the quality of their performance (Deci & Ryan, 1985). Conditions supporting the individual’s experience of autonomy, competence and relatedness are argued to be the most volitional and therefore, high quality forms of motivation and engagement (Deci & Ryan, 1985).

When clients receive the A-CHESS app, they are encouraged to create a “profile” similar to the profile feature of Facebook. The profile allows clients to share common interests that they might not know about one another. The additional features of the app allow the client to connect to recovering peers and their clinicians through the team feed, support team, messaging, and discussion boards. The messaging function is used as a private email which allows clients to contact each other, their recovery coach, and/or their counselor. The discussion board is used to engage clients in ongoing discussions about recovery topics which can be started by clients or the coach/therapist. Clients have access to recovery podcasts, recovery news, events, and recovery information which help keep them in touch with more self-directed resources.

One of the most innovative features of the app is the “panic button” which allows the client to make contact with one person or many people if they are in a risky situation or at risk of relapsing. At the touch of a button the client can choose to call or text their support team, email their therapist, or engage in various recovery based interventions through the app. They can choose to listen to podcasts that focus on assertiveness cues, relaxation techniques, dealing with urges, and refusal skills. This provides a 2-3 minute “time out” to the distressed client who may need to ride out the temporary emotional state.

The A-CHESS has an administrative function where the clinician can mass message clients, add sober events to the clients’ calendar, monitor participation, and evaluate client progress and concerns on the app. Data available to the clinician include individual and group Brief Alcohol Monitoring (BAM) survey responses. The client is prompted weekly to complete the BAM survey which assesses not only relapse triggers, but evaluates protective factors as well. If the client’s BAM responses are indicative of clinical decline the treating therapist is alerted by the ACHESS system which allows for prompt intervention to occur.

The treating clinician is also provided with information regarding client’s use of specific features on the app, as well as, the amount of time the client is engaged with the technology. This data can be utilized in treatment planning and developing client specific interventions. This easy to read clinical data compliments quality practice and assists in providing measurable outcomes required by the Affordable Care Act. Clinicians are given the tools needed to provide a continuum of care for each client participating in the A-CHESS program.

As a next step, First Choice Services Inc. through the ATARI program partnered with sixteen organizations around West Virginia to provide access to smartphones with unlimited talk, text and data for six months, including comprehensive behavioral health centers, smaller behavioral health centers, and private practices. The phones are pre-programed with the A-CHESS app along with several recovery-based apps that were vetted and chosen by staff, including Sober Day, 12 Steps, NA Speakers, and Room to Breathe. The additional apps were chosen to help compliment and add to the tools available with A-CHESS. While A-CHESS is more focused on recovery from alcoholism, clients may use these other apps to access to resources related to recovery from narcotic use etc.

Client engagement is a very strong indicator of success in treatment and relapse prevention. A-CHESS allows for engagement with staff, both clinical and non-clinical, as well as peers who are in the same treatment groups. The Affordable Care Act is going to change how many treatment providers deliver service to clients and A-CHESS is a great example of a safe, secure, closed recovery environment which is very affordable at less than $2.00 per week per client. If clients are engaged with their clinician and peers, it seems a very good investment and would likely lead to better outcomes.

The ATARI program administers a “first day survey” through a custom A-CHESS survey option to collect information about access and impact of technology prior to joining the program. In looking at data from ATARI’s first six months and comparing to data obtained in these “first day surveys,” clients are reporting a 21.6% increase in abstinence, a 9% decrease in depression, a 24% decrease in anxiety, and a decline of intravenous drug use from 7% to zero. “A little over half of ATARI participants had no online recovery help before this program,” says Carmen Combs, evaluator at First Choice Services Inc. and First Choice Health System Inc., “Now 87% of the clients who responded to the survey stated they feel connected with their recovery support using A-CHESS.” This means recovery help is making an impact.

In the spirit of Motivational Interviewing, adopting new technology during these times of extreme changes in the field has presented challenges. Clinicians and staff enter partnership with ATARI at varying stages of fears, concerns, and excitement. The setting and role of the clinician made a difference in the willingness to embark on integration of the smart phone and apps. Many of the more traditional clinicians were extremely concerned about HIPAA and boundaries. However, recovery coaches, peer specialists, and staff at day report centers were eager to embrace technology and were excited to have the additional resources made available by A-CHESS, and saw the ability to provide a reliable form of communication with clients via the smart phone as a tremendous resource. In order to allay fears of HIPAA breaches, clients were provided an extensive informed consent, required to set a unique password on the phone, and given the option to select a user name which could be fictional.

