It wasn't until 2018 that I even realized that teletherapy was becoming a thing. I was late to the party. And even with that being 2 years ago, there are some that are still a little cautious about what it is and what it means. Here's my perspective of what you should know about it, what I like and dislike, and some tips on making your teletherapy productive.
What is teletherapy?
Teletherapy aka online therapy or e-therapy is receiving your therapy online rather than in-person. There are many platforms (TalkSpace, BetterHelp, Ginger, etc.) as well as individual therapists like myself that provide services via video, phone, text, and email. But like any other therapy practice, every therapist even on these bigger platforms may practice therapy and conduct their systems differently.
During my conversations with potential clients, many have asked me, "But does it work?" Short answer, it can. Longer answer, therapy in general is not guaranteed "to work". But studies have shown that therapy online can yield similar or better results than in-person therapy. I hate when people just say that "they" say something. Maybe I have trust issues lol. So here are a couple studies about it in case you're like, "I don't know this woman":
I've also been on the client side of teletherapy and so I understand that, just like not all clients are a good fit for teletherapy, not all therapists are either. Of course there are trainings for how to provide teletherapy and I would say that the biggest part of teletherapy is continuing to maintain active listening and a therapeutic relationship. Some therapists can struggle with this through this format so make sure that you feel heard and connected with your therapist despite the format. With therapy, the relationship is the most important part.
Some of my personal thoughts about teletherapy:
There are some things that I enjoy about online therapy and some things that get a bit frustrating. Here are my thoughts on the pros and cons.
Kick off my shoes and relax my feet!
I love that I don't have to go anywhere to get therapy! I have done therapy at work, in my apartment, or even at a park (it was early and no one was around). I can be in my comfortable space and not have to worry about travel time, travel expenses, taking time away from other responsibilities beyond that period, and even just being in a comfortable space.
For some of my clients, it's also meant not having to find a babysitter. Their kids can be in the living room playing while they're meeting with me in the bedroom (as long you deem it safe). Or I've met with clients while their kids are asleep. I've even been able to send my therapist a message with no one being the wiser. And this also means that I can wear whatever I please when I meet with my therapist. Since I also offer early morning times, I've seen clients as they just open their eyes and are literally still in bed, putting on makeup as they get ready for work, or cooking their meal. Some have even used their time to actively work on their goals (exercise, cleaning, etc) while meeting with me.
I have a number of specialties but being able to meet with couples that don't have to worry about meeting in my office or people that struggle with anxiety and all of the triggers that may come with meeting me in-person has allowed them to remain consistent with their mental health. Even with illness, you don't have to worry about being in a space where others might get you sick or leaving your house sick.
The convenience is awesome!
Oh!... You got money!
Let me state that this is not the case across the board nor do I recommend it for all therapists but there are times when going the teletherapy route can save you money beyond childcare, time, and travel. Because I work from home, my overhead is lower than if I met people in-person. When I say overhead I mean renting a space, paying for the electricity so we can see one another, potentially receptionist costs, etc. I have lower rates than many people with similar expertise due to this not being as high as if I were renting a space. However, if you are seeing a therapist who also does in-person practice, you may not see this savings.
You get a therapist! You get a therapist! EVERYBODY GETS A THERAPIST!
Not everyone has access to a therapist in their area. Or some people live in small areas where you grew up and feel WAY too close to the local therapist. Sometimes it's the opposite and the therapist in your area is not someone you feel connected to at all. Teletherapy provides an opportunity for you to find a therapist that may not live anywhere near you! I personally live in New York City but since I'm licensed in California, all of my clients live there. But even if I still lived in the Bay, a client in Humboldt, Vernon, Fresno, or San Diego could still meet with me!
Therapists can't just go rogue.
With that being said, therapists still need to be licensed in the state where you are located to legally provide you therapy. Just because they are online doesn't mean that you have access to the entire teletherapy community. This part can be frustrating for some clients if they are not aware of these limitations. This also means that they should be following additional law and ethic practices that they would if they were in-person including HIPAA secure software and confidentiality.
This is not the Psychic Friends Network.
Non-verbals can be very important. Knowing that your therapist won't see all of your nonverbal cues especially if you're not receiving video sessions may create some gaps in your treatment. If you have a history of struggling with an eating disorder but your specialist can't see your body, they may miss some things you may not be sharing or not aware of. Although I'm pretty good at reading my client's facial expressions and vocal cues, I may not see the client shaking their leg or fidgeting off screen that may show clues of feeling uncomfortable or anxiety. Keep in mind that no therapist is a mind reader but there are obvious things that teletherapists may not be able to see.
The internet is sketch sometimes.
I love the internet. It has made it possible in finding out what's happening on the other side of the world. It has made it where people are able to create support and advocate even with those not around them. Shoot, full disclosure, it's how I met my husband! But I remember the times when we used to have to wait for our family to get off the phone so we could plug in the computer, log on to hear the automated random (at least to my young ears) noise of the internet connecting, and find out we got mail. Don't even think about logging into the internet from a device you could carry in your pocket!
With all that being said, the internet can act up sometimes. It glitches and lags and that can be a hiccup when you're talking to your therapist. It can also mean that you have to make sure everything is charged. I've had a number of sessions where I sat looking at a blank screen while my client found their charger because their phone died. And sometimes there are outages. None of that is fun. And just like there are challenges with in-person therapy, there are challenges on occasion with teletherapy.
It's not one size fits all kind of therapy.
As I mentioned, teletherapy isn't for all clients as it's not for all therapists. If you're not tech savvy and technology generally stresses you out, you may want to pass on this. In addition, I personally don't recommend starting this type of therapy if you're already in crisis, having concerns about self harm, or concerned about hurting others. In that case, I recommend either finding an in-person therapist so if things happened to escalate during the session for you, they may provide more of a hands-on approach or contacting local emergency services. Calling 911 is also okay if you feel you need immediate help. And a few other contacts I'd recommend are:
National Domestic Violence Hotline:
1- 800-799-7233
National Suicide Prevention Lifeline:
1-800-273-TALK (8255)
Crisis Text Line:
Text "DESERVE" TO 741-741
Self-Harm Hotline:
1-800-DONT CUT
(1-800-366-8288)
Tips for teletherapy:
I do not promote blind optimism in general. That's just not how I live and not how I practice. I think of myself as very much a realist. And with that being said, I know that I love teletherapy overall, even with it's faults. (Because that's love anyway, right?!) But here are some tips if you're considering giving it a chance.
Set up a phone consultation with the therapist to discuss how they run their practice.
Ask them about their systems being HIPAA secure (they cannot say that their system is HIPAA compliant because that's also based on the provider following certain rules but they can ensure that it's secure).
Connect your computer directly with an ethernet cable rather than using wi-fi to decrease interruptions or lagging.
Test out going to the link for video sessions and making sure any software needed is downloaded before your session so you're not wasting your time and money (the clock starts at your appointment time, not the time you show up).
Make sure devices are charged.
Ask your therapist what happens if you get disconnected.
Find a space that is quiet and private for your sessions. Your therapist should ensure that on their side as well.
Therapy works best if you're not under the influence of unnecessary substances or don't have additional distractions. Driving is not recommended.
If you would like to hear about my services in particular, feel free to look through my website and contact me at therapy@marcellejcraiglmft.com to set up a consultation.
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