Online Mental Health Counseling
"Caring online counseling -- just what the doctor ordered."
-- Updated March 14, 2015 --
You have come to a place of healing and growth, where you can purchase information, counseling and personal guidance from a very experienced, supportive, and thoughtful psychiatrist, Ron Sterling, M.D.
This is an online mental health information and counseling center. Dr. Sterling's 40 years of psychiatric expertise allow him to assist you by E-mail and by Telephone, with just about any type of non-emergency personal difficulty you may be experiencing.
Confidential, Caring, Convenient and Cost-Effective Counseling.
- Online and Telephone Counseling services can be powerful and effective methods for obtaining information and feedback, and for making changes in your life.
- Dr. Sterling is a seasoned guide, coach, and advisor and he will work with you to help you attain your goals as efficiently as possible. This is a place where you can gain awareness, become more thoughtful, and move much further toward the life that you desire.
- If you are interested in purchasing Online or Telephone Counseling services from Dr. Sterling, we invite you to review the information contained on this page.
This Page is Very Comprehensive. It's a Good Thing!
This page contains a comprehensive discussion of Internet and Telephone Counseling and provides you with complete information about what Dr.Sterling offers.
Would You Like to Contact Dr. Sterling Right Now?
- The upside is that you can read this at your leisure. The downside is that it requires a fair amount of reading to become fully informed about the benefits and limitations of Internet and Telephone Counseling.
- Most information on this page applies to ongoing therapy and not to a one-time or a short series of communications.
- Links to Order Pages for E-Mail and Telephone Counseling are found at the bottom of this page.
- We recommend scanning the subject headings first and then going back to areas that attract your attention. The following links will take you directly to sections on this page. Click a [Back to Index] link to return here from further down on the page.
If you would like to talk to Dr. Sterling briefly by telephone to get more information about his services, please feel free to call him at 206-784-7842. You will often reach him directly.
Dr. Sterling Does Not Provide Emergency Services.
- Please call 911 if you think you need emergency medical attention.
Do not hesitate.
- Another source for mental health crisis assistance in Seattle, Washington, is the Crisis Hotline at 866-427-4747. The Seattle Crisis Clinic also has a Crisis Clinic Web page.
- If you are having serious suicidal or homicidal thoughts, you need help immediately. Get off the computer and get on the phone.
- You can call 1-800-784-2433 (1-800-SUICIDE) from anywhere in the United States for help.
All About Online and Telephone Counseling [Back to Index]
Frequently Asked Questions. [Back to Index]
- Surveys have clearly shown that online counseling is very attractive for many reasons, including convenience, confidentiality, and cost-effectiveness.
- Dr. Sterling Offers a Full-Range of Internet and Telephone Counseling. Although no interaction short of in-person psychotherapy can legitimately be called psychotherapy, there is a broad range of Internet and Telephone Counseling services which are clearly beneficial.
- What is a "Full-Range" of Internet and Telephone Counseling? The full-range of services includes anything from short, clear answers to questions about mental health or relationships to ongoing, deeper work on personal growth.
- Brief, Clear Answers to Specific Questions. At the least complex level, Dr. Sterling can answer specific questions that you may have, such as "Do antidepressants really help people and would they help me? I can't sleep, don't eat much, sit around thinking about the girlfriend I lost in high school, and I am barely functioning at work."
- Dr. Sterling can give brief, clear answers to such questions, which can help you make the next set of decisions with respect to your health care. Access to healthcare professionals is often so difficult that just getting an answer to a simple question from a professional can be difficult and can be a real obstacle to making the next set of decisions.
- Longer Answers to More Complex Questions. Sometimes, your question about emotional, mental or social health may be more complex or you may desire more than one communication about an issue.
- More complex questions may require a short series of communications between you and Dr. Sterling to come to a conclusion about what to do next. Dr. Sterling may recommend that you get into in-person treatment if it is acceptable or accessible to you.
- Ongoing, Supportive and Personal Growth Work.
- Dr. Sterling offers ongoing counseling services, but only to residents of or visitors within the State of Washington, the state in which Dr. Sterling is licensed to practice medicine. Please go to Dr. Sterling's Biography Page to view details about his education and training.
- Ongoing Internet and Telephone Counseling share many similarities with in-person psychotherapy but they are not psychotherapy in the traditional sense and they have certain limitations as noted further below.
