Alternatives to Zoom for Groups and Family Therapy

We reported earlier this month that we have a number of concerns about Zoom. Specifically, we were shaky on trusting them with health care privacy.

Since that time, our concerns have only deepened. Unfortunately, Zoom is widely considered to be the best option for group and family therapy. This has lead many colleagues to ask us about good alternatives to Zoom — which I present below.

Didn’t Zoom Fix the Problems?

First, I know a number of colleagues want to hear why we persist in giving Zoom the thumbs down despite their recent announcements about security fixes. Many of you have forwarded to us your emails from Zoom discussing their future development plans and stating their official reasons for the security issues arising in the first place.

I spoke at length about my reasons for continuing to give Zoom a thumbs down during a casual Sunday FB Live video. You can watch that video for the extended take.

The short version, however, is this: Zoom’s security and privacy issues expose an internal bias towards sloppy security and privacy practices. (And I’m not the first one to call their practices “sloppy.”) There is no reason to think this sloppiness is limited to non-healthcare users of the platform.

Zoom has made a lot of noise about fixing the particular security issues that have been identified by reporters and researchers. And they likely will fix those particular issues. However, they haven’t said or done anything that indicates they will fix their sloppiness — or any other cultural tendencies that should worry us — with regards to how they handle our clients’ private information.

Think of it in terms of heathy relationship principles: if someone behaves abusively, and we wish to maintain any kind of relationship with them, we need them to do deep work on changing the psychological bases for their abusive behavior. Simply stopping the behaviors they were called out on and promising “I’ve changed” is not sufficient. This principle holds true in all things, including the world of security and privacy.

Useful Alternatives

That said, let’s talk about alternatives to Zoom that work well for group and family therapy! The Person Centered Tech team has been talking to people about this a lot, and we have what we think are some good ideas for you.

GoToMeeting

Yes, we were also surprised when we got the tip that GoToMeeting will now execute HIPAA Business Associate Agreements. We have not yet done a formal review of their process for actually executing the Business Associate Agreement, but we use the product at Person Centered Tech quite a lot and find it to be “perfectly fine.”

See GoToMeeting’s pricing here. Be sure to speak with a sales rep about getting the BAA with your account. It does not appear that there is an automatic process for doing that.

Google Meet

Okay, I can already hear what you’re saying: “For years, Roy and Liath have discouraged us from using Google Meet for teletherapy!”

It’s true. We have done that because Google Meet’s way of working is better suited to team meetings than to therapy sessions (not as much anymore, however — see the update below.) However, we’re in a situation where we need something that is HIPAA-friendly, affordable, and that can carry the load of having many people on a call even during the COVID-19 emergency (when everybody and their cousin is hogging all the Internets.) Google Meet fits the bill when you use it through a GSuite account where you have executed the HIPAA Business Associate Agreement.

Besides, it’s already included with any GSuite account. That is a very nice aspect of it!

Update: Google Meet has undergone several improvements which make it much better-suited to group therapy. It now will show everyone in the call in a grid (for up to 16 people.) This is often called “Brady Bunch Mode”, and it makes Google Meet calls more closely resemble Zoom calls.

Webex (Untested, but Good Reputation)

Cisco’s Webex service has been in the HIPAA-friendliness game for quite a while. They have a good reputation for quality, although we haven’t tested the platform ourselves. Get info on their plans and pricing here. Be sure to inquire directly about getting your Business Associate Agreement — don’t assume it’ll be executed automatically.

Microsoft Teams (Untested)

We haven’t tested this option ourselves yet, nor have we gotten much feedback on it from colleagues.

However, we do know that MS Teams is essentially Microsoft’s answer to Google Meet. You would use it as part of a Microsoft 365 account with a Business Associate Agreement executed. Get info on MS Teams here.

Moving Forward

It is possible that Zoom will clean up their act, but we’re not in the habit of holding our breath (the masks make breathing rough enough as it is!) In the meantime, voting with our feet is a great way to let companies know what our priorities are as health care providers.