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When you look on a therapy directory these days, the chances are pretty good that you’ll see clinicians saying they provide teletherapy services.
So what does that mean exactly? Think about teletherapy as an extension of telehealth, only instead of speaking with a doctor, you’re talking with a therapist.
We live in a digital world. In the scheme of things, it wasn’t so long ago that we had to physically travel to see a friend or do an errand. Now, almost anything– including your deep and personal conversations with your therapist– can happen online.
But is that a good thing? As a licensed clinical social worker, I’d been doing all of my therapy face-to-face for years until the COVID-19 pandemic hit. Suddenly, in the course of a week, I was flung full-force into the wild world of telework. Talk about an adjustment! By this point, I’d call myself a grizzled telehealth veteran. As a therapist, I love it. The convenience and flexibility opens me up to being able to work with more clients while still practicing a healthy life balance.
A provider’s preference shouldn’t be the determining factor, though. The bigger question is whether a person can benefit from teletherapy just as much as talking face-to-face. There are a lot of myths and preconceptions about this. In this article, I’ll combine the latest research with my personal experience to give you a better idea of what to expect from teletherapy, and whether it’s a good option for you.
What Does Teletherapy Look Like?
After you contact a clinician and decide to start teletherapy, you will agree on a meeting date and time just the same as if you were planning to talk in-person. Expect to get an email with a bunch of forms to fill out. We can never escape paperwork! Many therapists also set the system to send out reminders of the appointment ahead of time, too.
Once it’s time for your session, check your email (or, in some cases, text message). There should be a link to join the video meeting. If you can, click the link a couple of minutes early to fill out any last minute paperwork that the video platform may want you to use. It’ll ask you to type your name how you want it to appear on-screen. Join the video session, and your therapist will connect with you.
You can probably guess many of the features on the teletherapy platform. Both you and the therapist can turn your mic and cameras on and off. There’s typically a chat functionality, where your provider might send you helpful links or reminders. Share screen is an option, too.
By the way: I’d recommend you make sure your therapist is using a HIPAA-compliant video platform. Not all video is created equal. Skype and FaceTime, for example, are not secure enough to meet strict privacy standards. It’s perfectly reasonable to ask about this. Personally, I’ve used teletherapy platforms like VSee and Simple Practice. They’ve worked well in my experience. To be clear, though, it’s not your job to pick out which video platform you and your therapist are going to talk on. That responsibility falls on your provider.
When you finish, just “hang up” and leave the session like any video call. Most platforms show this with a red button. And just like that, ta-dah! You’ve completed a teletherapy session. Not too bad, right? If you have any experience with video calls, teletherapy should be right in your technological comfort zone.
The Argument FOR Teletherapy
Teletherapy is Effective
First and foremost, people want to know that video therapy works. After all, what’s the point of finding a therapist and opening up if the whole process doesn’t work?
Fortunately, researchers have been trying to figure this out for over a decade. In 2013, a study was released that claimed the following: “Videoconferencing appears to be as effective as in-person care for most parameters, such as feasibility, outcomes, age, and satisfaction with a single assessment and consultation or follow-up use.”
Translation: for most people, teletherapy works just as well as traditional face-to-face sessions.
This finding has been found to be true repeatedly. In 2020, several months into the COVID-19 pandemic, research ramped up further to make sure video therapy was helping. The American Psychological Association concluded that “telehealth is essentially just as effective as face-to-face psychotherapy—and retention rates are higher.”
So while many people worry that telehealth won’t help them feel better, the science suggests that their needs might be met perfectly well over video. There are a couple of notable exceptions… but I’ll get to those in a bit.
Accessibility Matters
Even as we’ve started taking this technology for granted as an everyday part of our lives, video calls are an amazing thing. With a few clicks, you can see the faces of loved ones, friends, and coworkers.