- Before Dr. Sterling can enter into Ongoing E-Mail or Telephone Counseling with you, he will need to obtain from you the same type of medical information he would normally get from you if he was consulting with you at his office.
- Before you make a decision to enter into ongoing Online or Telephone Counseling, please read the Frequently Asked Questions section further below to become more informed about the benefits and limitations of Online and Telephone Therapy.
- What is E-Therapy? The term "E-Therapy" refers to an ongoing interactive process with a therapist (counselor) in which you and a therapist use e-mail, Internet chat (instant messaging), or telephone communication for the purpose of bringing about improved psychological awareness and to allow you to gain emotional support and make changes in your life.
- Because of the ongoing nature of the E-Therapy process and the attempt to deal with deeper personal issues, E-Therapy is similar to traditional psychotherapy.
- As in in-person psychotherapy, an E-Therapist will attempt to get to know you over time, to work with you in a supportive way and to gather information, give feedback, formulate goals, and assist you with making changes.
- However, E-Therapy should not be viewed as a substitute for in-person psychotherapy or other types of direct counseling techniques such as cognitive behavioral therapy. It is an alternative form of therapy with certain limitations due to the format of the interactions.
- If it is Therapeutic, is it E-Therapy? Many things can be therapeutic that do not establish a "therapeutic relationship" between the provider of services and the purchaser.
- The term "E-Therapy" is reserved for an ongoing process that takes place during a series of communications. E-Therapy implies forming an alliance with a mental health care professional to explore and deal with personal issues. It is a valid alternative for help when in-person psychotherapy is either not accessible or acceptable or when a person is utilizing E-Therapy with a therapist they have already consulted in-person.
- One-time or a short-term series of answers to specific questions and general helpful medical or mental health information can be given over the Internet and by telephone, but such infrequent and less in-depth interactions do not realistically establish a treatment relationship. Nonetheless, providing such information and assistance can be very helpful in an age where access to professionals who can give authoritative answers to healthcare questions is less than ideal.
- How Can Traditional In-Person Psychotherapy Not be Accessible or Acceptable? Many people cannot or will not see a therapist in person.
- Some people are geographically isolated.
- Even if not geographically isolated, many people are so busy that taking time off for therapeutic appointments is just too difficult.
- Some people do not want to be seen entering or exiting the waiting room of a therapist's office.
- Often, there can be long waiting periods for a first in-person appointment.
- Some people are just too shy or embarrassed to start in-person therapy.
Does Dr. Sterling Provide a Range of Services? Dr. Sterling provides a broad range of e-mail and telephone services from one-time or short-term psycho-education, guided self-help, medication information, answers to mental health questions, and responses to concerns about relationship issues to ongoing, in-depth work on personal growth.
- When Do Purchased Internet or Telephone Services Cross the Line From Helpful General Information to a Therapeutic Relationship? Dr. Sterling reserves the terms E-Therapy and Telephone Therapy for a series of ongoing communications with you about your personal growth.
- Not all purchased consultations from Dr. Sterling are made with the intent to enter into ongoing therapy.
- Most people first purchase e-mail or a telephone session to obtain an answer to a specific question that is troubling them and to find out if Dr. Sterling can be of further assistance. They may then pursue such questions and discussions further or they may feel that they have gotten the information they needed from just a few interactions with Dr. Sterling.
- Relationship counseling and caregiver support generally do not constitute ongoing treatment because they focus much more on psycho-education and information than on individual therapy.
- If you do not pursue mental health care information much further than a few questions and answers, such a brief interaction is not viewed as ongoing E-Therapy.
- When you begin to engage in several communications with Dr. Sterling related to personal issues in your life, a treatment relationship will begin to exist.
- Please Note: Dr. Sterling is only licensed to practice medicine in the State of Washington and, therefore, can only provide Ongoing E-Therapy or Telephone Therapy for residents of or visitors within the State of Washington. If, after a few exchanges of questions and answers, you decide you want to enter into ongoing therapy with Dr. Sterling, please keep in mind you must be a resident of or visiting within the State of Washington to do so.
- Is E-Therapy Effective? [Back to Index]
According to several authoritative sources, a vast majority (as much as 90%) of people who have worked with a therapist online say that it has helped them.
