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
Screen Safety Essentials Course offers a comprehensive family program with tools for fostering open communication and creating safer home screen environments.
Screen Time in the Mean Time is the parenting guide needed in this digital age. Dr. B’s book posits tangible ways to keep your family safe and connected while utilizing technology.
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.
It’s a battle keeping students engaged in education in our screen-soaked world. Kids love learning. But they seem less in love with school and more in love with screen time. How do we reengage our students in school and the love of learning? Have we reached the tipping point where tech in the classroom is necessary for engagement? Or since COVID-19 Stay at Home Orders, have screens isolated kids and made them too fatigued to learn? Screens are great at teaching kids to self-interrupt, leading often report that real-life classrooms turn them off instead of turning them on. Today’s GKIS article highlights the benefit of tech and how gamification is being tested in education.
Traditional Teaching Methods Versus Screen Tech
Traditionally, schools use teacher-led workbook activities, in-class discussions, and textbook-based homework that rely heavily on structured lessons and memorization. Lessons often span longer than 10 minutes. This can be problematic considering the typical adult’s attention span is only 15 minutes.[1]
Screen technology, on the other hand, is fast-moving and interactive and offers the student on-demand selection at the click of a button. The opportunity to self-select content is empowering and gratifying. Teachers can also track the student’s learning process in real time and gradually feed relevant and increasingly challenging content.
The rewarding versatility of technology has led children to immerse themselves in their virtual worlds an average of ten hours a day. With this number of hours on-screen, many kids are creating brain pathways best matched with on-demand screen delivery rather than teacher-facilitated instruction.
Evidence of Disengagement
Even before COVID, a 2014 poll of 825,000 5th-12th grade students found that nearly half of the students surveyed felt disengaged in the learning process. Only 40% of their teachers believed their students were engaged. Reported numbers were even lower (26%) in high-poverty schools.[2] This finding is particularly concerning, considering that a student’s engagement in grade school is correlated with how well they will do in college.[3]
When schoolteacher and gamification enthusiast Scott Hebert asked his students why they didn’t seem to care about the lessons taught in school, they replied, “I don’t get why we need to do this stuff, give us a reason to care.”[4] Without intrinsic interest, meaning the task isn’t naturally motivating, they felt like they had to jump through meaningless hoops to learn.
To be successful, education must speak their language and meet them where they’re at. For most kids, that means reaching them in their virtual worlds. Studies have reported that 90% of students agree using a tablet will change the way they learn in the future, and 56% of high school students would like to use mobile devices in the classroom.[5]
Gamification
Gamification was coined by computer programmer Nick Pelling in 2002. The concept of gamification is to take the natural enjoyments that attract people to technology and inject those into education. In other words, create a more fun humanisticapproach to education, rather than our traditional instruction-led, function-focused approach.[6]
Dr. See is a professor at the University of Hong Kong who teaches human anatomy and medicine. He noticed that video games and education have features that overlap. For example, they both:
require solving mental puzzles,
recalling information,
looking for patterns,
working under pressure,
communicating ideas, and
working within a time limit.
Because his students loved video games, he decided to use gamification within his classroom. He applied puzzles and games to the curriculum, like for the memorization of the names of medications. As a result, his students reported that they were more motivated and learned better.[7] His gamification worked!
Learning through gamification does not mean it is easy. Gamification is engaging because it requires the student to generate the material instead of being instructed to do so. It is not about making school easier. Instead, it allows the student to actively engage in the learning process.[8]
Intrinsic & Extrinsic Motivators
We are psychologically motivated by intrinsic and extrinsic factors.
Intrinsic motivators (things that you enjoy doing that compel you forward) are important for well-being.
The psychological needs that must be met to feel motivated are:
autonomy (working on your own),
competence (being good at it), and
relatedness (feeling connected to what you learn).
Extrinsic motivators are rewards that come from outside. Examples include grades, points, and praise. External rewards may become harmful to our psychological well-being when they’re the only reason for engagement.[9]
For great learning, then, we must avoid rewarding students with points and grades. Instead, we must allow students to have a choice in what they’re learning and a chance to try it on their own and celebrate their efforts. These goals within a classroom can be challenging.
Gamifying Tests
Video games are set up for lots of autonomy, competence, and relatedness. The player gets to pick the game they relate to. then they get to play it on their own, simply restarting after they fail. They may lose points. But so what. They can just start over. Nobody is judging them.
Traditional school testing methods do the opposite. Typically, a failing grade on the test is the student’s final act of the lesson. They don’t get a do-over. That means failure has huge consequences and may leave the learner feeling hopeless and demoralized.
Gamifying testing could reverse that process by offering smaller quizzes that the student can retake over and over as they learn the material. Instead of feeling terrible about their first attempt, they can see their points going up and up – just like in a video game.
Starting a student at 100% with nowhere to go but down can lead the student to feel hopeless. According to prospect theory, people have a difficult time choosing activities when they anticipate a loss.
Alternatively, starting at zero and gaining points from there encourages a growth mindset. That means looking forward to learning instead of feeling defeated by it. The student would begin the semester with zero points and as the year progresses, they could earn points as they complete assignments. This would give students a growth mindset for their education!
AltSchool
Educators have tested technology-assisted education models, especially since the 2020 COVID-19 pandemic. For example, millions of dollars have been invested in AltSchool, a school that promotes a personalized learning platform using technology. In Altschool, students are provided with iPads or laptops and given individualized learning activities. The school encourages students to learn at their own pace, developing the mastery skills needed to learn the subject. The goal is engagement and learning potential.
Outcome studies revealed that students who learned at their own pace felt more competent and autonomous.[10] However, a teacher noticed his students were less connected with each other than before. They were more engaged with the technology than they were with one another. Also, we all remember the Zoom burnout students felt after the COVID epidemic. Losing motivation and connectedness over time may be risks of technologically assisted education.
The need for relatedness and connection is particularly important in learning because others provide feedback and perspective.[11]Authoritative instruction may trigger the reactance theory, which explains how people value autonomy so much they will “react” or do the opposite of what they are told to feel they made their own decision.
Quest to Learn
Another applied experiment for new and creative education is Quest to Learn. This is a gamified high school in Manhattan that was founded in 2009. Many of the classes at the school are not internet-based but instead teach through role-playing. Students act out the responsibilities of a chosen profession, like learning about politics by impersonating a politician.[12] By narrating the character, a student generates the answers needed for complex subjects.[13]
Because screen technology is still new, innovative (new and creative) teaching models and outcome studies are still being developed. Hybrid models (part in-classroom and part on-screen) are also being tested. As tech optimists, we at GKIS look forward to seeing all the cool things coming up in education.
Thanks to Andrew Weissmann for his research for this article. For a glimpse into some of the benefits of video games, check out our GKIS article Is Your Child a “Professional Gamer”?
Works Cited
[1] Usnews.com Kids asked to learn in ways that exceed attention spans by the Hechinger Report
[7] School of Biomedical Sciences sbms.hku.hk Dr. See, Christopher
[8] Christopher See Gamification in Higher Education
[9] Kasser and Ryan (1993) A dark side of the American dream: Correlates of financial success as a central life aspiration. (1996). Further examining the American dream: Differential correlates of intrinsic and extrinsic goals.
[10] Black & Deci, (2000) selfdeterminationtheory.org
[11] The Backlash Against Screen Time at School by Rob Waters
[12] Worldgovernmentsummit.org Gamification and the future of education
