When Face to Face Isn’t Possible: Teletherapy as Treatment

When Face to Face Isn’t Possible: Teletherapy as Treatment

Seeking out therapy can be nerve-wracking – it’s easy to worry about what it will be like, if you’ll like your therapist, and opening up to someone new. Due to COVID-19, nearly all therapy is being done remotely right now through video, phone, or even live chat sessions. For some people, this makes it less intimidating; for others, it adds an extra layer of uncertainty. Long-term teletherapy may not be for everyone, but if you’re looking to begin seeing a therapist soon, you’ll likely start off with remote sessions. If you need or want some professional support, it’s worth trying out – it’s better than nothing, and you may find you like it more than you expect!

How does teletherapy work?

Virtual therapy sessions are similar to traditional therapy sessions – the only big difference is that you and your therapist aren’t in the same room. You will both join the session through a secure platform where you can chat over video, audio, or messaging – whatever your therapist offers, and you decide on together. Most likely, your therapist will offer (and encourage) video sessions because they are the closest option to being in-person, allow you to see each other’s facial expressions, and feel more personal than other options. Depending on your therapist and their practice, you might enter via a portal/website, or they may send you a new link for each session. You and your therapist will be able to see and hear each other, and your therapist will use the same skills and techniques that they would use in an in-person session. If you don’t have reliable internet access or a personal computer, you may opt for phone sessions – it can feel less personal than talking over video, but is still a valid and effective way to receiving therapy.

Confidentiality still applies, too; therapists must follow privacy laws that prevent them from sharing details about teletherapy sessions with others and they must be in a private room while conducting the session. Teletherapy must be done using specialized software that is fully encrypted, which offers a high level of security and privacy. This software has to be approved by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) – the federal law that ensures data privacy and security for medical information.

Is teletherapy as effective as in-person therapy?

Generally, yes – a number of studies have found it just as effective as traditional face-to-face therapy for depression, anxiety, PTSD, eating disorders, substance use, and more[i]. Even some therapists who started providing teletherapy due to COVID-19 have been surprised by how well it works[ii]. There are a lot of great benefits to teletherapy but as with everything, there are some downsides to think about too:

Pros

  • No commute: not having to get to and from therapy can help reduce some of the burden you might feel in going. It may make it easier to fit into your schedule too – you can just hop online for an hour at work rather than building in travel time on each side and having to leave the office.
  • More privacy: since you don’t have to sit in a public waiting room, there’s no chance of running into someone you know. 
  • Increased access to therapists: this depends on your therapist and their practice. With in-person therapy, you will typically see your therapist weekly with little communication outside of that session (aside from emergencies). With teletherapy platforms like Talkspace or BetterHelp, you’ll likely be able (and encouraged!) to message your therapist at any time.
  • More therapists to choose from: if you live in a rural area without many mental health professionals, want a BIPOC or LGBTQ+ therapist, or need someone who specializes in something less common, teletherapy can allow you to see the provider who is best for you, even if they aren’t local.

Cons

  • Can be less private: even though therapists are responsible for guaranteeing privacy on their end, you’ll still want to find a private space for yourself during the session, which can be difficult if you aren’t living alone. 
  • Tech glitches: technology isn’t perfect, so you may run into classic problems like your screen freezing or being stuck on mute. On the bright side, your therapist will probably expect this to happen occasionally and be able to get in touch with you to sort out the issue.
  • Can feel less personal: even though it’s still a one-on-one conversation, talking over video isn’t quite the same as being in a room together. You can’t read body language as well.

How do I get started?

You can seek out a provider by simply Google searching for therapists in your area or using a therapist search engine like Psychology Today or SAMHSA’s Treatment Services Locator. Finding someone this way is a great choice if you hope to eventually switch to in-person therapy once it is safe to do so. If you’re thinking you want to stick with teletherapy long-term or are interested in messaging your therapist regularly, a teletherapy-specific platform may be a good fit. This is also a great option if you want to start quickly – these platforms can often get you started right away, while independent therapists may have a wait list. Most of these platforms are accessible through both desktop (best for video or lengthy messages) and an app (great for quick, in-the-moment messages). Staff from MHA’s IDONTMIND program tried out two popular platforms – Talkspace and BetterHelp. Learn more about their experiences here.

Starting therapy is a brave choice, especially when it looks different than you ever expected it to. Above all, the success of any therapy heavily depends on the effort you put into it, your therapy goals, and having a good relationship with your therapist; you don’t have to love them, but you do have to trust them and feel safe opening up (and it’s okay if it takes a few sessions to get to that point). If you’re considering therapy but looking for some other resources too, take a mental health screen – based on your results, you’ll be linked to articles, DIY tools, and support communities that can help you manage your mental health during this difficult time.

[i] Greenbaum, Z. (2020). How well is telepsychology working? Monitor on Psychology, 51(5), 46. https://www.apa.org/monitor/2020/07/cover-telepsychology  

[ii] Wilser, J. (2020, July 9). Teletherapy, popular in the pandemic, may outlast it. The New York Times. https://www.nytimes.com/2020/07/09/well/mind/teletherapy-mental-health-coronavirus.html