Everything You Need To Know About Online Therapy and Counseling
Even before COVID-19 (otherwise known as coronavirus) began sweeping the United States online therapy was becoming popular. Access to a counselor, therapist, or other mental health professional can be difficult and speaking to someone online can bridge the gap.
However, not everyone feels comfortable with doing online video sessions for therapy. My practice is moving to online-only sessions for the foreseeable future. Here is everything I want my clients and potential clients to know about telemental health! Telehealth is also known as online therapy, virtual therapy, or video therapy.
Facts About Online Therapy
- Many insurance companies cover online therapy just like face to face therapy. Since quarantining and shelter-in-place have started in many states, some insurers are even waiving co-pays for clients!
- Counselors use HIPAA compliant, secure video. While some people might be more familiar FaceTime or Skype, there are secure video platforms that keep your protected health information safe.
- Once you try it, most people are surprised that it is not much different than in-person therapy. You can see and hear your therapist so you don’t miss out on things like facial expressions.
- You can do it from a computer, laptop, tablet, or phone. All you need is video and audio capability plus reliable internet or 4G/5G.
Online Therapy is as Effective as Face to Face Therapy
While it seems new, telehealth (virtual therapy) has actually been around for a while! The VA has been using mental health services through telehealth for veterans for almost 20 years. In some cases, online mental health services for depression and anxiety actually had better outcomes for clients than face to face services did!
Before the COVID-19 crisis, some reasons that people might chose video sessions over coming in to an office were things like:
- Lack of transportation.
- Rural location or long distance from a therapist’s office. No nearby therapist that takes their insurance.
- No childcare or caring for a sick or elderly loved one.
- Working full time and can’t leave work for long enough to attend a daytime session.
- Fear of people seeing car in the parking lot of a counseling office.
- Those with disabilities worried about accessibility.
- People feel more comfortable at home than they do going to an unfamiliar office.
While it might feel uncomfortable at first, most people who try online therapy report that they like it.
Drawbacks to Online Counseling
Like anything, there are risks and drawbacks to online counseling sessions. Some people do not have access to a private space. They might feel like others in the home can overhear them. Others may not have internet service at home or reliable cellular coverage due to rural area. Technical problems are the main drawback to doing video sessions online.
Ways To Find Privacy For Online Therapy During Quarantine
While we must be in close quarters with our loved ones during a shelter-in-place or self quarantine, that does not mean that we can’t find privacy for a 45-50 minute session. Many of us are working from home, kids are not in school, and that limits the alone time that we can have.
If your spouse or partner is home, ask them to watch the children while you have your session. Make sure that you are in a space where you feel comfortable physically and mentally. You want to get the most out of your session. Choose a room where you can be alone and shut the door to minimize distractions. Don’t be afraid to speak up to let your therapist know if you are having difficulty concentrating or do not feel emotionally safe.
Avoid noisy rooms where there is a lot of activity. It’s not advisable to do online therapy in a public place like a coffee shop or a park. If you are at work, be sure that you are someplace private like an office with a door that can be shut or in your car. It is better to reschedule your appointment to a time when you can be comfortable so that you can get the most out of your session. Remember, just like with face to face therapy this is your time and you should be getting out of it what you need.
“Always make decisions that prioritize your inner peace.”
A Word of Caution On “Unlimited” and Anonymous Online Counseling Services
I have noticed that many of my favorite YouTubers and Influencers talk about using services like BetterHelp or TalkSpace. These services are really appealing to people who don’t have insurance coverage and are afraid they can’t afford therapy. It is also less intimidating to talk to someone over text than it is to see a therapist, even over video. Many professionals question the safety and ethics behind these type of platforms. Remember that statistics about the effectiveness of online therapy do not include these type of platforms!
Amy Morin, a psychotherapist, tried these online platforms and wrote an article for Inc about her experience. Her opinion on them was not overwhelmingly positive. BetterHelp states in their terms of service that they are not providing mental health treatment and are not a substitute for therapy. Huh?!
If It Sounds Too Good To Be True Usually Is
TalkSpace, another popular online only mental health service came under fire in 2016 after a former therapist employed there filed a complaint that clients’ confidentiality was being violated. Although they have since taken steps to become HIPAA complaint it is important to note that all the text conversations you have with a therapist are logged and saved. While some clients like the continuity of not having to tell a new therapist everything when they switch, as a professional I feel logging everything a client says is unethical. You would probably feel uncomfortable if your therapist recorded all of your sessions but essentially that is what TalkSpace does.
I was also surprised to see what these platforms charge people! While being able to text a therapist 24/7 sounds good, you can see a therapist once a week for much less than $80+ a week. Grace Christian Counseling Center, a local nonprofit, sees clients without insurance on a sliding scale basis. Some clients pay as little as $10-$25 a session for a licensed therapist who does this as their main/only job. Many therapists use services BetterHelp or Talkspace as a “side hustle.” I am not sure I would want my sessions with a therapist to be their extra money side job. Remember that not all counselors are experienced in their field. Platforms like these might attract those who are inexperienced or under-educated.
In Mississippi, we offer services only to those in Mississippi because of restrictions on our licenses. Therapists and counselors here are licensed to practice within the state of Mississippi. Just like with doctors and other medical professionals each state has their own licensing board. For professionals here, we would likely be working in violation of our license if we worked with clients all around the United States. While this model might be appealing, be sure to know all the information before you sign up. While most professionals don’t offer 24/7 texting, most people don’t want or need that. You can likely have a video session with a therapist in your area for much less than what online only platforms charge! It is also nice to have the option to see someone face to face. If you see a therapist in your area for video sessions now, you can see them in person once COVID-19 restrictions have passed.
“People need people – for initial and for continued survival, for socialization, for the pursuit of satisfaction. No one – not the dying, not the outcast, not the mighty – transcends the need for human contact.”
– Irvin Yalom
Stacey Aldridge, LCSW
Stacey is a therapist in private practice and the owner of Inspired Happiness Therapy and Wellness in Ridgeland, MS. If you are in the state of Mississippi and are interested in seeing Stacey for therapy, please visit the Appointments page.
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