Does Teletherapy Work?

One of the most serious side effects of COVID-19 has been its impact on mental health . It is understood that the global pandemic is causing people to experience more anxiety and depression than usual, not to mention the additional hardships it causes for people with other conditions, such as obsessive-compulsive disorder and post-traumatic stress disorder.

People already in therapy may have switched to teletherapy in the past two months, but for those new to this type of service – or those new to therapy in general – communicating with a mental health professional via video chat can be powerful. raise. questions about confidentiality and efficiency. To give you a better idea of ​​what teletherapy involves, we spoke with several experts, including a pioneer in the field. Here’s what you need to know.

What is teletherapy?

Teletherapy – also called telepsychology , telemedicine, or telemedicine – involves communicating remotely with a licensed mental health professional. Most teletherapy is now done via video chat. Dr. Mary Elward , a psychologist with over 35 years of experience, was one of the early adopters of teletherapy and has been actively promoting the service since 2005 . And since March 8, Alvord has trained nearly 10,000 psychologists and other mental health professionals to practice teletherapy.

The Veterans Affairs Office has spearheaded the use of teletherapy as well as research into its effectiveness, Alvord said. Teletherapy for the general public began in the late 1990s as a way to reach people in remote areas who might not otherwise have access to mental health services. The introduction of video chatting in the 2000s gave us the version of teletherapy we are familiar with today.

While teletherapy itself is not new, the pandemic has transformed it from one way of getting mental health services to being the only option. For example, before COVID-19, Alvord said 10 to 15 percent of her practice was through teletherapy. Since the onset of the Talkspace pandemic, an online therapy platform offering teletherapy services has increased live video sessions by 250 percent, a company spokesman said. In addition, since mid-March, the total number of users has doubled compared to last year.

HIPAA changes

Prior to COVID-19, one of the biggest concerns with teletherapy was that under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), all meetings had to take place using certain encrypted online platforms that meet a number of privacy requirements (e.g. ,, VSee or Updox). While it makes sense to protect patient privacy, installing on a HIPAA-approved platform presents another barrier for mental health professionals, especially when it comes to what is covered by the health insurance plans they accept.

But in March 2020, HIPAA rules were relaxed and teletherapy is now allowed via FaceTime, Zoom, Skype, Facebook Messenger video chat or Google Hangouts video – previous methods that were banned – with the aim of making mental health services widely available. whenever possible during a pandemic. HIPAA has also eased restrictions on inter-legal practice – which means that if you normally live and see a GP in New York City but have moved to Montana, your GP must be able to obtain a temporary license to practice in the state.

Rachel D. Miller , a Chicago-based marriage and family therapist, works with a practice that did not previously offer teletherapy services, but began providing teletherapy services in mid-March when the state went into effect with a homebody ban. Like other practitioners, Miller’s was unable to offer telemedicine before the pandemic because insurance – specifically the Blue Cross Blue Shield of Illinois in their case – usually does not cover the service. But given the current situation, the Blue Cross Blue Shield of Illinois has agreed to cover teletherapy by the end of 2020, Miller says. Check with your insurance company to see if there have been similar changes since the start of the pandemic.

If you’ve previously asked your therapist about teletherapy sessions that weren’t an option, it might be a good idea to check again now if you haven’t already, as relaxing HIPAA regulations could make this possible.

Is teletherapy effective?

In short, yes. There has been extensive research into teletherapy since 1996, Elward said, and has concluded that it is just as effective as, or even superior to, personal therapy (such as teaching parent-child interaction ). However, Alvord notes that while teletherapy is for many the equivalent of personal therapy, others struggle with the format.

“The most important aspect of mental health care — in person or in person — is the therapeutic relationship,” said Lifehacker Dr. Rachel O’Neill, director of clinical effectiveness at Talkspace. “A strong relationship between therapist and client is likely to lead to better overall treatment outcomes.” Teletherapy also makes it possible for the person to receive mental health services no matter where the person is – in some cases, making it the only option for the person. “I definitely like this format better these days, and I love the enhanced access it gives my clients,” Miller tells Lifehacker.

Benefits of teletherapy

Dr. Mo Gelbart , a 45-year psychologist and director of community psychiatry development, California’s largest outpatient mental health organization, says COVID-19 has quickly and dramatically changed the way people work in the profession.

“Levels of fear, insecurity and uncertainty, combined with social isolation, rightfully increased our anxiety and depression,” he tells Lifehacker. “In addition, the shelter at home has cut off many of us from our loved ones, our friends, our work colleagues, and our needed and trusted psychiatrists and therapists. Fortunately, telemedicine is available and readily available, which may not be widely known or understood. “

Another important benefit of teletherapy is that it saves time. Between commuting time to and from the office and waiting time while you are in the office, a typical trip to see a therapist can take a total of several hours. But, as Gelbart explains, not only is waiting time eliminated, but you can also do chores at home while you wait for your appointment to start. In addition to this, teletherapy can make it easier for families from different geographic locations to participate in the same session.

Alvord also notes that teletherapy gives people more options when it comes to finding culturally competent mental health professionals. “It is very important to understand the values ​​of people and their culture,” she says. “And if you can have suppliers who really understand the culture and provide services, people not only feel more comfortable, but they also have more understanding and, I think, more support.”

While some people fear that telemedicine is impersonal, Gelbart has found the opposite in his experience when it comes to teletherapy. “There is actually a stronger bond and connection as you get each other’s undivided attention,” he says. “Everyone I worked with said they were amazed at how connected they were.”

Disadvantages of teletherapy

Before embarking on a teletherapy program – especially if it’s someone you’ve never worked with before – Elward stresses the importance of finding a licensed mental health professional. This is especially important when looking for potential therapists through the app: make sure the person you are talking to is tested, licensed and qualified to practice.

While this is not an option right now, Alvord recommends seeing a potential therapist in person on your first visit. “There is a distinct advantage to seeing someone in person first,” she explains, noting that it can be difficult to pick up non-verbal cues without seeing the whole person.

“When I can only see someone through the screen, there are many things like body language, tears in my eyes, fidgeting, things happening in the environment outside of what I see, etc., which can be easily skip, ”says Miller. It can also be problematic to work virtually with unstable families or couples who do not provide the same opportunities to comfort clients by passing them napkins or sitting next to them on the couch. “This is what ensures that I will most likely never stop meeting people in person once it’s safe enough,” she explains.

Finally, as Miller points out, there can be logistics problems. An unstable Wi-Fi connection can disrupt and disrupt a teletherapy session, and the lack of privacy at home means some clients may not open in the same way as during a private session. But in most cases, there are solutions to these problems, and the benefits of teletherapy outweigh the concerns.

How to find a therapist for teletherapy

If you’ve never worked with a therapist before and want to get started now, we have a complete guide on how to choose the mental health professional that’s right for you. And, according to Alvord, those looking to start therapy now should seek a doctor just as they did in non-pandemic times. Find someone who specializes in your specific needs (anxiety, depression, etc.) and make sure they are a licensed psychologist, psychiatrist, or social worker “because clinical competence is a top priority,” she says. While it may not matter right now, Alvord also suggests finding a therapist in your area so that when the pandemic is over, you can see them in person.


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