For further information and advice about Internet and telephone services, Dr. Sterling recommends the following Web sites:
- The ABC's of Internet Therapy provides a comprehensive discussion of Internet counseling written by the Martha Ainsworth, a past president of the International Society for Mental Health Online.
- Internet Therapy Clicks for Patients is a USA Today article written by Marilyn Elias, dated May 22, 2001.
- Clarifying the Definition of E-Therapy is the most recent article from Dr. John Grohol, Psy.D., about online counseling, dated May 2, 2001.
- Link to a Shrink is a CNN article dated January 6, 2001.
- Assessing the Potential of Online Psychotherapy is a Psychiatric Times article written by Marian O. Dunaway, dated October 2000.
- Another extensive review of online counseling as of May 2000, can be found at Online Shrinks: The Inside Story.
- Are Other Forms of Internet and Telephone Advice-Giving Effective? As Dr. Koop always said "The best prescription is knowledge."
- Even though there are huge resources for information on the Internet, sometimes it is difficult to find it easily or it takes a significant amount of time to sift out the important details from the abundant information that can be found.
- Direct answers from licensed professionals has been shown to be useful and helpful.
- Who is Best Suited to Benefit From Ongoing Internet Interactions? People who have the following characteristics are best suited for ongoing e-mail interactions:
- Enjoy writing.
- Comfortable typing on a keyboard.
- Comfortable with computers and computer software.
- Write expressively and descriptively.
- Willing to be honest.
- Willing to write about feelings and reactions.
- Comfortable with the circumstance of not being able to view or hear the provider of services.
- People who are not comfortable writing or typing or who get frustrated with not hearing the voice of the person with whom they are communicating might find more benefit from speaking with Dr. Sterling by phone. However, please keep in mind that a major disadvantage of phone conversations is that after they end, unless you have kept very good notes while talking with Dr. Sterling, you will have a more difficult time reviewing the content of the conversation.
- Advantages of Internet Consultations.
- No travel time involved in the consultation.
- Relatively more confidential than an in-person consult.
- Set your own pace. You are in control of how much and how often you participate.
- Cost-effective. You pay only for the actual time Dr. Sterling reads and responds to your e-mail. Offline, you can take all the time you need to understand and compose e-mails. Offline, you can take all the time you want to read and think about Dr. Sterling's responses.
- Disadvantages of Internet and Telephone Consultations.
- Therapists cannot diagnose disorders or complex issues as easily or quickly since they cannot use all the senses to evaluate a person.
- Therapists can only proceed on the information given by the client. Many cues that might be helpful, such as body posture, facial expressions, tone of voice, etc., are not available and, therefore, evaluation and feedback is less informed than in in-person consultations.
- Therapists cannot provide certain interventions as easily, such as evaluating transference issues, using Gestalt techniques (role playing) and other therapeutic interventions and exercises.
- Generally, no health insurance coverage is available for Internet or telephone consultation.
- Internet counselors cannot provide direct help in a crisis.
- Medication cannot be prescribed.
- Clients who keep printed records of Internet chat and e-mails are creating a second medical record which may make the confidentiality of such records less secure.
- In What Situations is E-Therapy Not Recommended? People who are feeling overwhelmed with troubles and problems realistically and ethically require in-person support and assistance. Ongoing Internet counseling is not recommended in the following circumstances.
- In emergencies - when you are feeling suicidal or homicidal.
- When your life problems are complex and are causing a great deal of distress.
- When your life problems have a long history and have involved hospitalizations for mental health care.
- When your life problems involve current severe substance abuse.
- When your problems seem very overwhelming to you.
- Can You Mix All The Different Forms of Services Offered? Yes, you can.
- Any plan of personal growth is a plan that is mutually worked out between you and Dr. Sterling. Such a plan can include any of the services offered in any order.
- You may wish to start counseling through e-mail and then utilize telephone consultation, or vice versa. You may switch from Internet or telephone interactions to in-person therapy.
- There are advantages from an information-gathering standpoint to conducting an early consultation by telephone. Dr. Sterling can generally gain more awareness of historical factors and other dynamic and diagnostic data by talking to you on the phone.
- Clients who have started therapy in-person with Dr. Sterling may, at times, wish to purchase Telephone or Internet Counseling or even switch exclusively to ongoing E-Therapy.
