What is Online Teletherapy?
Teletherapy is the online delivery of counseling and mental health therapy services via high-resolution, live video conferencing. Teletherapy sessions are very similar to traditional speech, occupational therapy, or mental health sessions. Instead of sitting in the same room, clients and therapists interact via live video conferencing. This allows more flexible schedules and appointments for therapy sessions. Most importantly, it's just as effective as regular therapy sessions while protecting privacy. Also, those who feel more comfortable staying in their homes may be a better option for teletherapy.
Better Your Health through Teletherapy
Clients and patients using teletherapy enjoy distinct benefits. First and foremost, many people have difficulty accessing in-person psychotherapy due to a lack of transportation, trouble finding or affording childcare for their appointment, their location, and illnesses or disabilities.
Some people have severe phobias or family obligations that prevent them from leaving their houses. Others may have compromised immune systems or provide care for vulnerable populations.
During the COVID-19 outbreak, the benefits are particularly significant. Many restrictions and the guidelines had to be followed and both therapists and patients were able to meet those guidelines through teletherapy.
How is Teletherapy used for Mental Health?
In general, teletherapy sessions work exactly the same as traditional therapy. Patients schedule individually with a therapist for a live video appointment. Patients should plan ahead and prepare just as they would for an in-person session. If it’s your first appointment, be sure to have relevant records and information available, including prescriptions, and a list of questions to address.
In addition to one-on-one therapy sessions, teletherapy can also be used to deliver other types of counseling. This includes group, family, and marriage counseling. Just like online therapy for an individual, patients can use video communication technology to meet in groups, or as a family or couple, to take part in therapist-mediated sessions. These sessions are conducted just as they would be if everyone were together in the same room.
Is Teletherapy As Effective As In-Person Treatment?
You might be wondering if teletherapy is as effective as regular in-person visits to your therapist. The answer is, for most patients, yes. In fact, the American Psychiatric Association states, “Telemedicine in psychiatry is a validated and effective practice of medicine that increases access to care.” Studies have also shown that telepsychiatry can be more beneficial for certain patients, especially those who feel uncomfortable in a clinical or unfamiliar setting.
Teletherapy can help some patients feel more relaxed and willing to share their thoughts and feelings. Being inside the comfort of their own home can make a huge difference for certain individuals’ comfort levels. For some patients, the use of technology may seem like a hurdle. However, as technology improves and people become more familiar and comfortable with video communication, teletherapy will become more prevalent and accessible.
Of course, teletherapy does have some limitations. Certain types of therapy, such as play therapy for children, are limited by telehealth. However, online play therapy is offered in some cases that is also effective.
Some people may be familiar with the term telehealth, but many people may not know how far it extends or even the correct definition. Telehealth can come in a variety of forms but, as a whole, it refers to any type or a portion of medical care provided through technology. Telehealth is most commonly known as a method by which doctors are beginning to treat patients. However, many people do not know that this option is starting to become more highly used by occupational therapists, physical therapists, and speech therapists.
Telehealth can come in the form of patients watching videos of exercises they are to complete at home. Some facilities may use secure computer programs to exchange text messages/emails with patients to increase adherence to home recommendations. One of the most common uses of telehealth that most people are not aware of is a shared online portal for health records.
Each of these technologies comes with their own nuances; however, they all serve to make the job of a health professional much easier. More importantly, all forms of telehealth have a common goal of ensuring equal access to health resources.
Types of Teletherapy
Telehealth for therapists is more commonly known as teletherapy. Physical therapy has started expanding the amount of orthopedic teletherapy services they provide. This includes treatment of muscle sprains, joint replacements, fractures, and more.
Speech therapy has entered the teletherapy sector in the form of pediatric services, mainly through the school system and home-based services.
Occupational therapy has begun serving the teletherapy arena in settings such as outpatient mental health, home health, and school-based pediatric rehab.
All treatments provided will vary based on the discipline of therapy you are receiving (occupational, physical, or speech therapy) and the type of diagnoses which you possess (orthopedic, neurological, sensory integration).
