Although teletherapy has been an available option for a long time, the COVID-19 pandemic has pushed many therapy practices online. For those seeking teletherapy or curious about what it would be like, this article reviews what to expect and some potential benefits and drawbacks of teletherapy.
Access to Therapy
A major benefit of teletherapy is that it greatly expands your access to therapists and other types of mental health providers. Seeking therapy in person, you generally have to limit your search to the areas where you live, work, and regularly commute. Searching for a teletherapy provider, however, you can expand your search to all providers licensed in your State who are operating online. You can be more selective in finding the right therapist for you. You can limit your search to therapists with a particular treatment modality, specialization, or background. This ensures you are able to find the best fit for you.
Increased Need for Descriptive Communication
There are some subtleties in interpersonal communication that can be lost through the use of telehealth versus in-person care. Sitting in the room with someone, it is easier to pick up on slight shifts in affect and energy level. With teletherapy, it becomes more important for both the psychotherapist and the client to be more descriptive at times. The therapist may need to ask questions to clarify if something has shifted or is impacting you. For example, the therapist may see you looking away from the screen and think you are processing something deeply but not realize your dog is doing something adorable off camera. You may also need to express that you are noticing a change in your affect by saying something in the moment, like “As we’re talking about this my eyes are starting to water” or something similarly descriptive. Although this can be an adjustment to those used to in-person therapy, it can also be a positive, powerful experience. You are beginning to track, honor, and give voice to your physical and emotional states and expressing your true Self.
Another major benefit of teletherapy that cannot be overemphasized is the convenience factor. Making the weekly commitment to therapy can be a challenge for many people who already have an overloaded schedule. When you are participating in teletherapy, you can easily join a session on your scheduled lunch break or at the end of the work day. You don’t have to worry about the added time stressors of commuting, finding parking, waiting in a lobby. Between the demands of job, kids/family, and appointments, usually the first thing we let go of is self-care. Scheduling a teletherapy session requires blocking out at least an hour in your week to be focused on yourself, sit with your feelings, and practice good self-care.
Technology makes mental health care so easily accessible, literally at the push of a button. One of the most obvious potential drawbacks, though, is that teletherapy can be impeded by technical glitches and internet outages. It is important to be patient with the process and understand that sometimes sound or video may cut out, there may be a delay in the video, or someone’s screen might freeze. The therapist may need to ask you to repeat something you just finished saying if, for example, the sound cut out at some point. It is important to join the session in a place where you have a strong internet connection and to have a backup plan for the session if there is a technological glitch, such as, I’ll call you at this agreed upon phone number to continue the session. An individual’s comfort level with technology in general may be a factor in considering teletherapy. Someone who is on the computer for long stretches of the day for work may not want to continue online after work for a therapy appointment. With the availability of providers, however, the reality is that you can find someone to work with on a day and at a time that is most convenient to you. There are so many different HIPAA- compliant telehealth platforms on the market today that you may need your therapist to give you an overview of the particular platform being used so that you have a working knowledge of the navigation and functionality so that you can join sessions and participate effectively.
Another benefit of teletherapy is that it allows you to share more and at a deeper level. Many telehealth platforms provide screen-sharing options so you can share with your therapist the artwork you just completed or the journal entry you wrote last night. You therapist may also utilize screen-sharing to share an excerpt from a book or instructions for a therapy homework exercise. Or, if you are describing the beautiful garden you have been tending or the new way you’ve set up your office space for maximum comfort and efficiency, you can pan the camera around and show your therapist. Inviting a therapist into your home and sharing a piece of your living environment can be a very connecting experience.
The flexibility of being able to log into a session instantaneously from multiple types of devices is both a huge benefit and a potential drawback, if appropriate parameters are not set. On the positive side, if you have been on your computer all day and your therapy appointment is approaching, you can transition to a comfortable chair and participate on your phone or tablet. This flexibility can become a hindrance if you are not giving your session the proper time, focus, and privacy for therapy to be most effective. Logging into a session while you are sitting on the couch with other people, drinking coffee at a busy café or driving your car (yes that has happened and, no, it is not a good idea) does not give yourself the space and confidentiality to engage in your therapy in a deeply meaningful way.
Personal experiences of teletherapy vary. It is important to be aware of your level of engagement, comfort, and experience and communicate your findings to your therapist. Some people may feel disconnected from their therapist by having a screen in between them. This may make it harder for them to open up or feel a connection to their therapist. If this is your experience, it is helpful to recognize it, voice it to your therapist, and see what could be adjusted to improve your experience. Just the simple act of sharing that something is not feeling comfortable or fully engaging can be helpful. Other people have had quite an opposite experience where transitioning to teletherapy from in person sessions, with it actually allowing them to go deeper. The experience of talking through the screen gives just enough of a sense of safety or distance that they feel freer to share more intimate details of their feelings and experiences.
It’s hard to predict what your personal experience of teletherapy will be. The best way to find out is by trying it. If you are considering teletherapy or wanting more information about my services, please feel free to reach out to me.
Danielle K. Price, LMFT