In August, it was announced that 24/7
counseling via video hook-up would be made available to active and
non-active-duty National Guard members. "We wanted to offer people
a variety of options to get mental health care," TRICARE spokesman
Austin Camacho tells us. "There’s a reluctance to go to a [therapist]
because of the stigma attached. But if you do it in the privacy of
your own home, there’s an added layer of confidentiality."
Since then, this service has been made available to all military
personnel in the U.S.--though not yet for overseas troops. "It’s
almost like an EAP type of service," Camacho says. "Being face-to-face
gives the provider another layer of contact. They can pick up on
So far, use of the program has been
minimal, according to the three TriCare regional offices we
contacted--TriWest (Western region), Humana (South), and MHN (North).
But TriWest spokesman Richard Gray says the
potential is still there. "The people who really need this are members
of the National Guard...The problem is they come back to their job
after being on active duty, and then they’re on their own.
And a lot of times they live in more remote areas, so they don’t have
the opportunity to access a counselor directly. Now they have the
chance to do video counseling."
TRICARE is using Skype to deliver the
service. (For the uninitiated, Skype is a free online provider of
telephone services--similar to Vonage.) But it’s not yet clear what
this means for private practice clinicians. We’ve spoken
with a handful of therapists who do online video therapy--but none
who’ve done it with TRICARE clients.
Stephen Tobin from Portland, OR, tells us
he’s had about half a dozen "Skype clients." "Mostly it’s been people
I’ve seen before in my office, who are now traveling for one reason or
another." Tobin does a lot of EMDR--eye movement desensitization and
reprocessing--in the treatment of patients who’ve experienced traumas.
For that, he says, Skype has worked well.
In a way, it’s surprising that clinicians
haven’t taken to video therapy more readily. Counseling and coaching
via telephone, live online chat, and even email, have become very
common--and adding video seems like a major improvement on those
The biggest obstacle, some therapists tell
us, is that not enough of their clients are equipped with the right
cameras and software.
But costs are dropping rapidly, as
discussed in the box above, and it seems likely that there will be
more of this before long. We’ll be following up with a "Niche
Marketing" article on video therapy in the months ahead.
Contacts: 1) Austin Camacho,
TRICARE, Falls Church, VA, (703)681-1765; 2) Richard Gray,
Tricare West, Phoenix, AZ, (602)564-2399, email: rgray@ triwest.com;
3) Stephen Tobin, Portland, OR 97212, (503)699-5534, email: