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With COVID-19 quarantine guidelines and stay-at-home orders, many aspects of our daily lives have transitioned into virtual worlds. Online school, work, communication, socialization, and even grocery shopping are accessible from the safety of our homes. Mental health services are no exception to this virtual transition. With face-to-face meetings impossible, telehealth psychology services became the only viable option. As a result, state and federal regulatory agencies and insurance companies temporarily relaxed rules and regulations to ensure that more people could receive the services they need. Today’s GKIS article covers the critical issues you need to know about teletherapy.

What is teletherapy?

Teletherapy is a branch of the broader service of telehealth (or telemedicine). Generally, teletherapy facilitates remote mental health services through technology. In other words, teletherapy allows clients to receive therapeutic or psychiatric treatment from practitioners over the phone, through video chat, or even text message.[1]

How does it work?

Teletherapy involves entirely virtual interactions between mental health experts and clients through the use of smartphones, computers, or tablets. In general, teletherapy sessions are supposed to work in the same way that traditional therapy sessions work. Therapists work with clients remotely to provide talk therapy, teach therapeutic techniques, and develop coping strategies. Teletherapy can be used for one-on-one, family, marriage, and group counseling.[1]

Who offers teletherapy services?

Teletherapy services are offered by licensed mental health professionals.[1] Many of us have recently seen an increase in advertisements for teletherapy services from companies such as Talkspace and BetterHelp. These companies are online therapy platforms that hire clinicians to work for them in exchange for a steady number of clients. To apply, clinicians must provide proof of credentials, proof of competence in therapeutic treatment, and undergo a rigorous screening process.[2] Unfortunately, it is impossible to ensure that this standard of hiring and assessment is upheld by every online therapy company.

What are the potential benefits/risks of teletherapy?

Potential Benefits for Clients:

Increased Access to Mental Health Services

  • Telehealth can be very convenient. It alleviates travel restrictions, time constraints, and other barriers like childcare needs.

Greater Sense Of Security

  • Many people feel more comfortable in their homes, which allows clients to relax and be more willing to share their thoughts and feelings.

Public Health Concerns

  • The primary factor responsible for this shift to teletherapy is concern over public health during the global pandemic. Telehealth allows clients and experts to abide by stay-at-home safety protocols.

Economic Advantages

  • Teletherapy alleviates costs associated with travel and childcare.

Client Control

  • It’s much easier for a client to move to another therapist when using teletherapy because factors regarding commute and location of the new therapist are removed.[3]

Potential Benefits for Mental Health Practitioners:

Greater Access to Clients

  • Teletherapy allows therapists to meet with clients who may be unable or unwilling to travel. Many people find the prospect of meeting with a therapist in a clinical setting intimidating. For people who feel more comfortable at home, teletherapy may increase their likelihood of seeking out therapeutic treatment.

Economic Advantages

  • Teletherapy alleviates costs associated with travel, business expenses such as rent for office space, and allows practitioners to meet with more clients.

Time

  • With less time spent commuting from home to work, practitioners have greater flexibility regarding scheduling appointments with more clients.

Efficiency

  • Sessions conducted via chat or messaging automatically generate a record of the session, and video-conferencing allows the opportunity for sessions to be recorded.[3]

Potential Risks and Limitations for Clients:

Privacy

  • There are several potential risks to client privacy associated with teletherapy services.
  • It’s possible for hackers to access private data from a client’s device. Files containing sensitive client information that are unsecured may be accessed by an unwanted third party.
  • Even HIPAA compliant teletherapy services may be subject to data breaches that put client confidentiality at risk.
  • Unsecure chat and conferencing programs may expose sensitive client data, so clients should only work with therapists who have the tools and knowledge to encrypt data.
  • Some people lack access to private environments even within their own homes, this can make it difficult to protect client confidentiality as people may overhear or listen in on a private session.

Competence of the therapist

  • Therapists who are not competent regarding the use of technology and commercial software put their clients at significantly greater risk of breaches in confidentiality

Environment

  • Some people may prefer the security, and calm of a clinical office setting and have difficulty accessing a comfortable and private environment to facilitate their session.

Distractions

  • It is very easy for people to become distracted by things like notifications, emails, and text messages when using their devices and these distractions may impede upon the therapy session.[3]

Potential Risks and Limitations for Mental Health Practitioners:

Privacy

  • It is the responsibility of the clinician to protect client data, ensuring this protection is much more complex when relying on online/virtual programs than it is for clinicians in a traditional therapy setting.

Legal and ethical concerns

  • Therapists must comply with state licensing board regulations in both the state where they practice and where the client is located. Following the proper rules and regulations requires special knowledge and legal understanding which can be difficult to keep up with.

Communication

  • With the absence of face-to-face interaction comes the loss of many non-verbal cues and paralanguage that enhance overall communication among clients and clinicians. It can also be more difficult to establish a comfortable rapport with a client in a virtual setting where people feel distanced. In other words, the physical separation may impede the therapeutic dynamic.

Anonymity and client safety concerns

  • Clients can easily hide their identities online. This can make it much more difficult for clinicians who have a responsibility to report clients who may harm themselves or others to the proper authorities.[3]

Is teletherapy comparable to traditional therapy?

There is a lot of debate as to whether teletherapy is truly comparable to traditional therapeutic treatments. Some experts claim that there is a lack of research or evidence regarding teletherapy including its efficacy and effectiveness with long-term outcomes. Other experts claim that there is no significant difference between teletherapy and traditional therapy regarding the practices used and their efficacy. Some clients have reported great experiences with teletherapy, and others have expressed the opposite. As with traditional therapy, what seems to matter most is the compatibility of the client and the therapist. As of now, it seems difficult to definitively say which avenue of mental health care is superior. The bottom line is, whether it’s teletherapy or traditional, it is up to the client to decide what avenue best suits their needs.

Dr. Bennett has been practicing teletherapy with her child, teen, and adult clients since the beginning of the pandemic. She says she’s had to get creative figuring out how to keep kids focused with fun games and skill-training strategies. She says she does miss the natural comfort and improved intimacy of face-to-face therapy. But she suspects that over half of her clients will opt for telehealth services in the future. She says it’s particularly convenient for busy families who have multiple children in sporting and learning activities. She even got licensed in Hawaii and Idaho so she can work remotely while she is on vacation!

GKIS Services

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Thanks to CSUCI intern, Mackenzie Morrow for researching Teletherapy mental health services and co-authoring this article.

I’m the mom psychologist who will help you GetKidsInternetSafe.

Onward to More Awesome Parenting,

Tracy S. Bennett, Ph.D.
Mom, Clinical Psychologist, CSUCI Adjunct Faculty
GetKidsInternetSafe.com

 

 

 

Works Cited

[1] Villines, Z. (2020). Teletherapy: How it works. Medical News Today. https://www.medicalnewstoday.com/articles/teletherapy

[2] Person, M. (2019). The pros and cons of contracting with online counseling companies. Counseling Today. https://ct.counseling.org/2019/01/the-pros-and-cons-of-contracting-with-online-counseling-companies/

[3] Stoll, J. et al. (2020). Ethical issues in online psychotherapy: A narrative review. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026245/

 

Photos Credited

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Photo by Muhammad Daudy (https://unsplash.com/photos/4eeG4Mn0HVY)

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Mackenzie Morrow
Mackenzie Morrow
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