For additional accountability, the ATARI staff participated in bi-weekly calls with 50 other TAC grantees across the nation to share program successes and problem solve obstacles as they arose. Additionally, we worked closely with JBS International and participated in onsite reviews of the ATARI program.

In March 2014, the ATARI staff participated in a technology showcase at the SAMHSA headquarters where we were able to meet with Dr. H. Wesley Clark and the TAC grantees for a two day healthcare and technology conference. This provided a platform to not only evaluate the current Healthcare Technology Programs, but to begin to develop sustainability objectives and look toward future projects.

As a result of these successes. ATARI has begun to develop a secure online platform for the delivery of one-on-one counseling services in order to further facilitate the integration of technology in West Virginia. There are many platforms available and a very comprehensive list can be found at In addition ATARI selected approximately 25 Master’s level licensed social workers, licensed professional counselors, psychologists, and Advanced Alcohol and Drug Counselors from West Virginia and provided the face-to-face two-day training for the National Board of Certified Counselors’ Distance Credentialed Counselor (DCC), a national credential recognizing a professional with training in the best practices in distance counseling.

Some states are beginning to require additional coursework, continuing education or credentialing before clinicians provide “distance counseling.” West Virginia licensing boards do not require additional formal education, however, the newly released American Counseling Association Code of Ethics indicate under section “H.1.a Knowledge and Competency- Counselors who engage in the use of distance counseling, technology, and/or social media develop knowledge and skills regarding related technical, ethical and legal considerations (e.g. special certifications, additional course work)” (American Counseling Association, 2014). Additionally, counselors and agencies need to seek clarification from malpractice insurance carriers about whether distance counseling is covered under their policy, and usually provide information about the platform security and assurance that the service delivery method falls within the counselors’ competencies and scope of practice. Additional resource organizations which provide training and certifications include the Online Therapy Institute and the Telemental Health Institute and the National Frontier and Rural Addiction Technology Transfer Center (NFARATTC), which solely focuses on addiction treatment and technology, instead of “telemedicine” and “telepsychiatry”. These allied professions have certainly forged the path for all behavioral health professionals; however, many of the resources fall short in addressing the needs of licensed counselors. NFARATTC, International Institute for Mental Health Online, Online Therapy Institute and the TeleMental Health Institute provide more specific resources for what is considered substance abuse and mental health. The Regional Technology Resource Centers are also a tremendous resource and similar to the ATTC Network, most states have a regional center and they are happy to assist.

As “digital immigrants” being able to conceptualize technology based counseling was initially difficult. However, this project has allowed us to see how this additional layer of support has enhanced the client’s treatment experience and improved client engagement. Health care reform, governmental policy, and reimbursement sources are all trending toward technology enhanced treatment. However, we have been most powerful impacted by receiving thankful messages like “I’m not sure where I would be without this program” and “this program has helped save my life quite a few times just by having instant access to my fellow addicts and counselor.” This is an exciting new time.

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the “Tech Support”- Using Technology to Support Ongoing Recovery article.

American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author
Chih, M., Patton, T., McTavish, F., Isham, A., Judkins-Fisher, C. L., Atwood, A. K., & Gustafson, D. H. (2014). Predictive modeling of addiction lapses in a mobile health application. Journal of Substance Abuse Treatment, 46(1), 29-35. PMCID: PMC3963148
Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum.
Gustafson, D. H., McTavish, F. M., Chih, M. Y., Atwood, A. K., Johnson, R. A., Boyle, M. G., Levy, M. S., Driscoll, H., Chisholm, S. M., Dillenburg, L., Isham, A., & Shah, D. (2014). A smartphone application to support recovery from alcoholism: A randomized controlled trial. JAMA Psychiatry. 2014 Mar 26. [Epub ahead of print] doi:10.1001/jamapsychiatry.2013.4642. NIHMSID: NIHMS550949

Gustafson, D. H., Boyle, M. G., Shaw, B. R., Isham, A., McTavish, F., Richards, S., Schubert, C., Levy, M., & Johnson, K. (2011). An e-Health solution for people with alcohol problems. Alcohol Research & Health, 33(4), 327-337. PMCID: PMC3536059

McTavish, F. M., Chih, M. Y., Shah, D., & Gustafson, D. H. (2012). How patients recovering from alcoholism use a smartphone intervention. Journal of Dual Diagnosis, 8(4), 294-304. PMCID: PMC3541672
Prensky, M. (2001). Digital Natives, Digital Immigrants. On the Horizon, 9(5):1-6.

