Skype-Assisted Therapy – How Secure Is It?

Jan
17
2012

Security Concerns about Skype

Back in October, Dr. Arthur S. Trotzky, a member of the Georgia Therapists Network, brought up on the online discussion list his concerns about the security of using Skype for online counseling. He specifically cited Fast Company’s post, Skype’s Huge, New Security Headaches.

Frank Pratt, III, LCSW responded on the GTN list by offering the following explanation.  While I do not use Skype or provide online counseling at this time, I thought that many of you would, like me, find his explanation useful in understanding how and what potential risks might be.  I contacted Frank and he graciously agreed to allow me to print his email below.

How the Internet Works

I have a good working knowledge of this kind of thing, so I’ll take a stab at it.

The point of this [Fast Company]Skype-Assisted Therapy - How Secure is It? article is that hackers have been able to determine IP addresses of Skype users. Without going into too many details, you could easily determine the general location of an IP address, though in most cases, it would be far more difficult to pinpoint the exact location of the computer.

It is usually very easy to get an IP address, because this address is always sent when you send data to another computer on the internet. This email [from Frank to the GTN discussion list] is being sent from the following address: 68.213.17.7. We have a DSL line and BellSouth assigns this IP address to our [unique] modem, which is connected to the BellSouth system. All the computers on our network use this IP address.

Every time you send an email address or send data to a remote server (e.g. you post a message on an online forum,) there is a good chance that the remote server keeps a log of your IP address. I looked up this address on several search engines. My research indicates I am in Atlanta. Georgia. Look at my e-mail signature below, and you will see that the search engines are off by 50-60 miles.

Note that this quick and dirty search did not reveal the name on the DSL account. Just a rather inaccurate geographical location.The search engines show me to be in Atlanta, because our modem connects to a server in Atlanta, via. a phone line (much the same way as my fax machine would be connected to a fax machine in Atlanta if I sent a fax to a business in Atlanta). I would guess that hundreds, if not thousands, of a DSL modem in Atlanta and the surrounding area connect this very same computer in Atlanta. So, I am connecting to the internet from Rome? Lawrenceville? Atlanta? Athens? Snellville? Conyers? one of the Suburbs? Good question!

If a skilled hacker were so inclined, he/she could possibly hack into BellSouth’s servers to get the name on the account, which is the name of our company. This would require extensive expertise, and a possible risk of felony prosecution for the hacker. Even if a hacker decided to do it anyway, they would only get the name of our company, since that is the name on the account.

That narrows it down to 6 computers and just as many staff members. If you get the IP address for a computer at an academic institution, or a large company, you might be able to easily determine which school or company the message was sent from, or perhaps even which campus building the message originated from. However, this might only narrow it down to hundreds or thousands of individual users. Again, the servers at that institution might have logs that could tell you which user was assigned a given IP address at a given time, but a hacker would need to hack into a server to get this data. Bypassing security measures, and possible civil/criminal prosecution continue to be problems.

So, can you get the name of the person who is using an IP address for a Skype call? The practical answer is probably “no”, in most cases. The far more important question is whether or not the actual content of the conversation can be intercepted. Could a hacker listen in on a session that was conducted via Skype?

When it comes to hacking, anything is theoretically possible. However, given the encryption that Skype uses (see “Does Skype Use Encryption?”), it would be extremely difficult to do so. Breaking a 256 bit AES encryption key would probably require a considerable expertise from a hacker, and a very powerful computer (or computers).

It would probably be far easier to tap a normal phone line. Keep in mind that we all use phone lines to convey privileged information on a daily basis (along with every hospital, physician’s office, etc.) Also keep in mind that caller ID and “reverse lookup” search engines make it quite possible to pinpoint the street address of a caller, perhaps far more accurately that an IP address. After spending 30 seconds on a site such as WhitePages.com, you could very easily (and legally) use my phone number to figure out the street address of my office. I am not an attorney, but I would argue that if a phone line is secure enough to convey protected health information under HIPPA guidelines, then Skype is as well.”

Thanks, Frank!  I so appreciate your explanation of how / where mental health professionals might be vulnerable online.

Other Skype-Related Resources

One of my primary resources for online / distance therapy is the Online Therapy Institute.  As you are making your own decisions about if and how to conduct online therapy, you may also want to check out OTI’s post, Videoconferencing – Secure, Encrypted, HIPAA-Compliant.

And, if you know of other resources related to conducting therapy online in real time, I hope you’ll share them with us below!

[Frank Pratt, III, LCSW notes that since I writing his response above, his office has
switched from traditional phone service to using a Voice Over IP (“VOIP”) service for
all of voice and fax lines.]
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On 13 Insurance Panels And The Phone Isn’t Ringing

Dec
20
2011

Sometimes in trying to get a practice started, Image of On 13 Insurance Panels & the Phone Still Isn't Ringingit’s easy to overlook logical steps.  Last month, I received a couple of emails from a reader that I’ll call “Stephanie.”  Stephanie wrote . . .

I am on 13 insurance panels, have been doing everything possible (since April) that I know how to do and have not received one call.

I would do anything to accept private pay.

My unemployment benefits ran out in September and I applied for food stamps yesterday.

I am revising my website for the third time to focus on clients who are ________ and are non compliant in hopes I can market to and get referrals from physicians.

I never thought it would come to this. I am trying not to panic”

And, in a follow up email she wrote . . .

I have not built a referral base. I’ve been working in agencies with clients who are ________. Not my ideal clients. I only recently returned to the city and know few in private practice. I have been working on marketing 8-12 hrs a day, but not getting ‘out there’. I don’t know how.

I am changiing my niche to aging and dementia using CBT. Not many therapists do this.

