At one practice, more clients keep telehealth appointments than in-person ones

Christian Counseling Associates in Plano, Texas, typically has faced challenges attracting and retaining clients.


When COVID-19 hit, the practice needed to find a way to continue offering counseling services and retain its clients despite the pandemic. Telehealth has helped achieve that goal.

“Telehealth provides a convenient and completely safe interaction for both the counselor and the client,” said Derrick Sledge, a licensed professional counselor at Christian Counseling Associates.

“As a result, I have more clients now than I ever had since being with the agency. In short, because telehealth offers a safe and convenient venue in which to provide and receive therapy, it has fostered greater consistency in terms of client participation.”


Christian Counseling currently uses IT vendor TheraNest’s electronic health record for billing, notes and scheduling. The vendor also offers integrated telehealth within the system.

“We reached out to our counselors who wanted to see clients virtually to gauge interest, and went from there,” said Laura Hardman, office administrator at Christian Counseling Associates.

“We had confidence in the telehealth solution because we knew it was HIPAA-compliant and had competitive pricing. The transition to telehealth was easy because we were using the same vendor’s system, so we could continue to schedule appointments, just now in telehealth form.”

“There seems to be a greater commitment to keeping appointments for telehealth than in-person.”

Derrick Sledge, Christian Counseling Associates

Telehealth technology provided an avenue of convenience and safety at the onset of the COVID-19 pandemic, Sledge said.

“Telehealth was extremely appealing to prospective clients, as well as therapists, for two primary reasons,” he explained. “First, with there being no in-person contact, there was no risk of COVID-19 transmission or contraction. Second, telehealth is easy to use. It proved to be a very user-friendly platform, even for a technologically challenged person like me.”


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At the beginning, the counselors would notify Hardman of their desire to use telehealth, and she gave them access to the system.

“All of our counselors used the technology once it was offered to provide continued care to their patients,” Hardman said. “Their client information already was in the system, so it was a simple transition, since everything was integrated.

“Our challenge was that, at the beginning of COVID-19, we had a two-week dry period because we didn’t know exactly how to proceed,” she added. “Patients waited to make decisions until they heard more news.”

Patients wanted to keep receiving counseling, and about 75% of Christian Counseling’s existing patients came onboard for telehealth visits. Although the practice did lose some clients during the transition, it gained back clients who decided to use telehealth the longer the quarantine was in place.

“In the case of a new client, I would open TheraNest and enter their personal data, which gets them into the database,” Sledge explained.

“From there, it is super easy. I just click on appointments, and it goes to a client page. I then select telehealth, which launches a scheduling screen. Then I select the date and time of the appointment, and the session is set. Last, I copy the link and email it to the client with a personalized note and description of the appointment.”


From March until August, Christian Counseling’s telehealth sessions increased more than 200%.

“Because of TheraNest’s integrated telehealth solution, we have been able to keep 100% of our client base throughout the pandemic,” Hardman reported. “We can schedule appointments across the board, and we can provide options for patients seeking care. From March through July, we saw an 83% increase in monthly revenue, because we were able to continue serving patients via telehealth.”

As a result of adopting telehealth, Sledge has experienced such a big demand for it that he actually has had to turn away potential clients because the influx has increased so dramatically.

“With telehealth, the number of clients who keep their appointments is higher than those who scheduled in-person sessions,” he noted. “There seems to be a greater commitment to keeping appointments for telehealth than in-person. I would say this is due to convenience and because of COVID-19, the need for quality counseling services is greater than ever.”

With increased anxiety and stress due to job loss or the loss of a loved one, or trying to function in the role of quasi-educator with virtual learning, this crisis is weighing heavily on people, he added.


Definitely, at the very least, try telehealth, Sledge advised his peers.

“The fact that it’s a very secure platform is a big plus,” he said. “I’m very satisfied with using telehealth. Before, I was in the old school of thought that virtual counseling wouldn’t work. I was wrong. It does. Once I learned how to use telehealth, not only did I find I enjoyed it, I found it just as effective, if not more, than in-person sessions.”

Sledge could share a word document with a client and have a lesson based on that. He could invite in parents to close out a session with their children, something that did not typically happen when parents would drop their children off for an in-person session.

“I give telehealth two thumbs up,” Sledge concluded, “and if an agency is in the market to connect with a platform to do virtual counseling, I highly recommend it.”

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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