Telehealth

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Therapy in the digital age: Why sharing our stories matters more than ever.

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Written by Thomas Giardini, MHC-LP
CoreStory Clinician
[Click here to read more about him]

 
Technology is increasingly present and unavoidable in our lives. As a therapist, I find myself regularly thinking about the impact of technologies—some potential, and some already here—on how we live and engage with one another in an increasingly digital world. For example, it is now common for people to meet with therapists over chat and text lines through providers that primarily rely on textual exchange as the medium for “listening” and intervention. Moving a step further from embodiment, there are a growing number of platforms that allow users to engage in or supplement therapy through automated conversations with artificial intelligence.  

To me, the experience of partnering with a person in talk therapy to listen and explore a person’s life stories is founded in genuineness, acceptance, and empathy. The implications of nonhuman or technologically mediated treatment offer a dizzying array of opportunities and challenges. As you consider whether now may be the right time to begin or perhaps resume therapy, I encourage you to keep in mind three beneficial aspects of exploring your story (whether in person or across virtual space) with a human therapist:

 1. Building patience

Therapy functions in contrast to a world focused on problem-solving and immediate gratification. It encourages us to slow down and take stock of the details that form our personal narratives. Talking to a therapist offers an enduring venue in which to bring understanding to the various complexities of your life, and to generally put words to your journey. By engaging in a weekly protected process, we become accustomed to the benefits of exercising patience toward ourselves and our growth.

2. Embracing presence

A therapist provides a special kind of listening–one that empowers us to discover ourselves in the presence of others. Emerging from a relationship between a listening  therapist and person sharing stories of their life is a safe, positive sense of individual and shared presence. The development of therapeutic rapport provides a social context for transformation and invites us to discover our own patterns of independence and interdependence. When we connect with our therapist, we engage in an opportunity to experiment with how we interact and maintain a sense of curiosity and presence in our  lives.

3. Locating intention

It is often the unplanned moments, the unexpected revelations, and the unrehearsed exchanges that bring us closer to breakthroughs and transformation. In therapy, balancing intentionality and improvisation can guide conversation and challenge our assumptions. When working collaboratively within a therapeutic framework, we remain open to unforeseen insights that may arise and consider how our actions (and reactions) can help propel us closer to our goals.

Your stories are valuable. By sharing them in therapy, it is my hope that each person can find solace, develop understanding, and foster growth.

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Blog Series: Talk Therapy When You’re Stuck at Home (Part 1)

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Image courtesy of @danielbarretoes

Image courtesy of @danielbarretoes

 

In these strange pandemic times, it feels like things are changing every moment and strangely, at the same time, things seem to never change!  We simply have to roll with it all. This means embracing unfamiliarity for the sake of safety, and talk therapy is no exception. As a result of the need for social distancing, face-to-face counseling is now digital and remote.

Over the next several weeks, we’ll be putting out a series of posts that will outline the full teletherapy experience - what it is, what it isn’t, and how it can benefit you (particularly during the pandemic).

To begin this series, let’s first talk about what teletherapy is, who can use it, and why we’re talking about it.

What is teletherapy?

Teletherapy is a term that refers to counseling services that are provided via the internet or phone. It means you use a computer or phone to have meetings and speak with a therapist--you being in one place (e.g., your home) and your therapist another. You may have only recently begun to hear about this practice due to COVID-19, but it has existed since the 1990’s. We’ll get into much more detail about what the remote therapy process entails in upcoming posts.

Who uses teletherapy?

In the past, the teletherapy option has been aimed at particular demographics such as people who have limited access to services, lack of transportation, or mobility issues. More recently, in response to the necessary transition to remote services due to coronavirus, teletherapy has demonstrated that it can be used by virtually anyone. Most insurance providers will cover telehealth visits. In light of the pandemic health crisis, insurance companies have temporarily modified certain policies to make it easier and more affordable to receive telehealth services. It is always a good idea to call and double check with your plan.

Why might you use teletherapy?

You may have noticed how online / telephone therapy has become an unusually hot topic due to the public health crisis. The uptick makes sense as the quarantine has forced many in-person services to shut down, or be delivered remotely when possible. What this means for you is that if you were previously in therapy, it doesn’t have to end. You now have the option to transition to teletherapy. Similarly, whether you’ve simply been wanting to try therapy for a while, or the pandemic situation has caused extra stress, teletherapy is a convenient outlet for immediate emotional support.

