The Benefits (and Drawbacks) of Virtual Therapy

By: Dr. Denise Renye

For people who are interested in therapy right now, or maintaining contact with a current provider (psychologist, therapist, psychoanalyst, coach, mentor, teacher or indigenous healer) video and phone are valid options. It’s different than in-person, that’s true, but it can still be effective. In fact, several studies have found online treatment is just as effective as face-to-face treatment for depression, panic disorder, social anxiety disorder, and generalized anxiety disorder. If you’re worried about whether online therapy is effective, science at least says it is. 

I won’t say virtual therapy is more effective than in person therapy because every person and every relationship is different, but therapeutic alliance can still be established from a distance. If a person is introverted, or lives far away, or has physical challenges that make in-person visits more difficult (like being under quarantine!), virtual visits can even be a boon.

What’s interesting about virtual visits is because sessions most likely take place in a person’s home, it offers the possibility to gain new insight about a client. I can see what’s important to them, their taste, and whether or not they choose to use a Zoom virtual background. I may meet their cat or see their child walk by. I can witness an interaction with their roommate or partner and that can shed new light on the relationship dynamic. Family members become three-dimensional rather than just figures on a verbal storyboard. Virtual visits are offering intimacy in way that in-person office visits do not. And it’s not only one-sided – folks I work with are getting to see more of my humanity as well. They are seeing my home, my taste, and what matters to me too. We are connecting in different ways now and there’s a shared reality that didn’t exist before – we are all living through a global pandemic and psychotherapists aren’t immune to its effects.

Some of those effects? Almost half of adults in the U.S. reported that stress from the pandemic negatively impacted their mental health, according to a Kaiser Family Foundation poll. Also, the Journal of the American Medical Association said social isolation, economic stress, and other factors stemming from the crisis may increase suicide risk. Now more than ever is a great time to see a psychologist. And the great thing is, you can!

A good portion of my work has always been online, such as work with international clients and students, leadership development, and executive coaching clients through my industrial organizational psychology work. However, these days I’m finding that much more of the work I do can be conducted online.  I’m still able to speak with clients, witness their experiences, work through elements of symbolism and metaphor, and guide them to deepen their experience of their own internal landscape. I continue to offer an invitation to them to deepen their relational experience with their internal landscape so that deeply engrained patterns can be explored and they can be supported in long-term change. I still meet clients where they are emotionally speaking, so that hasn’t changed. We just don’t meet where either of us are physically. At the same time, there’s also a special connection, an energy to meeting in person, that cannot be replicated over the phone or computer. I don’t want to gloss over that, because it’s real. There’s a reason why my practice pre-pandemic included in-person visits, but there’s also a reason I included virtual visits.

Some of the reasons for including virtual visits include flexibility in scheduling, as well as the ability to speak with someone out of the country, or out of state. Virtual visits are convenient, and result in fewer cancellations than face-to-face settings, they save commute time, they eliminate fears of running into someone you know in the waiting room (although when you did, I very much looked forward to hearing how that was for you), and like I’m seeing with this pandemic, can enhance vulnerability and disclosure.

And let’s be real here, while it’s possible to continue meeting in person six feet apart and wearing a mask, that’s way less effective than meeting over a computer screen where we can see each other’s full faces. A mask hides too much of the face to read facial expressions – to know whether a person is smiling or frowning, etc. And that goes both ways – my clients won’t be able to read the expressions on my face either. And because the work that I do is trauma-informed therapy, facial expressions and nonverbal cues are important for effective, compassionate treatment.

Until it’s safer to be together in person, I’ll be continuing to practice my indoor work online and on the telephone, and for now at least, it’s working. If you’re nervous about meeting online, I understand, and that, too is something we can talk about.

 References

Charnock, Matt. “Therapy Is a Whole New Level of Personal These Days.” The Bold Italic. May 4, 2020. https://thebolditalic.com/therapy-is-a-whole-new-level-of-personal-these-days-d60deb652ba4

Kirzinger, Ashley; Kearney, Audrey; Hamel, Liz; Brodie, Mollyann. “KFF Health Tracking Poll - Early April 2020: The Impact Of Coronavirus On Life In America.” Kaiser Family Foundation. April 2, 2020. https://www.kff.org/coronavirus-covid-19/report/kff-health-tracking-poll-early-april-2020/

Morin, Amy. “Does Online Therapy Work? Here's What Science Says.” Inc.com. July 17, 2019. https://www.inc.com/amy-morin/does-online-therapy-work-heres-what-science-says.html

Reger, Mark; Stanley, Ian H.; Joiner, Thomas E. “Suicide Mortality and Coronavirus Disease 2019: A Perfect Storm?” JAMA Psychiatry. April 10, 2020. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764584

Stringer, Melissa. “Confessions of a Virtual Therapist: Pros and Cons of Online Therapy.” Good Therapy. Accessed March 26, 2020. https://www.goodtherapy.org/for-professionals/software-technology/telehealth/article/confessions-of-a-virtual-therapist-pros-and-cons-of-online-therapy