There’s real convenience in using video to engage in telehealth, too. Want to talk to a doctor for a routine checkup? No problem! Skip the traffic and long commutes. Just hop onto whatever HIPAA-compliant app they use and move on with the rest of your day. Beautiful!
For teletherapy, having video appointments is not just about convenience. The regular nature of psychotherapy means that people have to show and speak with their therapist on a regular basis. Obstacles that might be challenging yet doable with other types of appointments can become a brick wall blocking people from accessing weekly sessions.
Let me show you what I mean. People living with certain disabilities might have a hard time trekking to an office every week. Maybe they need to arrange for transportation or a caregiver to take them. In my experience, even if somebody starts off being motivated for treatment, the hullabaloo of getting to the clinic in-person can sometimes discourage them from treatment altogether.
Many other situations create the same sort of friction. Have a little kid toddling about and getting into trouble? Organizing childcare every week so that you can talk to a therapist for an hour can be difficult and expensive. Many small towns and rural areas may not even have a psychotherapist nearby. That means in order to talk out their problems, this person has to hop in a car and make a long drive. The logistical issues might lead somebody needing help to toss up their hands and say forget about it.
Sadly, these individuals facing barriers are often the ones who need treatment the most. Telehealth is not just convenient– it’s a solution for people to get the care they need.
The Argument AGAINST Teletherapy
Some People Prefer In-Person
Sure, the data says that telehealth works just as well as in-person, but that doesn’t mean it’s to everybody’s tastes. In my experience, some people– especially folks who are isolated– crave that face-to-face contact. There’s something to be said about sitting across from someone in the same room.
On the other hand, people who struggle with technology may prefer to commute to their therapist’s office rather than wrestle with their laptop. In my experience, most people don’t have any problem hopping onto a video session. After all, a major benefit of teletherapy is the convenience. Still, if service delivery becomes the focus instead of that person’s problems, telehealth is getting in the way of that person’s therapeutic process.
Also, it probably goes without saying, but not everybody has access to the kind of equipment video sessions require. If these individuals have a choice between doing their sessions by phone or in-person, I strongly encourage them to see their providers face-to-face. Seeing a therapist (and in return being seen by them) while talking through your thoughts and feelings is incredibly valuable.
Safety Concerns
In some cases, doing therapy over video can be counterproductive or even dangerous. If talking about certain subjects will make a person seriously emotionally dysregulated– that’s therapist-speak for folks who go to emotional extremes and sometimes act impulsively– then they should probably see a therapist face-to-face. Having a professional physically there could make the situation safer. Similarly, the safest choice for people who are seriously suicidal is to talk to their therapist in-person.
Certain mental health diagnoses might weaken teletherapy, too. Actively psychotic people experiencing hallucinations or delusions may get thrown off talking to a person over video. The session is just that much less tangible, potentially making it harder to engage.
Lastly, it’s important a person engages in telehealth in a safe environment. I can’t believe I have to write this, but DO NOT DRIVE WHILE DOING TELETHERAPY. Way too many distractions. A person can’t fully access their deepest thoughts like that, and worse, they may get in accident. Safety also extends to privacy. Some people may not have a place in their home where they can feel comfortable sharing their true thoughts. Going into a garage, car, or park for privacy during video sessions helps. If they can’t find anywhere to talk, though, it’s probably best to do therapy in an office.
Choose What’s Best For You
There’s no one-size-fits-all strategy here. For anybody interested in starting therapy, consider all the factors while picking how to engage. What will the commute be like? Did you find a therapist you really like, but they only offer one option? Are there any safety concerns to worry about?
At the end of the day, teletherapy is just as effective as in-person therapy. It all comes down to a person’s situation and personal preference.
Looking for a therapist? Here’s a list of all the different kinds of mental health providers, as well as some tips on how you’ll be able to afford a provider. You should also check out these lists to see if stress is affecting your physical and mental health.
Feel free to share your experiences with telehealth in the comments below. And if you know somebody who may benefit from knowing more about the ins and outs of teletherapy, please share this post.