Substance Abuse and Mental Health Services Administration. (2011). Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014. HHS Publication No. (SMA) 11-4629. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved at:

The International Society
Online Therapy Institute
National Frontier & Rural ATTC
Telemental Health Institute
Telehealth Resource Center
American Counseling Association Code of Ethics 2014

Susie Mullens MS, LPC, ALPS, AADC-S, Licensed Psychologist, SAP, DCC (Distance Credentialed Counselor) is the program director for the ATARI project at First Choice Services in Charleston, W.V. She is the immediate past president of WVAADC and serves on the NAADAC Veterans Subcommittee. Prior to ATARI, she was the Director of Counseling & Wellness at Davis & Elkins College in Elkins, WV. Ms. Mullens has been working in the mental health & substance use disorders field for over 23 years.

Teresa Warner is the ATARI Program Coordinator for First Choice Services, Inc. She has over 20 years working with substance dependent and the dual diagnosed clients, providing direct service in the community behavioral health centers, serving as a case manager in outpatient and residential settings, and as a probation officer for the West Virginia Supreme Court. In 2011, Ms. Warner began working for the West Virginia Physicians Health Program which provides intervention and supervision of medical professionals struggling with addiction. Under the supervision of Dr. P. Bradley Hall she obtained her Medical Review Officer Assistant Certification.

More about ATARI project:
““Tech Support” Using Technology to Support Ongoing Recovery first appeared in the July 2014 issue of Advances in Addiction & Recovery. © 2014 NAADAC, the Association for Addiction Professionals. All

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When is an Online Ending really an ending?

November 13th, 2014   •   no comments   

When is Online Ending ImageI’ve been reflecting a lot on endings recently. This is partly because I’m entering a new phase of my life and have cut down my work load (I can hear friends and family snorting with laughter and disbelief at this point!). However it is also to do with other things that I have been doing.

At the recent UK Council for Psychotherapists’ (UKCP) conference ‘Psychotherapy 2.0’, I was fortunate to co-host the online delegates’ stream with Aaron Balick. One of the interviews I conducted was with Aaron about his new book ‘The Psychodynamics of Social Networking’. Anyone who knows me will know that I am truly not into social networking sites (SNS), so I had to read the book most intently before the day, and to my surprise, really enjoyed it!

One of the many things that took my attention was the chapter in which Aaron explored ‘Being in the Mind of the Other’. Here an area he considers is the fact that SNS allow or enable people to continue to know about ‘the other’ even when the relationship has, on the surface, come to an end. So when a relationship breaks up, one or both partners can still find out a lot about their ex-partner.

That led me to think about online supervision, both from the perspective of supervisor and supervisee. As a supervisor, it would be quite possible for a supervisee to ‘keep tabs’ on me, or follow what I was up to by tracking me through SNS after our contract came to an end. The same would apply to me as a supervisee – what would I do if I had a sense, or knew, that an ex-client was following me as best s/he could after we finished our work together? What might alert me to this, and what would I need to do about it within supervision? In either case, it might be totally benign, or it could be rather like stalking. Also what does it mean for me, for my supervisees and for clients if in fact there hasn’t been a total ending? Are we shying away from experiencing the feelings that may arise from the loss of another? If so, how might that affect our ability to deal with the losses experienced through the death of someone we love (or hate)? I don’t have an answer to this, but it is good to have been made to consider it, and think about what is available freely about me online.

A different online ending I have been wrestling with actually happened to a therapist friend. As she put it, ‘My supervisor dumped me by email!’ She did know that the supervisor was retiring before too long and that they were working towards an end. They normally met online synchronously, using video, and there had been a difficulty in making the next session due to both of them having holidays booked. However, my friend was ‘gobsmacked’ when she received an email from her supervisor stating that as they had not made another appointment, she (the supervisor) was ending the contract and hoped it wasn’t too much of a shock. Could this possibly have happened in a f2f relationship? I rather think not, as there would have had to be a telephone call, or a letter, and letters tend to be more thought through than emails in such circumstances, I would venture. Apart from it being unprofessional and unethical simply to end supervision without an ending, it seems to me that there is something about the ease of pressing ‘send’ that may have allowed the supervisor to do this without due consideration. Perhaps she would have done well to remember the ’24 hour rule’.

In supervision online, particularly if it has been asynchronous, every exchange, every word, may have been stored. As Dunn (2014) states ‘ They describe returning to the transcripts, sometimes months or years later, and gaining new insights from re-reading the exchanges’. She is talking about clients. But in fact the same applies in the supervisory relationship. We perhaps have more to return to after the ending than in f2f supervision.

So when is an ending not an ending? Perhaps we need to reconsider what we mean almost in the same way that bereavement therapy has moved from encouraging ‘letting go’ to ‘continuing emotional bonds’. Considering that together could be a part of working towards a good enough online supervision ending. Who will we be for and to each other in the future?