14 Benefits of Teletherapy for Clients
Having recently moved to a fully virtual therapy practice using live video (e.g., like FaceTime but using HIPAA-compliant technology), the benefits have been immediate and in many ways unexpected. It is no surprise that telehealth is currently a $6 billion industry with estimates that it will reach close to $20 billion in 2025 (HCInnovation, 2018). While I initially dabbled with teletherapy more by accident than intention (starting with college students in-state living two to three hours away from my office), I quickly came to see its benefits for a much larger range of clients. Below, are listed some of the most notable benefits to date.
Low Barrier to Entry: One of the biggest challenges facing prospective therapy clients is that initial appointment. Statistics indicate the modal number of sessions attended by clients is: one. That’s right, patients will go to one session and never go back again. Theories abound—the experience was awful, there was not a fit with the therapist, or the most self-satisfied of them all- the therapist was so highly effective that they managed to “cure” their client in one majestic session (likely not the case). How does telehealth fit in? An easy way to describe it is this—all those things you hate about your dentist waiting room? They apply in therapy as well. Finding the office, sitting, anxiously counting down the time, waiting for your name to be called. With teletherapy, it’s almost always in the comfort of your own home. You can have your cozy blanket, your special mug, all the things that make you feel at ease. What better start to therapy and opening up than in your safe space?
Privacy: While this can certainly vary depending on geographical location and the diversity of clients seen by a therapist, teletherapy ensures maximal privacy every time. As one who specializes in teens and young adults, I have found more than once that my clients (even going to different schools and residing in different cities) manage to know one another. I have walked in (and out of my office) on more than one occasion witnessing awkward small talk between these clients who knew each other in kindergarten or who are mortal enemies. With social media anymore, everyone is connected. While I have often managed to help teens find the silver lining of running into acquaintances (we all have issues, therapy is normalized), teletherapy removes this concern altogether.
Efficiency: Time is perhaps our most precious resource. As such, commutes can be frustrating and stressful for clients already prone to anxiety. Unexpected traffic closures often lead clients to race in, anxious about being late or missing any part of their therapy time. In one scenario I had a patient get into a car accident on the way over to see me. Needless to say, our conversation that session wound up focusing on something entirely different than what we had intended. With enough on their brimming plates, the last thing clients need to worry about is one more place to be. And for that matter, one extra cost if parking tickets or accidents are involved.
Flexibility: Relatedly, teletherapy allows for maximal flexibility for overworked and overcommitted clients. Having worked with many high achieving populations who are at the verge of mental breakdowns, those who need services the most often have the least time. Being able to reschedule and integrate emergency sessions impacts the therapist and caseload at large minimally. Although of course high severity patients should rarely be seen in outpatient situations without extra staff support, for clients with severe anxiety that is otherwise well managed, the ability to schedule an emergency check-in can be invaluable.
Safety: Across much of the nation, severe winter weather can put a kink in plans. In Oregon, where an inch of snow shuts down the city, snow days can wreak havoc on scheduling. Some clients are stranded on mountain tops, others have four-wheel drive and trek their way to an office that closed down hours ago. Such concerns are eliminated in teletherapy. Further, there is no expectation that clients leave their homes in dangerous weather, there are no late cancellation fees, or consideration of what school districts are opened or closed. With teletherapy, the show can go on, each time.
Illness: It is not uncommon for teens with heavy workloads and many pressures to repeatedly succumb to illnesses. I have had clients with severe flus and viruses (often actively contagious) come in which puts me and by extension my other patients at risk. Further, illness often can cause additional last-minute cancellations while mood plummets. The ability for clients to continue working with their therapist, especially when ill, can be highly impactful. Teletherapy makes it safe for both clients and therapists.
Patient Timeliness Improved: When sessions begin at the click of a button, timeliness is certainly improved. Without the concern of a traffic jam, getting lost on their way to the office, or running low on gas, it is a no-brainer that timeliness is significantly improved when clients are always in reach of their devices.
Communications Improved: Like many therapists working independently, prior to moving to a full-time virtual practice, I rented a space in an executive office suite. While there were front desk staff servicing the floor, they also represented dozens of other entities from lawyers to accountants to real estate agents. With high turnover on their staff, messages were often missed, and information was not always clearly articulated (such as the time I was told a patient came in for me on a day I was not scheduled- there was no name, number, nothing leaving me guessing who on my caseload came in for an appointment!). Removing the middleman so to speak eases communication significantly and improves the overall therapeutic experience.
