The growing world of telemental health

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    You may have been hearing more about telehealth including telemental health services and wondering what all this means and if it might be an option for you or someone you care about. Telemental health involves using technology to provide and receive mental health services including talk therapy and medication management. These services have been around for a long time and now the use of telehealth for therapy appointments is on the rise.

    Research shows that therapy can be provided virtually without negatively impacting its quality or effectiveness.

    The impact of the COVID-19 pandemic made this option more common, but it is not a brand new method for receiving therapy services. Research shows that therapy can be provided virtually without negatively impacting its quality or effectiveness. It became more popular during the pandemic due to necessity and because insurance companies expanded their coverage of these services. It is unclear whether this option will remain as widespread after the pandemic ends, but leaders are calling for it to remain due to the effectiveness of telehealth and the increased use of services overall.

    How can you know if teletherapy is for you?

    When seeking therapy services, a primary logistical concern is the cost. Deciding between in-person or online services might include what your insurance plan covers. Not every therapist offers both online and in-person options.

    Your own comfort with technology may also be a deciding factor. If you are uncomfortable with technology, the stress this brings you can be intense enough to be a barrier to treatment. Some therapists offer a free consult for clients to try online platforms to see if telehealth is compatible with their lifestyle.

    Having regular access to dependable internet service and related equipment is usually necessary for telehealth appointments to be effective. Beyond the logistics there are other pros and cons to telehealth therapy services to consider. Let’s take a look.

     » Read: Key differences between therapists and counselors

    Benefits of teletherapy

    Increased comfort in your own home

    Many people feel that attending therapy is more accessible to them from within their own home because of the reduced mental steps involved in showing up to appointments. If you are feeling depressed or anxious, feeling that you have to look a certain way or taking the extra steps to drive into an office can increase the challenge of attending an appointment, and this can lead to cancellations. Others feel more comfortable opening up about difficult topics since they are already in a familiar space. Clients may even be in the mental space to fully engage in session sooner since they don’t have to decompress from rushing to get to the office, traffic or related situations.

    Access to more providers

    If you live in a small town, it may be difficult to find a provider at all or it might be hard to find one you don’t already have a different type of relationship with. Teletherapy gives you access to providers that would be inconvenient if you had to travel to their physical location. This is especially true for rural areas that commonly lack providers and public transportation. It is important to note that this still means you will be limited to providers within the state your provider is licensed in.

    Convenience

    Many clients report convenience as a factor in choosing online services. With teletherapy, they do not have to worry about transportation or childcare. It also takes less time out of their day since they don’t have to factor in traffic or travel times. The increased convenience for providers can mean there is more flexibility around scheduling during non-traditional office hours.

    Confidentiality

    By attending therapy online, you don’t have to worry about someone seeing you coming in or out of the therapist’s office or recognizing your car in the parking lot. If you don’t have independent transportation, teletherapy can increase privacy because there is no need to explain to someone why you need a ride.

    Therapeutic relationship

    There are also reported benefits for clinicians using teletherapy. In a telehealth session therapists can see environmental aspects of a client’s life they do not get access to in the office; e.g., meeting their pets, witnessing relationship dynamics within their household, and seeing what their personal space looks like.

     » Read: Will mental health apps replace therapists?

    Limitations of teletherapy

    The benefits of teletherapy can also have related downfalls. Sometimes an in office therapy appointment can motivate someone to leave their house, when otherwise they would struggle to do this. Living with others and not having access to a private space, can raise concerns about confidentiality. An unreliable internet service or access to essential devices can also limit your access to teletherapy. Other considerations for teletherapy relate to the issues presented below.

    • Children often benefit from play therapy techniques that are hard to replicate online.
    • Those who are actively self-harming, actively using drugs or that are experiencing hallucinations or psychosis are best met in person for safety and assessment reasons.
    • Some therapy providers report feeling that teletherapy does not work as well as in person services. This is often due to their own personal preferences including their level of comfort with technology or their theoretical orientation.
    • Some styles of therapy do not easily transfer into an online version.
    • Clinicians may not live in an area that has reliable internet access.
    • Therapists are trained to not practice beyond their competency and these competencies can include aspects related to technology.

    The increased use of teletherapy means that as more people use it, more issues will become apparent and the rules surrounding it can change. For example, in some states insurance companies cover telehealth sessions that are audio only phone calls. Other states have laws that stipulate that telehealth sessions have a video connection. There are also laws about counselors, social workers and psychologists practicing within the state they are licensed in.

    When the COVID19 pandemic first emerged, many of these laws were waived due to the state of emergency. Some of these have changed, so if you were seeing a therapist and moved or took a break from therapy and returned, teletherapy might look different from how it did before.

    Platforms for appointments

    Telehealth is still regulated and subject to the legal and ethical standards of in-person services. Your provider is likely to use a platform that is approved to meet these standards, so not every mean of communication will be an option. Whatever method your provider uses, they will help you figure out how to access it as part of their intake process. Here are some of the commonly used and approved programs for telehealth appointments:

    Zoom

    Zoom has emerged as a common method for video conferencing. This program is available in both Apple and Android app stores. If your provider uses this platform, you can expect to be given a meeting ID and password to protect privacy. This method also uses an online waiting room option to increase security and privacy.

    Doxy.me

    This is another commonly used method for video conferencing for telehealth appointments. For this platform there is no app to download. You will be given your providers personal link to join them for your appointment.

    Simple Practice

    Simple Practice is the name of an electronic health record system commonly used by therapists. If your provider uses this platform, you will receive an invite to activate your client portal. This can be used for scheduling, secure messaging, billing, and sharing any documents. Your provider may also use another program that offers similar features such as Theranest or TherapyNotes.

    Whatever program your provider uses in their practice, you can expect them to explain how you can gain access to what you need.

    Telemental health companies

    In addition to how telemental health services are offered as a change or supplement to traditional therapy services, new companies designed around offering virtual therapy services have emerged on the healthcare scene. Just as with individual providers, these companies vary in the services they offer in your area, cost, and if they accept insurance. They also vary in how you are matched with a therapist and the type of appointments offered. Some therapists work for these companies full time and others work for them on a more limited basis.

    Better Help

    You may have seen commercials for Better Help. It is one of the most well known of the online only therapy companies promising to make meeting with a therapist easier than traditional methods. Whether or not this is easier depends on your individual circumstance as therapist availability and cost vary. Their therapists are required to be licensed in the state they practice in. They do not work with insurance companies and therapists on this platform are not able to provide a mental health diagnosis, but this is not always something clients need. If this is something you know you need, then seeking out a provider in your area that offers online services is something to explore. You can review their frequently asked questions here.

    Talk Space

    Talk Space is another popular company offering online only therapy services. They use fully licensed clinicians and are able to accept some insurance plans. You can review their general services and frequently asked questions here.

    What option is the best?

    It is important to remember that when seeking any therapy services, whether online or in-person, or whether with an individual provider or online service company, the relationship you build with your therapist has a lot to do with meeting your therapy related goals. Even with the increased convenience offered by online services, finding a therapist can be a frustrating process because there are so many individual needs to consider.

    When you first meet with a therapist feel free to ask them about their qualifications, how long they have been working and if they have experience providing help with your issues. You may want to ask how they handle situations where technology causes issues with meeting as scheduled or if an emergency arises. Feel free to ask about any limitations to confidentiality and how your information is used. If you are concerned about any of these issues, getting answers can help you find the therapist that can best meet your needs.

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