What Is Telehealth Therapy? How It Works And Where To Find It

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What Is Telehealth Therapy? How It Works And Where To Find It

Especially during a crisis like the COVID-19 pandemic, access to mental health care is essential.

Whatever the status of your baseline mental health was prior to the COVID-19 pandemic, it's likely being adversely affected by the trauma we're all experiencing at this time.

Stress due to the uncertainty of how this crisis will play out is universally high.

If you're doing your part to flatten the curve by self-isolating, the idea of getting therapy may, understandably, seem like a non-starter.

Fortunately, there are therapists — including psychologists, psychiatrists, social worker, and licensed mental health counselors — who are trained to help people function better even when in-person therapy isn't available via telehealth services.

What is telehealth therapy?

As defined by the U.S. Human Resources Services Administration, "telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration."

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Telehealth is different from telemedicine, they explain, "because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services."

In plain English, telehealth therapy is shorthand for technology-assisted therapy, also called teletherapy, telehealth therapy, technology assisted therapy (“TAT”) or virtual therapy.

This format of therapy is not new, but until the last week or so, it was far less common.

After all, a lot has changed in the world of healthcare delivery over the past couple of weeks.

With social distancing measures in place, people are being asked to avoid in-person appointments with even medical doctors, who are "meeting" with patients via telehealth services instead.

The same goes for therapy appointments.

Therapists who provide in-person counseling services have had to make sudden shifts in both how and where they work.

In telehealth therapy sessions, psychotherapy is most often provided virtually on a HIPAA compliant platform such as VSee, and usually involves video chat.

The government and insurance companies recently relaxed the criteria required for the security of the platform and HIPAA compliance due to the pandemic.

In March, HHS Office for Civil Rights (OCR) Director Roger Severino announced, "We are empowering medical providers to serve patients wherever they are during this national public health emergency. We are especially concerned about reaching those most at risk, including older persons and persons with disabilities."

So even FaceTime, Google Duo, and Skype are permitted as platforms for therapy until further notice.

Historically, teletherapy had been utilized by people living in remote areas where access to mental health services is not widely available. It has also been used when people are seeking an opinion from an expert in another part of the state or country whom they wouldn’t otherwise be able to see due to restraints on time, money, and/or travel.

Another form of teletherapy that's gained popularity over the last couple of years is private online counseling in which a person chooses a therapist from a website or app — such as BetterHelp or Talkspace — then speaks with that counselor online.

The counselors on these sites offer easy, sometimes immediate, access. They also tend to be more affordable.

The basic gist of therapy is similar in the office or online: The patient has concerns to address, and the therapist helps the patient with those concerns.

For patients and therapists under a certain age, using technology in this way is second nature. For others, it feels more like suddenly needing to speak a foreign language.

How can you find appropriate telehealth services for your own needs?

There are a few ways to find telehealth therapy.

First, you can look online for therapists in your area, then ask those you prefer if they provide telehealth sessions.

Online directories, like the one available on Psychology Today, provide a list of therapists you can filter by geographic region and speciality, many of whom now provide telehealth. Just contact them and ask.

You can also go through one of the online therapy services mentioned above.

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For the first time in my 20 years in practice, all of my sessions with patients are currently being held remotely, using different platforms.

The 50 or so telehealth sessions I've held as of now have gone well overall.

There have definitely been some technical glitches. Thank goodness for backup planning!

Out of concern for the quality of my patients' experience, I asked several to share their thoughts on what they do and do not like about teletherapy so far. I also asked 25 colleagues to share their thoughts about what it's like for them to provide therapy in this way.

Here is a list of the pros and cons of telehealth therapy identified by patients and mental health professionals:

Pros of telehealth therapy, as identified by patients:

  • "I can stay in my pjs, or at least in my sweatpants."
  • "I don’t need to leave my house or deal with traffic to have a session."
  • "It's better than nothing if the alternative is not meeting."
  • "I'm more comfortable talking online than in person."
  • "There's no need for small talk in the waiting room."
  • "I don't have to sit in the waiting room wondering who I will see."

Cons of telehealth therapy, as identified by patients:

  • “It's awkward."
  • "I don't have any privacy at home to talk openly."
  • "It just feels weird."
  • "I miss your office! I love your couch and decorations."

Pros of telehealth therapy, as identified by mental health professionals:

  • "It reduces overhead expenses."
  • "It's better than not being able to help people by providing therapy."
  • "There's no commute time."

Cons of telehealth therapy, as identified by mental health professionals:

  • "It's harder to see the patient's full body language or expression."
  • "I wonder if there is someone else outside of the view listening in?" (This is an especially serious issue when there are concerns about domestic violence.)
  • "Payment is trickier, especially if I don't accept credit cards or online payments."
  • "Depending on my technology and my patient's, the online connection can be poor."

Metaphorically speaking, therapists are all about connecting! Even if the poor connection is technology-based, it can still feel bad for both patient and therapist.

That said, telehealth therapy is definitely preferred by some patients and therapists, even if my non-scientific survey suggests otherwise.

There is certainly consensus that telehealth therapy is better than not having access to any therapy whatsoever.

Over time, our appreciation for teletherapy may increase.

Once the initial crisis of COVID-19 passes, there will be a new normal in lots of areas of life for just about everyone.

Telehealth therapy is an good example of how one service industry is successfully adapting with the help of technology in order to remain accessible.

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Dr. Elayne Daniels is a Boston-based psychologist now offering telehealth therapy. While she misses being in her office with patients, she is thrilled to be able to provide therapy to existing and new patients.

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