Streamlined Communication: One of the most integral components of my practice is my online billing, scheduling and charting program which also offers teletherapy directly via secure link. Clients can opt for a reminder text, email, or both and all the information regarding their appointment is at their fingertips. While this unfortunately sounds like advocacy for the takeover of robots, the truth is these programs simply don’t make errors but for exceedingly rare glitches. Having everything in one place is beautifully simple and fits in with the general ethos of teletherapy. In rare times when two patients have shown up for the same session, I have always felt terrible sending them home again when I know they rushed to get there. With teletherapy, when these rare errors occur, there is no harm, no foul.
Access to Facilities, Food, Drink, etc.: As a therapist to many teens who are often rushing over from school or other activities, I have more than once encountered a ravenous and therefore grouchy teen. I have often supplied my office with healthy snacks and drinks and watched teens polish off bag after bag of snacks while telling me about their day. While I don’t encourage eating for the full duration of therapy, a satiated client whose basic needs are met is certainly important. As such, one of the benefits of teletherapy is access to any of the needs that may come up for a client, down to a bathroom with no line (or worse, risk of running into the therapist in the next stall over!).
Access for Remote Patients: More times than I can count, I have done a double-take when I have reviewed a new client’s file and seen their home address listed in a city about an hour away. In one case, it was a teen living with an elderly grandmother who would drive through wind and rain and on windy dangerous roads to get to my office. It was dangerous for them and frankly unnecessary. When we switched to teletherapy, the therapeutic relationship was maintained, the therapy continued effortlessly and there was no disruption for this family. If anything, our clinic likely saved some harm to the teen and the driving grandmother whose vision had been slowly deteriorating over time.
Access for College Students: The fact that college counseling centers are more and more swamped is hardly news to those who have worked in such settings. Further, not all colleges are in towns with access to private providers, nor do all college students even have cars. Enter the beauty of access to a wide network of providers without any transportation hassles. As previously discussed, my earliest work in teletherapy came out of necessity for college students who either could not be seen at the college counseling center or who did not feel comfortable walking into the center and being seen by friends.
Access for Disabled Populations: In many scenarios, those who are bedridden, have chronic illness or otherwise can be major beneficiaries of online treatment options. There are times when clients suffering from IBS, Crohn’s, or other diseases may experience shame or embarrassment at their need for leaving to use facilities. In an online context, some of these concerns can be diminished significantly. Further, wheelchair accessibility can be a significant barrier with populations as well; I recall working with one patient and quickly learning we had to make sure to use a room with a door wide enough to let the chair pass, as well as extra room for the wheelchair to maneuver into position. While ideally, more locations will be ADA-accessible, the unfortunate reality is that in older locations, historic buildings, and so forth, making these changes can take time and in other cases be impossible.
Wait Times Reduced: Finally, perhaps obvious but well worth stating is the benefit of near-immediate access. Having worked in large clinics, I have observed insurance teams taking weeks to confirm benefits, process paperwork, and possessing other bureaucratic hassles. For clients able to see private practitioners, access can be near immediate. To be frank, that is one of my favorite parts of solo practice—for too many years I witnessed those in severe need go weeks until they could get an appointment. With virtually all aspects of my practice being paperless and electronic, I can send paperwork to the patient via secure connection, have it filled out, and sent back to me within the day. Most often I can accommodate patients within a week, if not within 24 hours depending on how quickly we can get things going. For clients who are in need to talk to someone urgently, or perhaps finally mustered up the courage to see someone, often waiting weeks can lead to appointment cancellations or clients in dire situations.
While there is no doubt that much more needs to be done before clients and therapists fully embrace and explore online therapy options, the future certainly looks bright. With more and more individuals telecommuting, busier schedules, and the need for greater flexibility in our ever-changing world, teletherapy opens up a whole new frontier. For more on therapist benefits of teletherapy, click here. (PsychologyToday 2019)