Limitations of Internet and Telephone Services. [Back to Index]
How Do I Know if Dr. Sterling is for Real? [Back to Index]
- You must be 18 or older to purchase any Internet or telephone service from Dr. Sterling.
- Parents may purchase services for a child under their care, but this service requires that the legal guardian contact Dr. Sterling first by phone to coordinate the service and discuss and agree upon the appropriate confidentiality and service agreements.
- No prescriptions for medications of any type will be offered by Dr. Sterling through any Internet or telephone consultation service. However, Dr. Sterling's current clients for whom he has already prescribed medication may request and receive further appropriate services by online or telephone consultation.
- To enter into ongoing Online Therapy or Telephone Therapy with Dr. Sterling, you will be required to be a resident of or visiting within the State of Washington.
- Before entering into ongoing Online Therapy or Telephone Therapy, Dr. Sterling will need to obtain from you the same type of medical information he would normally ask you for if he was consulting with you at his office. There are three options for providing such information to Dr. Sterling which are described on each of the Online Therapy Order Pages.
- To receive general Mental Health Care Information or advice with respect to relationships and social aspects of your life, you may reside anywhere.
- Please Note: The provision of general medical or mental health information, or advice about relationships or social concerns by Dr. Sterling does not constitute or imply a therapeutic contract or a doctor-patient relationship.
Ronald Murray Sterling, M.D., is Dr. Sterling's full name and Medical Degree. Please go to Dr. Sterling's Biography Page to view details about his education and training and to get information about how to confirm his Medical License in the State of Washington.
Confidentiality and Record Keeping. [Back to Index]
- Confidentiality. Confidentiality is the cornerstone of all health care consultation, even if it is a single interaction. When you purchase Internet or telephone services from Dr. Sterling, the following applies:
- Dr. Sterling highly recommends that you establish a secure e-mail address at which you will be comfortable to send and receive confidential communications, including receiving receipts for services rendered which may contain, among other things, terms and words such as "Short E-Mail Consultation," in addition to the date the order was placed, the merchant, "Ron Sterling, M.D.," and the amount paid. For more information about e-mail security and options, please go to our E-Mail Page.
- When a user purchases services from Ron Sterling, M.D., by credit card, the credit card statement related thereto will contain the words "Ron Sterling, M.D." A user purchasing services from Ron Sterling, M.D. on whose credit card account statement appear the words "Ron Sterling, M.D.," irrevocably agrees to this disclosure of such purchase(s) of services on said credit card account statement.
- A purchaser is required to fill in certain details at Dr. Sterling's credit card processing pages including real name, address, telephone number, and e-mail address. This is required because Dr. Sterling is required to keep specific records of all services, even if such services are brief. More information about Dr. Sterling's Record Keeping procedures can be found further below.
- Only Ron Sterling, M.D., is authorized to read and only Ron Sterling, M.D., reads e-mail sent to DearShrink.com or to RonSterling.com, whether through a purchase of services or otherwise.
- Only Ron Sterling, M.D., participates in telephone conversations purchased by users and no other person is authorized to listen to such conversations and no recording of such conversation is made without the express consent of all parties to the conversation. All such purchased telephone consultations will take place on a "wired" phone line belonging to Ron Sterling, M.D., unless the purchaser expressly consents to some other arrangement. It is recommended that users who purchase telephone consultations from Dr. Sterling utilize a "wired" phone, rather than a wireless or cordless phone system.
- Only Ron Sterling, M.D., has password protected access to his computer(s) and only Dr. Sterling accesses, operates, and repairs said computer(s). Said computer(s) will not be resold. If a computer becomes unusable, the hard drive(s) existing in it will be removed and stored in a locked and secured file cabinet.
- No content, information, data, or identities, whatsoever, disclosed pursuant to purchased services from Ron Sterling, M.D., by way of purchased e-mail, Internet chat, telephone, or in-person consultation will be used in any way, whatsoever, for the purpose of providing content on the DearShrink.com Site. Any relationship of any issues discussed or any similarity that may occur between any content posted on the Site and the content of any purchased service from Ron Sterling, M.D., is purely coincidental.