I am 55 and have also tried for 2 years to get a job to sustain me.

I sound pathetic but am not. I am determined to make this private practice work. All I need are five clients to start so I can survive.

I hate the idea of insurance panels but I have no choice. I am desperate.

You can use my note but not my name.

I value any advice you can give and thank you for your kind words.”

I thought this might be a good opportunity for you to help Stephanie out.

What is she doing well?

What might be her strengths?

What seems logical to you that she might be missing?

Wiithout any magical solutions, without making anything up, and without adding any information that you have not been given – can you comment on what Stephanie might need to hear and focus on to get her practice on track?

And, what is the logical step that you are missing in your own marketing efforts?


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How a Tiny Picture of You Can Help Drive Traffic to Your Website or Blog

Dec
13
2011

For those of you who have been with me a while, you already know about my web guru and friend, Beth Hayden of Blogging with Beth fame.  I was trying to figure out how to add a tiny little picture of me (and you) to our comments so . . . of course, I called Beth.  She made this so simple that I invited her to write a guest post to share with all of you and she graciously agreed to do so.  Check this out!

(If you are interested in writing a guest post, check out the guidelines here.)

_______________

A Guest Post by Beth Hayden


Are you regularly commenting on other people’s blogs? You can use comments to encourage your favorite bloggers, to thank them, to show support, to give an example, or to contribute to the discussion in a myriad of ways.

If you’re commenting thoughtfully – and consistently adding your blog URL to the “Website” field in the comment form – you are hopefully seeing some traffic flowing back to your site as a result of your comments. It’s a great (and FREE) way of picking up some extra traffic.

But there’s a way to make your comments even MORE powerful and making it even MORE likely that people will click through to your blog and sign up for your mailing list or become regular readers.

Perhaps you’ve been noticing recently that when some people comment on a blog, a little picture of the person appears next to her name. Those little pictures look like this:

Example of a Gravatar on a Blog Comment

When you use that little image for your comments, it makes it more likely that people will click through to your blog from your remark. A picture makes you more recognizable, more authentic, and a thousand times more relate-able than your name alone.

And that small image also has another HUGE benefit – it helps the host blogger get to know you. I recently read an interview with Sonia Simone of Copyblogger in which she highly recommends using these little images. She said if she can put a name with a face when she sees your comment, it makes you much more memorable. And being more memorable makes it more likely that she’ll be willing to open your email when you write to her to submit a guest post for publication on Copyblogger.

If that’s true for Sonia, it’s true for tons of tons of other host bloggers, too. That little image – that teeny little you – can make the difference between your emails getting OPENED and your emails getting IGNORED.

That little image we’ve been talking about is called a Gravatar. And they’re really easy to set up and use.

Go to Gravatar.com to set up your account. It takes just a few minutes. Tips:

  1. Make sure to use the email address that you will be using most often when you comment.
  2. Upload a great photo. This picture is going to represent you all over the web, so make sure it’s a good one – not one that is fuzzy, unprofessional, or otherwise unusable.
  3. You can upload more than one photo, but you’ll have to choose one to have as your primary photo.
  4. Remember your username and password so you can go back and change your pic if you want to.

Once you create your Gravatar, every time you use your email address to comment on a site that uses Gravatars, you’ll see your photo automatically appear if that particular blog has Gravatars activated on their site. You don’t need to do anything special or upload that image again. Just enter your email address in the comment box field, and Gravatar.com will do the work for you.

Create your own “little teeny you” at Gravatar.com today. It takes five minutes and will start paying off as soon as you post your next comment!

About the Author: Beth Hayden helps business owners make more moneyImage of Beth Hayden by helping them create fabulous websites, blogs, and social media campaigns. Get her best tips for improving your blog by downloading her free report, From Blah to Hurrah: 25 Ways to Make Your Blog Bigger, Better and More Profitable.

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2011 List Of Online Directories For Mental Health Professionals

Nov
28
2011

It’s been another year since I last updated our list of online directories for mental health professions.  Because so many of you have taken Image of Online Directories for Mental Health Professionalsthe time to share your knowledge with us, I’m happy to say that our list continues to grow.

Remember, some of these are free; some charge a fee.  If you participate in any of these directories, I hope you will take a moment to let us know which ones are working well for you and what, if anything, you are paying for the listing.

And, of course, if you know of other online directories for mental health providers, please do take a moment to let us know about them so that we can continue to strengthen our practices and our networks as a professional community!

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The Knowledge Market – Free Q & A For Mental Health (& Allied Health) Professionals

Nov
15
2011

We’re BAAAACK!  The Private Practice Online Survival Guide is hosting another free Q & A session on how to grow your The Knowledge Market - Marketing Onlineprivate practice by marketing online.

You and your colleagues are invited to join me and social media guru, Beth J. Hayden for this one hour phone call as we plow through and answer as many of  your individual questions as we can!

During that time, we will try to answer anything you throw at us and point you to resources to support you as you grow your private practice.

Have I piqued your interest?  Great!  Here’s where you can go to get the details, start asking your questions early (if you wish), and to sign up for the call!  And, by the way . . . if you submit your questions ahead of time, you can get a recording of the entire call!

What: The Knowledge Market

When: Tuesday, December 6, 2011

Time:   1 p.m. Pacific / 2 p.m. Mountain / 3 p.m. Central / 4 p.m. Eastern

Remember . . . you MUST PRE-REGISTER to join us.  Then you will be able to ask your questions and hear the entire call!  I hope you’ll help us spread the word by telling  your colleagues, posting this on your Facebook walls, tweeting about the opportunity, and sharing it with your connections and groups on LinkedIn and Google+, too!

Got questions?  Bring ‘em with you to The Knowledge Market!  I look forward to talking with you there!

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