Teletherapy

Engaging in teletherapy can be safe, effective, and a powerful way for someone to improve their quality of life immediately. It also lowers the financial and emotional barriers of entry.

If you’re interested in learning more, check out a detailed summary of teletherapy. 

Or to find out if this could personally benefit you, 

Schedule a 15 minute mini session!

Benefits of Teletherapy:

1. It reaches people that brick and mortars can’t: Throughout my career I’ve found that one of the most frustrating things I have to deal with, as a provider, is lack of accessibility. On the client side of things, I’m sure the frustration is minimally double mine. Finding a therapist you connect with is a challenge all by itself, and then finding one that has fair prices, takes your insurance, has hours that work around your schedule, and is geographically close enough to not incur a whole day event is something else entirely. Teletherapy opens the doors for incredibly busy individuals, or those that live in rural or marginally served areas to have access to the therapist of their choosing, from the comfort of their home, and to interview multiple with minimal commitment. That leads me to my second point:

2. It lets you shop around: Almost the entirety of positive feedback from therapy comes from the development of a positive, healthy relationship with your therapist. It is no secret that therapists are humans just like anyone else, and on a frank note, some are just terrible. Traditional therapy has a lengthy intake process with pages of paperwork, and then a diagnostic interview that feels more like a job interview than building a relationship with someone who has requested enough information on you to fit in well at a family wedding. Teletherapy often provides the opportunity for 15 minute consultations (to schedule, see below) to simply get to know the therapist and see if it feels like a good match. Then if its not, clients can move on to the next one pretty quickly. There is less investment in finding a good therapist so that clients can put their energy where it counts- working with a good therapist. 

3. It’s more convenient and potentially more affordable: This may seem a bit redundant, but teletherapy allows for sessions to be booked on the client’s time. That means while they’re eating, doing laundry, making dinner, etc. What client’s do while engaging in therapy is entirely up to them, mind you the more attention given, the better the therapeutic outcomes. It ensures privacy- clients will never run into their neighbor or their kiddo’s 4th grade teacher when engaging in therapy in their own home or office. They won’t have to drive 20 minutes to hope the therapist is on time, and then drive 20 minutes home after the appointment, and that is probably best case scenario, factoring in construction and traffic.
   The other benefit of teletherapy is the opportunity for reducing cost as a barrier to services. The overhead fees associated with a brick and mortar therapy practice are extensive, and are usually absorbed by higher fees to the client. Teletherapy simply requires a private space, good internet connection, and functional laptop (as well as some tech knowledge). Most electronic medical records have billing, invoicing, and charting capabilities all rolled into one, further reducing the cost associated, and with no additional staff to schedule, make reminder calls, or cancel appointments- the savings continue. These savings can be passed down to subscribers, who can pay for monthly memberships, or for individual appointments. And while some insurances do reimburse for teletherapy services, cash practices are almost more accessible in some cases than approved insurance providers. 

4. A more readily absorbed power differential: Over the last five or so years that I’ve been doing therapy full time, my clients almost always comment on how nervous they are at their first session, and how overwhelming they anticipate it will be to have an “expert study them.” Generally, they are pleasantly surprised at home casual therapy feels and typically describe it as “having coffee with a good friend, who knows nobody.” Teletherapy lends itself to that because therapy can look like a simple phone call, or video chat, and there are often messaging capabilities that ensure you can reach out to your therapist at any time with questions or concerns you may have. With this service, the anxiety about what to talk about during therapy is reduced dramatically. We are often, for better or worse, most comfortable on our cell phones, and teletherapy works with that, rather than against it. 

5. It gives couples space to hear each other better: A huge area of teletherapy is for couples. This makes sense, right? Childcare is expensive, admitting your relationship could be in trouble is hard, no one wants to willingly walk into the “blame game”, and coordinating competing schedules is almost impossible. Teletherapy solves almost all of that. Couples are able to occupy their kids with a movie while they step into another room for live sessions. Throughout the week, they’re able to touch base with the therapist about their own concerns or reminders for what communication skills to learn. The therapist still holds that same traditional role: to mediate, create a safe space, improve vulnerability, and prompt answered bids for affection. Meanwhile, instead of the anxiety of an uncomfortable couch in an unfamiliar office space, and possible a less than enjoyable car ride, a couple can reach out for support from their kitchen while having a cup of coffee, or from the bedroom. These positive interactions in difficult spaces can help repair attachment traumas that have marred that spaces they share together, all without them wondering about whether or not they vacuumed last week or not.
   

   There are some drawbacks:

6. Teletherapy is not appropriate for all types of clients: Clients who are frequently in crisis or dangerous situations, have a high degree of suicidal thought, or have severe mental illness that require care coordination with a psychiatrist are likely not a good fit for teletherapy. While this seems to contest my comment earlier about accessibility to populations that generally wouldn’t seek traditional therapy, it is less of a black and white issue. Clients should be assessed for safety, and all clients starting teletherapy should immediately complete a safety plan. The therapist is the best judge of whether or not a client is a good fit, and will likely share that during the consultation or first session. 

7. Teletherapist cannot respond in crisis: While having messaging capabilities may give the impression that therapists are available 24-7, that isn’t actually the case, and therapists are often keeping “regular” business hours with good boundaries. Crisis situations will require the use of alternative resources, much like those of traditional therapy- this includes the suicide hotline, crisis centers, local community mental healh agencies, and of course emergency rooms or psychiatric facilities. Additionally, teletherapists are held to the same standards of traditional therapists when it comes to mandated reporting practices, or contacting outside authorities in cases of harm to self or others, or reported abuse or neglect of children or vulnerable adults. 

8. Confidentiality is often dependent on the client: In a traditional therapy office, methods are used to ensure confidentiality- doors without windows, noise machines, receptionists who limit exposure to your private information upon check in or appointment scheduling. With teletherapy, how much or how little privacy the client has is dependent on where they choose to conduct their sessions. The therapist is always obligated to be in a safe, HIPAA compliant space when conducting business including messaging, but if a client messages their therapist in line at the grocery store, there is always a risk that the person behind them saw it. 

9. Basic logistical issues: Some states will not allow providers to see clients traveling to different states. There are rules about who can see how and in what locations. As a general rule, unless the therapist is licensed in multiple states, getting a therapy session while on vacation in another state or country is probably out of the question. Additionally, technology issues have the potential to interrupt therapy, both during live sessions or on client platforms. While every effort is made to avoid this, sometimes technology doesn’t meet our standards of using it. In that same vein, if a video session is conducted with the camera showing the client from the neck up, there may be missed physical and nonverbal cues that a therapist would traditionally pick up on. Assessing tools including odor, gait, etc could be missed. This may hinder the therapist’s ability to truly assess the client’s level of functioning. Obviously in a phone session, these abilities are hindered even further. 

10. And then the ethical concerns: As I mentioned before, some therapists are just not that great and are willing to bend the rules for profit. Teletherapy runs the risk of working with a therapist who inappropriately advertised themselves, or has lacking skills, expertise, or client boundaries. Therapists may make poor choices about confidentiality and conduct therapy sessions in the hair salon, a family birthday party, or from the airport. As with any therapy, it is important for clients to know their rights and exercise them when they feel they’ve been infringed upon. It is also important to double check a potential therapist’s standing with the state board before working with them.
    

    If you’re interested in this modality and want to learn more about how telehealth could meet your needs, schedule a 15 minute consultation session.