- Record Keeping. Dr. Sterling is required by federal and state laws to keep records of the services he renders, no matter how brief. Please note the following:
- Dr. Sterling uses his best efforts to print out all e-mail and all verification of purchases made which are sent to him by PayPal®. Such best efforts can be subject to certain uncontrollable factors such as computer software, hardware, and/or Internet problems.
- Dr. Sterling uses his best efforts to delete all received and sent e-mail and verification notices from his mail boxes on a daily basis to reduce vulnerabilities to illegal hacking.
- All printed matter and handwritten notes relating to the provision of services by Dr. Sterling, however brief, are stored in a locked and secured filing cabinet.
- The office space from which Dr. Sterling provides online and telephone services is secure and completely private.
- Authorization to Release Information. Except for certain legal and ethical requirements noted below, Dr. Sterling will not reveal in any way, whatsoever, the content of any communication or personal information of any kind, whatsoever, unless a witnessed, written Authorization to Release Information is signed by the relevant purchaser of services, and sent to and received by Dr. Sterling by regular mail. Please note the following exceptions:
- Federal and Washington State laws require disclosure of confidential information, and reporting to appropriate authorities, in at least six types of situations: (1) an indication that child abuse or neglect is occurring or has occurred, (2) an indication that abuse or neglect of an incapacitated adult is occurring or has occurred, (3) threatened harm to self, (4) threatened harm to others, (5) in situations where a person may be gravely disabled and unable to care for themselves, and (6) when a court of competent jurisdiction orders the release of confidential information or medical records.
- In addition, the following circumstances may impose a duty to disclose information: (1) disclosure of a previously unreported felony crime that was committed, (2) to assist relevant authorized personnel (doctors, nurses, etc.) in the event of a medical emergency, and (3) to report the misconduct of other professionals.
- Click on the link to view the Authorization to Release Information form.
Continuity of Care. [Back to Index]
Next to Confidentiality, Continuity of Care is one of the biggest concerns for those who are seriously considering ongoing work on personal growth in an online or telephone service setting. For those who are not considering ongoing personal growth work, continuity of care is much less important. Please note the following:
- Dr. Sterling guarantees a response to purchased e-mail consultations and the scheduling of telephone services within a certain period of time, as noted on each of the service order pages. Purchasers are entitled to refunds if Dr. Sterling does not meet the guidelines for such response times.
- If Dr. Sterling is going to be out of town or unavailable for servicing purchasers, the Web pages that allow the ordering of services will be unavailable and no ordering of services will be allowed.
- Dr. Sterling does not offer unlimited e-mail or telephone counseling service agreements. Each service is provided as a one-at-a-time, paid-in-advance service, with no initial commitment for continuity of care.
- No one can foretell what the future holds in terms of hardware, software, and Internet difficulties, or with respect to emergencies in Dr. Sterling's life, however, Dr. Sterling will use his best efforts to provide currently posted services on a regular basis.
- A therapeutic relationship or contract cannot be realistically or ethically established by Dr. Sterling interacting with you on a short-term basis to provide limited but helpful information of an educational or general nature. However, once a purchaser and Dr. Sterling have mutually agreed to work on more in-depth personal-growth issues, a therapeutic relationship begins to exist. In this situation, Dr. Sterling is governed by moral, ethical, and legal considerations with respect to continuity of care. At that point in time and from then on, Dr. Sterling will use his best efforts to inform you of anticipated absences, such as vacations, and, if you desire, to provide for a contact person in his absence.
- If Dr. Sterling must terminate all Internet and telephone services, becomes very ill or is otherwise unable to perform the duties of his profession, either he or another person in the position to assist him, will use best efforts to notify you and to assist you in transitioning to alternative resources for care.
- If you have any concerns or questions about ongoing personal growth work and continuity of care issues, please let Dr. Sterling know.
- If Dr. Sterling feels he cannot provide the services that you may require through the use of Internet and/or telephone communication, he will clearly let you know, explain why, and refer you to in-person assistance with himself or assist you in finding a provider in your geographic area.
- If you are abusive, threatening, harassing, and/or sexually inappropriate in your interactions with Dr. Sterling, he can notify you clearly of his intent to stop services, the reason for stopping the service, and offer you a referral resource.
- Dr. Sterling cannot provide services without payment. No billing arrangements will be made.