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the When is an Online Ending really an ending article.

Anne Stokes is based in Hampshire, UK, and is a well-known online therapist, supervisor and trainer and Director of Online Training Ltd. She can be contacted at

Balick, A. (2014) The Psychodynamics of Social Networking: connected-up; instantaneous culture and the self. London, Karnac

Dunn, K. (2104) The Therapeutic Alliance Online. In Psychotherapy 2.0 – where psychotherapy and technology meet. Ed Weitz, P. London, Karnac

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The latest from Kate & DeeAnna! Writing & Flowers

November 7th, 2014   •   no comments   

While we keep you up to date on the topics of online therapy and coaching and we blog our articles from TILT Magazine~ Therapeutic Innovations in Light of Technology, Kate and  DeeAnna also blog about topics near and dear- sometimes overlapping with the remit of Online Therapy Institute, and sometimes not.

The most recent posts from both of us are offered here!


From Kate


On Being A Columnist

I’ve been thinking about both my contributors to TILT Magazine and my own role as a columnist recently.  This was inspired by the departure of my good colleague Anne Stokes over at TILT Towers, who has been with us from the inaugural issue right up to the present day – that’s 20 columns submitted for […]




From DeeAnna

flower therapy

What is Flower Therapy?

Flower Therapy [is a way to] welcome the angels of nature into your life… Doreen Virtue I learned about Doreen Virtue’s Flower Therapy Oracle Cards when I took her Certified Angel Card Reader course. I took the course because I wanted to learn about Tarot, and as many before me have said, Tarot can be…




We hope you enjoy!


Twitter Storms and Anti-Vax Flack

October 31st, 2014   •   no comments   

Wired to Worry 18 CartoonRecently, Jenny McCarthy asked her twitter followers to tell her the most important personality trait they looked for in a mate and to reply with the hashtag #jennyasks. She inadvertently caused a twitter storm. Here are a few examples of the flurry of angry tweets directed at the prominent anti-vaccinator:

Kevin Folta @kevinfolta Mar 16 Ideal mate accepts scientific consensus & considers the elderly, infants & immune compromised b4 spreading baseless hysteria. #JennyAsks

Thomas Levenson @TomLevenson Mar 14 My ideal mate? Easy: someone who cares enough about our kids to protect them from wholly preventable diseases. #Jennyasks #vaccineswork

SchneiderSales @SchneiderReps Mar 14 #JennyAsks I’m gonna go with intelligence. As in, someone who understands some basic facts about medicine and immunology.

Evidence of increasing opposition to McCarthy and the anti-vaccine movement is easy to find online. There is an anti-anti-vax website that keeps a running tally of the number of deaths attributed to the anti-vaccine movement. As more measles outbreaks occur throughout North America journalists and medical researchers are quick to point the blame at McCarthy. The recent twitter backlash is just one more example that not everyone is buying her pseudoscience stance.

I am happy that there is debate on this issue and that social media gives non-celebrities a means to talk back and to counter misinformation. I am less happy about the tone of that debate. Although I do think that McCarthy is misguided, I would never agree that she doesn’t care about kids. I believe that she cares deeply and that is why she has been willing to face what has to be an overwhelming amount of hostility and criticism.

Stephen J. Hoffman from McMaster University has suggested that we follow celebrity medical advice for a variety of reasons, including cognitive dissonance and the halo effect (Hoffman, 2013). This is fine when the advice is good, such as Jamie Oliver’s campaign to improve nutrition in school lunch programs. However, it becomes problematic when the advice is based on misinformation or ideology rather than science or evidence. Hoffman suggests that professionals are able to counter harmful celebrity advice by educating our patients – whether it is about vaccinations, a questionable fad diet or unsafe exercise regimen.

In addition, as therapists we need to speak out on social media whenever we hear similarly harmful information. However, we need to remember that it is never necessary to make a point at the expense of someone else’s feelings or dignity. We have the opportunity to raise the level of discourse, stick to the facts and reject personal attacks that only serve to increase animosity between each side of a debate.

Hoffman SJ, Tan C. Following Celebrities’ Medical Advice: Meta-Narrative Analysis. British Medical Journal 2013; 347: f7151. doi:10.1136/bmj.f7151.

This article first appeared in the Winter 2014 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.

Click here to read the entire PDF version of the Twitter Storms and Anti-Vax Flack article.

Christine Korol, Ph.D. is a cartoonist, psychologist in private practice in Calgary, Canada and the host/producer of a podcast on that provides free online anxiety and stress reduction education videos.

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