 

Have you done therapy using video or phone? What did you think of it? Share your story below.

 

Keep a lookout for our next post in which we’ll outline practical ways to help you prepare for teletherapy sessions.

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Online Counseling: The Future of Therapy?

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https://bit.ly/2OLYksI

https://bit.ly/2OLYksI

Thanks to the internet and its infinite apps, we’re able to gratify almost any need in an instant. So much of our day-to-day has become on-demand and platform-based. Curious about someone? Facebook. Hunting for a job? LinkedIn. Need a ride? Uber. Want a date? Tinder. Hungry? Seamless.

But what if you’re looking for therapy?

Telepsychology aims to make counseling easy to access. It simplifies and speeds up the process of finding a therapist. No more going to an office for a weekly appointment. For most platforms, it comes down to a quick sign-up, survey, live chat evaluation, and then via an algorithm, voila! You’re matched with a counselor. Sounds streamlined enough, but inevitably it’s more complex than that. For starters, which platform to choose?

Telepsychology Options At A Glance

Within the past several years, telemedicine has brought with it a wave of new online counseling platforms. These platforms offer a variety of modality options: video conferencing, live chat, audio, and texting. Some charge per session, others offer monthly subscriptions, with varying eligibility for insurance reimbursement. The table below offers a side by side comparison of the most popular recent online counseling services.

 
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Note: The Wirecutter, a New York Times product review company, recently published several informative articles about online counseling [see below for links]. Their team tried several of these services, ultimately choosing AmWell and DrOnDemand as their top two picks. Preliminary research has indicated that video is the preferred modality, likely because it gets as close to an in-person therapeutic interaction as technology allows.

Benefits and Risks

As with any new tool, online counseling comes with a host of positives and negatives.

Pros

  • Highly flexible

  • Eliminates barriers to treatment - ideal for clients who are highly anxious, homebound, disabled, dealing with PTSD e.g. veterans, or living in rural areas

  • Normalizes mental health treatment and decreases stigma 

  • Serves as a great introduction to therapy on the road to longer-term treatment

Cons

  • Hinges on accessibility to / reliability of technology

  • Introduces legal issues (clinicians are geographically bound by their license to practice in a certain state)

  • Brings up ethical issues (client privacy, limitations with crisis intervention)

  • Limitations of technology with regard to establishing an authentic connection

  • May not be ideal for high-risk cases or clients dealing with serious diagnoses

  • Can be more financially driven than care driven - companies compromise services provided to clients, and fail to support / protect clinicians

  • Are often launched by people who come from a tech background, not a mental health background; without enough clinicians on staff, team might not fully grasp the legalities and ethics of HIPAA compliance, geography-based practice limitations, etc.

Teletherapy has already showcased its potential to normalize mental health treatment and to maximize client access to these services. At the same time, its pitfalls are not insignificant and affect both clients and clinicians. For clients in crisis or dealing with severe diagnoses, the digital interface may not provide sufficient support. Depending on the platform, clients are not always required to provide identifying information, making proper crisis intervention very difficult for a therapist to carry out. In this vein, client privacy is an ongoing concern. Platforms are usually HIPAA compliant, text is SSL encrypted, but therapist access to client records and a client’s right to remain entirely anonymous remain gray areas.

Additionally, technology in general creates a certain barrier that may compromise an authentic therapeutic connection. Imagine being in the middle of an intense, emotional video chat with your therapist and all of a sudden the screen freezes or the WiFi cuts out. It’s a tall order to replace the in-person therapeutic relationship; online counseling is doing its best despite the restraints of technology.

The Takeaway on Teletherapy

Therapy doesn’t need to cling to the couch or fear the smartphone’s influence. Mental health treatment has to be able to evolve with the culture. At the same time, online therapy services shouldn’t compromise quality of care, or legal and ethical standards of the field. Teletherapy companies are a delicate combination of revenue-driven business and nuanced, human service. In online counseling's ideal form, protecting practitioners, supporting clients, and honoring the therapeutic process should always come first.

How do you feel about online therapy?

Would you try it? Have you tried it?

Is it the future or just too strange?

Share your thoughts and experiences with us! We’d love to hear from you. 

Leave a comment below.

More Links About Online Counseling

 

 

 

 

 

 

 

 

Everyone has a story. Let us help you find yours.