- Before entering into an ongoing therapy process with Dr. Sterling, please give adequate consideration to what you can afford in terms of frequency and continuity of service. If your financial circumstances make it impossible for you to continue consultations with Dr. Sterling, he will use his best efforts to assist you in transitioning to another source for mental health care.
Quality Control. [Back to Index]
As noted in several different places within the DearShrink.com Site, Dr. Sterling is humanistic and has a deep respect for each individual and for the work of information-giving, counseling, and the processes involved in guiding and gaining personal awareness and growth. Please note the following about quality control:
- Dr. Sterling invites and honors feedback. The counseling process is a two-way street in many ways. It consists of consultation. Consultation implies brainstorming (shared problem solving). Brainstorming cannot be at its best without Dr. Sterling hearing quality control feedback phrases, such as "that doesn't work for me," or "that does work for me." Or, maybe, "you are so way off base on this, I am upset."
- Dr. Sterling does not know everything and there will be times when he is asked for information that he cannot give. In such a circumstance, Dr. Sterling will clearly indicate to you that he cannot adequately answer your question and will offer you a refund.
Agreements are Needed for Online Services. [Back to Index]
Fees, Payments, Cancellations and Refunds. [Back to Index]
As noted below, each service order page contains its own Terms of Service. Fully informed consent is one of the most important foundations for ethical and professional counseling.
- Each Agreement is different. The Agreement related to purchasing E-Mail Services is different than the Agreement related to purchasing Telephone Services.
- Separate Agreements for ongoing counseling by E-Mail and Telephone are required for those types of ongoing services. Once you have decided, or it has become apparent, that you are seeking ongoing personal-growth work, you and Dr. Sterling will need to clearly agree that you are entering into an arrangement that has been traditionally governed by a certain set of professional and ethical guidelines and practices.
- Why are Agreements necessary? Informed consent is one of the most important prerequisites to providing ethical and professional counseling. When we consult someone in person, there is the opportunity to discuss all aspects of the service that we are attempting to purchase -- the advantages, disadvantages, risks, benefits, costs and guarantees. However, in a situation where the purchaser and the provider of services are not talking to each other in person, the advantages, disadvantages, risks, benefits, costs and guarantees need to be reasonably set out in writing. Agreements are a way of protecting the purchaser and the provider and enhancing the quality of the service provided.
- How do you sign an Agreement online? You don't. However, by purchasing a service listed on a service order page at DearShrink.com, you will be signifying that you agree to the Terms of Service set out on the page from which you ordered the service.
How to Purchase Internet and Telephone Services. [Back to Index]
All fees for E-Mail and Telephone Consultation Services must be paid prior to the service being rendered. Cancellation and refund policies are different for each service. Please consult the Terms of Service for each service to learn about cancellation and refund policies.
- Short E-Mail Consultation (15-20 minutes): $60.00
- Long E-Mail Consultation (25-30 minutes): $100.00
- Short Ongoing E-Mail Counseling (15-20 minutes): $50.00
- Long Ongoing E-Mail Counseling (25-30 minutes): $80.00
- Short Initial Telephone Consultation (25 minutes): $90.00
- Long Initial Telephone Consultation (50 minutes): $170.00
- Short Ongoing Telephone Counseling Session (25 minutes): $80.00
- Long Ongoing Telephone Counseling Session (50 minutes): $150.00
You can view the order pages for Short-Term E-Mail, Ongoing E-Mail Counseling and Telephone Counseling by clicking on the appropriate link below.
- Before purchasing any services online from Dr. Sterling, please be sure you have an e-mail address at which you are comfortable receiving receipts that will contain the following or very similar information: (1) "ORDER DESCRIPTION: E-Mail Consultation" and (2) "Merchant: Ron Sterling, M.D." The receipt will also contain the amount paid and what type of credit card was used.
- Please go to the Short-Term E-Mail Services Page to read about and order Short-Term E-Mail Services. Answers to general medical, mental health, social and relationship questions can be purchased by anyone 18 years of age or older. There are no residency restrictions.
- Please go to the Ongoing E-Mail Counseling Page to read about and order Ongoing E-Mail Counseling. Dr. Sterling can provide Ongoing E-Mail Counseling only to residents of or visitors within the State of Washington.
- Please go to the Telephone Counseling Page to read about and order Telephone Counseling Services.
Thank You for Stopping By! [Back to Index]
-- Best wishes, Dr. Sterling
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