A record number of people seek advice on online therapy during the pandemic. But is virtual counseling as effective as face-to-face sessions and will it normalize the need for help?
Online Therapy - The Revolution?
The past year was marked by grim news. People around the world have had to deal with grief, economic collapse, unemployment, and loneliness. Much has been reported about the effects on our state of mind, with reports of rising anxiety disorders, alcoholism, depression, and deteriorating mental health. It's easy to ask yourself: is there any reason to be happy?
And yet a quiet, worldwide revolution in psychology has brewed. One that does not attract much attention, but changes the way we help people in psychological need.
In October 2020, the World Health Organization (WHO) reported that around 70 percent of countries have now introduced "teletherapy" - therapy sessions via video call - to overcome the interruptions in personal psychiatric care. For example, New York City-based mobile therapy company Talkspace has seen a 65 percent increase in demand for its services since the pandemic began.
In addition, researchers in the Netherlands report that the pandemic "has radically changed the way therapists deliver their treatments and has led to a sudden increase in online psychotherapy sessions". The American therapist Kristen Gygi puts it this way: "Everything that happens online has increased during the pandemic, including therapy."
In China, WeChat is mainly used for online psychological counseling services, as an article published in The Lancet in February 2020 shows. However, as the weekly medical journal reported in July, remote therapy also has its drawbacks: Owning the necessary technology and the cost of internet access and the volume of data means that digital therapy can be used for some of the most in need, such as the elderly, people with reading difficulties or those with low levels Income, may not be suitable.
The WHO also found significant differences in the use of online help: more than 80 percent of high-income countries reported using online therapy to fill gaps in personal psychiatric care, compared with less than half of countries with lower income.
While many countries (including Germany, France, Italy, the UK, and New Zealand) have been locked down since March 2020, remote therapy has become more accessible, available, and less stigmatized - great news for anyone struggling to cope with everyday life.
There was a time when it was considered strange to have a therapist. When I first went to therapy more than a decade ago, I kept my appointments a secret. It seemed selfish to me to pay for psychological help. But the negative connotations surrounding the therapy are quickly disappearing. The psychological damage that Covid-19 has wreaked has only accelerated it lately, placing mental health at the center of public discourse. This is the first time that many of us seek psychological help.
"The so-called stigma may be less present nowadays as our world is viewed as increasingly stressful," says Gygi. "We could see this as a kind of reverse peer pressure where it is suddenly more acceptable to be afraid because everyone has it." Louise Chunn, the founder of Welldoing, a service that provides therapists and clients, agrees: "Many working men come to therapy and have decided to use the lockdown to address long-standing problems. Couples do the same."
Dr. Carla Croft, who works for the UK's National Health Service (NHS), says that online therapy has many benefits for clients: "I now often meet people via video during their lunch break, in their car or in the restroom at the Work, and of course many works from home, giving them newfound privacy from colleagues and additional flexibility. This means that working people potentially have easier access to therapy. "
Dr. James Arkell, counseling psychologist at Nightingale Hospital in London, has since found that online therapy is particularly appealing to younger people, as they are familiar with messaging services and FaceTime and he can easily assess them via smartphone.
I work with an online therapist today, and that's exactly what I prefer. I feel more relaxed sitting on my own sofa, surrounded by the familiar smell of the faded pillows. According to Chunn, this is also known as "the disinhibition effect". "Even couples and trauma work have had success online," she says. "People open up more easily, freed from sometimes challenging journeys and crowded waiting rooms."
Several studies from around the world, including by the University of Leipzig and the US Northwestern University (both 2014), suggest that online therapy is just as effective for clients as face-to-face counseling, especially in the longer term. A recent study, published March 2020 in the Journal of Affective Disorders, focused on the differences in the quality of interactions between face-to-face and telephone psychotherapy. The result: there was hardly any in terms of the effectiveness of the therapeutic relationship, the openness of the clients, or the level of empathy, attention, and participation. The only real difference was that the phone sessions were generally shorter.
Online therapy also works for the therapists themselves in a way that was previously unthinkable. "Attitudes towards online therapy have changed completely," says Chunn. "The therapists have been rather skeptical in the past, but according to a survey that we carried out with our therapists in July, the majority like to use it and many find that it has given them additional insights into their clients."
Consulting clinical psychologists such as Dr. Croft also find that they can offer more sessions - welcome news for both therapists and treatment seekers who often end up on waiting lists. Dr. Arkell found that in some cases he can actually hear a more emotional tone of voice over the phone without the visual distractions, in other cases the home environment can provide further information to the therapist.
Online therapy can sometimes be cheaper than a face-to-face session. The fees of established therapists can be exorbitant and not all services, such as couples therapy or life counseling, are covered by health insurance. It is different in the virtual world: In Germany, some health insurance companies assume the entire costs for online therapy providers such as Mind Doc or even offer their own free online services, often in the form of courses. Meanwhile, Kumaar Bagrodia, founder of NeuroLeap, a Mumbai-based mental health tech company, says online sessions in India are available from as little as $ 7 per session. "It is always worth contacting a therapist to find out whether he/she offers a flexible price list (depending on income) or a special tariff for students or job seekers," advises Dr. Croft. "There is so much goodwill among psychologists during Covid-19, I think we all helped where we could."
Of course, some clients and therapists would prefer to be "in the room" and have the feeling that something is lost in the distance therapy, says Bagrodia: "Online therapy inevitably means a lack of physical connection. It can be difficult for therapists to identify the signals and body language of their clients For many clients, the act of going to therapy was in itself important. "
Some psychological difficulties are harder to spot online, especially if they have a condition with a psychotic element or a problem with body image. Dr. Arkell adds that poor WiFi can become a hindrance and people with marital problems may have difficulty finding a safe room. But for others, it is a revelation to be able to receive teletherapy so easily. It could be the answer for anyone in need of something to celebrate in 2021.
Rachel Kelly is a British writer, mental health advocate, and author of Singing in the Rain: 52 Practical Steps to Happiness (Short Books Ltd, 2019)