01 May 2020 By: Natalya Bucuy
Benefits of TeletherapyEven before the pandemic, some behavioural health professionals implemented teletherapy in addition to the traditional face-to-face sessions. A 2017 study highlighted the convenience of remote therapy in various settings and the reduction of the cost of care. The study concluded teletherapy to be a promising alternative and a supplement to traditional care.
[U]sing telemental health care for psychotherapy and other mental services improves patient satisfaction and reduces the costs of care. While being comparable to in-person services, telemental health care is particularly advantageous and inexpensive through the use of current technologies and adaptable designs, especially in isolated communities. (Telemental Health Care, [...]: a Systematic Review)Diane Franz, PhD, Pediatric Psychologist at Children’s Hospital New Orleans, cites a number of benefits of teletherapy. Some of these include the ability to see multiple family members in different locations in a same virtual session, ability to see families in their natural environment, and the ability to share written information.
Some people actually find visits via telemedicine less stigmatising and less intimidating, possibly because many people already use similar applications to talk to friends and family members. For some who might find it hard to take the steps to schedule a visit, arrange transportation and get to the physical office, this is easier and less daunting. (Franz)In 2020, most people are self-isolating due to COVID-19 outbreak. As people find themselves in unprecedented reality of the quarantine, mental healthcare becomes more of a necessity than ever. Teletherapy then comes to the rescue by not only satisfying the increased need, but by also being the only option. Modern technologies, such as live chat, video conferencing, and instant messaging, aid teletherapy even further than telephone communications previously did.
Challenges of TeletherapyAs therapists and patients adjust to teletherapy, some challenges arise. Addressing them now will not only help smooth mental health sessions during the current situation, but also in the future. After all, if teletherapy works well, it might be here to stay even after the quarantine ends. A Wake Forest University School of Medicine study, Benefits and Challenges of Conducting Psychotherapy by Telephone, addresses benefits and challenges of teletherapy done through telephone. While since the time of the 2011 study additional technologies became available, the principles of phone communications still apply. The study presents the following challenges and solutions.
Lack of Control over the EnvironmentIn contrast with face-to-face communications, teletherapy does not allow therapists to control the environment to promote a certain atmosphere to aid the sessions. Additionally, controlling the conversation can prove to be more difficult during distanced sessions.The study sites the boundary establishment as a possible solution to the challenge. That means a therapist should set an expectation with the patient ahead of the session to promote similar practices as those during face-to-face interactions.
Privacy and ConfidentialityPatient privacy has always been of concern when it comes to medical care. The concerns become more acute in the age of technology. Exchanging private health information over digital mediums, such as live chat, make it more challenging to keep that information private. That is why federal laws, like HIPPA, provide guidelines for such interactions. Once again, establishing rules and discussing privacy ahead of the teletherapy session is a good rule. Just as in face-to-face sessions, psychotherapists and clients should fully discuss all planned services and complete a written contract to confirm their mutual agreement to the terms discussed. (Wake Forest University School of Medicine)
Development of Therapeutic AllianceNext, the study cites the establishment of a rapport or therapeutic alliance as an obstacle to successful treatment.Dr. Franz testifies to the validity of this claim from her own experience with teletherapy.
Some parts of therapy often consist of pauses and reflection, which is difficult to appreciate via telemedicine. It is sometimes difficult to see the subtle changes in facial expression that reflect mood changes, or changes in body language. For some, it is difficult to establish a connection via a computer. (Franz)Challenging for telephone communications, this important aspect of therapy might be even more difficult to achieve through mediums like live chat or instant messaging. Using video conferencing, when possible, could be a great alternative. Other solutions include discussing goals, minimizing distractions, upping empathy cues, and even adding more small talk to the sessions. (TheraPlatform)