Online Psychotherapy: Pros, Cons and Effectiveness
On March 12, 2020, a seismic shift in the world took hold. A global pandemic, the likes of which has not been seen in over 100 years gripped the global community and necessitated immediate adaptation to keep some measure of continuity in daily life, commerce and government. Psychotherapy as a field was no exception; therapists across the country began conducting sessions online to maintain treatment consistency as best they could. “Zoom” became a household word.
Today, seeing your therapist online is considered in some areas, routine. But now that the dangers of the pandemic have been attenuated, does an online therapy treatment work as well as one conducted in person? Which is right for you?
Advantages
Convenience
It’s safe to say that cutting down on commuting time to get to your therapist’s office is a notable advantage, given that “not having the time” is one striking reason against seeking therapy in the first place. Being able to have a therapy session at home, or in a private place at the office or on the road somewhere guarantees the trip to the therapist will be blissfully short. For those with small children, those who are dedicated work from home employees and those far from the therapist’s office, this is an attractive option.
Accessibility
Having your therapist available online creates a degree of accessibility that an in-person treatment does not provide. If one is too sick to leave home, but still desires/needs a session, the therapist is available (of course, before there was Zoom, there were phone sessions. Yet many will attest that seeing one’s face is preferable.). This accessibility may be preferable to those with physical limitations or medical conditions that interfere with mobility. Online treatments can also fill in the void in so-called “therapy deserts,” remote areas where there is little to no access to mental health services.
Immediacy
Online therapy can address immediate issues that come up, issues that are easily discussed and accessed by the patient, such as panic attacks or generalized anxiety disorder.
Affordability
Many states now require that behavioral health coverage be extended to online services. Not all do, however, so one should check with one’s provider. That being said, therapists practicing exclusively online may have fewer overhead costs and may be open to providing lower-cost treatment options where insurance does not provide coverage.
Disadvantages
Lack of Coverage
Not all insurers will cover online therapy; thus, the cost will be transferred to the patient and may be less affordable.
Privacy concerns
Having the ability to conduct therapy in theory “anywhere” has its pitfalls, namely that privacy may be at a premium. The office may not provide a quiet space; the children may not respect Mom or Dad’s “special” time, and having therapy at Starbucks could create some real privacy violations.
Reliance on Technology
Unstable or unreliable technology can disrupt one’s therapy session to the point where the disruption becomes the main focus and diverts attention for both therapist and patient in an intrusive and unhelpful way.
Lack of Therapeutic Intimacy
Being in the presence of the therapist provides a healing intimacy that is not readily attainable online. The act of going to the therapist’s office can be therapeutic. Reserving time each week (or some other frequency) with consistency in a specific place elevates the experience and emphasizes that this is protected, dedicated time directed towards bettering your mental health and wellness.
Limited Communication
Many issues that patients want to address in therapy are long-standing maladaptive patterns that are not easily accessed. Thus, the therapist will rely on non-verbal cues and body language to help the patient talk about painful memories, self-destructive patterns and dysfunctional coping styles. This type of non-verbal communication is very limited in online treatment. Therefore, patients looking to come to terms with pervasive interpersonal problems, or those resulting from complex trauma might benefit from an in-person therapy over an online treatment.
Geographical Limits
In theory, an online practice can be conducted anywhere, but there are legal and ethical constraints to be considered. States require that a therapist must be licensed in the state where the patient is located; only in special circumstances can therapists practice across state lines.
Effectiveness
Online therapy can be effective for some specific concerns, like panic attacks, generalized anxiety disorder and mild to moderate symptoms of depression. In short, any issue that is contained and readily discussed can be effectively treated. However, a more severe psychiatric illness, suicidal risk, complex trauma or conditions including long-standing maladaptive personality patterns may not respond as well as they could in an in-person setting.
Online therapy could be an appropriate choice for you but it is best to do one’s research and ask questions before making the decision to pursue online therapy options.