What is it?
Put simply, teletherapy is the same thing as in-person therapy, except it’s accessed remotely. Psychology.com provides a more robust definition: “Teletherapy offers treatment provided by a licensed and certified therapist through a secure audio or video connection. Patients can interact with their therapists the same way they do during in-person sessions, just from a distance” (2022). It can come in many forms, but generally teletherapy is offered either over a phone or video call, and it can be conducted through private practices with multiple providers or by individual licensed therapists who run their own practice. Teletherapy is often seen as a more easily accessible form of therapy, as it can reduce normal barriers to entry, such as distance, time of day offered, or cost, to name just a few examples.
Evolution since 2020
CW: brief, nondescript mentions of COVID-19 pandemic
Before 2020 and the COVID-19 pandemic, the vast majority of providers didn’t offer any virtual therapy services. Since then, however, there is no shortage of teletherapy options available; finding an online provider is as easy as navigating to the “online therapy” tab on Psychology Today (or similar features on similar websites) and taking your pick of the many hundreds available. In fact, “A recent survey of mental health professionals conducted by the American Psychological Association revealed that while prior to COVID-19, 63.6% of respondents did not offer virtual sessions at all, now that figure has dropped to 1.9%” (Wiederhold, 2020).
Something that struck me about this drastic shift was how quickly it happened the second that non-disabled or mentally ill people needed the service. That’s perhaps a bit of a oversimplification*, since there were obviously a lot of different factors at play at the time — providers, for one, weren’t physically able to practice in-person in many places during quarantine. However, it doesn’t escape me that, at the time, even people who didn’t previously struggle with mental health issues were experiencing elevated levels of stress, anxiety, and depression (among other symptoms) as a direct result of the pandemic. And when they needed therapy services and couldn’t access them, those services almost instantly became available. Yet, before then, it was rare to see, even though there are very obvious benefits for disabled and/or mentally ill individuals having access to therapy virtually — for example, it could be difficult or even impossible to get to an in-person therapy appointment with certain disabilities, or it could cause extreme stress to individuals with various anxiety disorders.
I don’t think this is anything anyone did on purpose, but I think it’s interesting to note. It reminds me of what some of our guest speakers have talked about when they mention the work the disabled community does that benefits everyone in ways they don’t necessarily recognize until they need it for themselves. And now that we’ve seen that teletherapy can be beneficial for anyone, even with reasons unrelated to disability — a lack of childcare or therapists that focus on helping individuals with certain social identities in your area, for example — it’s a practice that has stuck around.
*mistake in audio: said “simplification,” meant “oversimplification“
BetterHelp and similar services
CW: BetterHelp scam, selling personal and medical information
Unfortunately, some teletherapy services, such as those offered by BetterHelp and similar companies, discredit a lot of the good work other providers offer.
For those who are unfamiliar, BetterHelp is an online therapy service probably best known for its promotions by YouTube influencers, who have been paid for years to advertise BetterHelp’s extremely low prices compared to traditional therapy. Before 2020, I would say it’s relatively safe to assume that most people had only ever encountered the idea of teletherapy through these sponsored posts — I know I had. For me, BetterHelp was a revolutionary idea, and something that didn’t exist outside their app.
However, BetterHelp has been hit with controversy over the past few years. Namely, they have been accused of sharing private user information with websites like Facebook without consent, “despite BetterHelp’s privacy policy stating that user information would remain private and confidential” (Imran, 2023). They have since settled with the FTC for over $7.8 million (Imran, 2023). There have also been complaints of insufficient care, unprofessional therapists, sudden cancellations, inability to secure refunds, false charges, and more (Imran, 2023).
The problem with this, beyond the most obvious issues, is that it creates a lack of trust in teletherapy services in general. Many people turned to BetterHelp specifically because it used influencers that users trusted to promote the platform, taking advantage of the parasocial bond the creators had established with their viewers. And while many teletherapy services aren’t like this, this massive abuse of power has led to distrust of the service in general, which is unfortunate because of all the other benefits teletherapy presents.
For those who might be searching for teletherapy providers and questioning which teletherapy platforms to trust, I would encourage you to ensure the platform used for your appointments is HIPAA compliant (using a third party like Google, and not just the website itself).
Effectiveness compared to traditional in-person therapy
One of the most common questions people have about teletherapy is whether it’s as effective as traditional in-person therapy or not. While people tend to assume it isn’t, studies have actually found that there isn’t a significant difference between the results of in-person and virtual therapy. According to Wierderhold, “A recent large international study concluded that online cognitive-behavioral therapy is ‘effective, acceptable, and practical health care.’ The study found teletherapy to be effective for conditions including major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder. … Teletherapy is clearly an effective mode of treatment for many of the most common mental health conditions” (2020).
The question this leaves me with, however, is how effective teletherapy is for less common mental health disorders. It was unclear from my reading whether Wierderhold’s observation is a reflection of one of teletherapy’s weaknesses or a weakness of mental health services in general. Historically, many of these less common disorders have been highly stigmatized, and thus been left under-researched and under-treated; in contrast, we’ve done the most research for and thus best understand these more common disorders, so it makes sense to me that teletherapy, like in-person therapy, would be most effective at treating them.
Additionally, one of teletherapy’s major benefits is its accessibility. For those who would otherwise be unable to attend in-person therapy (whether due to physical limitations, such as lack of transport or a disability, or psychological, such as social anxiety or other mental health conditions), teletherapy can provide a viable alternative that actually allows them to receive the care they need. Additionally, while this isn’t true for every provider or patient, teletherapy can oftentimes be less expensive than in-person therapy (whether due to providers offering a lower cost of service for online appointments or cost of transportation, among other factors). There’s also something to be said about the comfort of being able to attend appointments from home, both for patient and provider. While not necessarily without its flaws (certain teletherapy platforms* can sometimes be difficult to navigate), teletherapy can offer a more accessible therapy option to many who otherwise would have difficulty receiving or be completely unable to receive that aid.
*mistake in audio: said “services,” meant “platforms“
Featured Image Source: https://www.medicalnewstoday.com/articles/many-psychiatry-patients-prefer-online-therapy
