Starting in March 2020 with the pandemic shutdown, many therapists shifted from providing traditional 50-minute office-based therapy sessions to online teletherapy sessions. The question is whether this approach benefits clients. According to studies conducted from both before and since the start of the pandemic, the answer is yes. It is important to be clear about what is being referred to as “traditional therapy,” which is a style of therapy where the process starts with an intake assessment that results in a diagnosis. Generally, sessions in traditional therapy are about an hour long and take place on a routine, scheduled basis. Finally, traditional therapy is more than just talking or coaching. Based on a relationship between the patient and the therapist, it uses a variety of techniques that have been found to be effective to reduce symptoms or increase an individual’s sense of well-being.
In the July 2020 journal for the American Psychological Association, an article titled “How well is telepsychology working?” gave a brief history of the use of telehealth prior to the pandemic. Using a phone to deliver care or do assessments started in the 1960s. Reaching certain populations has always been an issue. Rural areas have had a lower number of mental health therapists for a long time, but patients could be reached by phone. Other restricted locations, such as prisons, have also had a need for mental health providers. Sometimes the use of video conference psychiatry in the prison system was known as “the doc in the box.”
Studies exploring how effective teletherapy is have been conducted by the U.S. Department of Veterans Affairs to determine if it is helpful to treat post-traumatic stress disorder. Other researchers have explored the use of teletherapy for depression, anxiety, adjustment disorder and substance dependency. In these studies, groups of patients receiving in-person therapy were compared to patients receiving care through video or telehealth approaches. The outcomes indicate that the effectiveness of the telehealth approach is as effective as the in-person approach. Further, it seems that patients will stay in therapy longer when they can access their therapy via telehealth.
There are a few things that need to be kept in mind when participating in teletherapy. First, it is important that the therapist is a licensed professional. The state of Pennsylvania confers licenses to psychologists, social workers, counselors, and marriage and family therapists. The license is the assurance that an individual has completed a course of education that has trained them to provide psychotherapy. The license also requires the providers to continue to maintain their knowledge base with continuing education. Finally, the license indicates that the provider is following an ethical code of conduct that guides their work habits.
The state of Pennsylvania, and most insurance companies, require that both the therapist and patient are in the same state during sessions. This is the part of teletherapy that has made it extremely convenient. A patient can move but retain the same therapist as long as they move within the state. This allows for something called “continuity of care.” Therapy sessions can also happen even when patients are on vacation, as long as they remain in the state during the vacation.
Finally, when participating in teletherapy, keeping the sessions private is the responsibility of both the patient and the therapist. Both need to be in quiet, secure locations; in a room with the door closed is the goal here. Sometimes clients or therapists may use headphones or earbuds to help maintain privacy. Sitting in a busy restaurant or lobby is discouraged. Many patients have found that the perfect place for therapy is their car. They can step away from work to the parking lot, have a session and return to work during a lunch hour.
Teletherapy has been found to be effective in addressing the needs of individuals seeking help with a wide range of mental health concerns. Following a few basic guidelines will make the process secure and comfortable for most.
Margaret H. Swartz, Psy.D. is a licensed psychologist in private practice with Yorlan Psychological Associates. She is a member of the Behavioral Health Task Force of Healthy Adams County.
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