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TRICARE: making a push for therapy via online video

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 visual cues."

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 methods.

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@; 3) Stephen Tobin, Portland, OR 97212, (503)699-5534, email:

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