Mary Alvord, Ph.D., a Maryland psychologist who teaches telehealth to mental health professionals, Jay Shore, Ph.D., psychiatrist and director of telemedicine at the Helen and Arthur E. Johnson Depression Center at the University of Colorado Anschutz Medical Campus and Henderson offer these pros and cons for online therapy.
Benefits
Avoids mental health stigma. “For people who are concerned about stigma, especially if they live in a close-knit community, parking their car in front of a counseling center or therapy office can really invade their privacy,” says Henderson. “But online therapy is really discreet and can protect people’s privacy and confidentiality in a way that in-person (therapy) just can’t.”
Convenience and security. If you can’t travel safely in bad weather or can’t make time to travel to and from a mental health professional’s office, a virtual visit may be a good substitute.
Feeling of privacy. Dr. Shore says some patients may prefer their familiar home environment to an “artificial clinical environment.” Henderson echoes these sentiments. “In a way, video is more intimate than being in the same room, because we’re in each other’s space,” she says. “You may be in my office, but he’s at my house, so I feel like you’re at my house just like I am at yours. It really bridges a gap, instead of being on my turf when you walk into my office.
Similar results. In-person and video visits can potentially achieve similar results, according to Dr. Shore. Henderson agrees: “We’re seeing as much, if not more, improvement in online therapy settings. Apples to apples, in-person therapy or telehealth, there really is no difference between which is more effective.
Easier access. For people who live far from the nearest therapist’s office or counseling center, online therapy can be a readily available alternative.
Little to no wait time. A virtual appointment may start on time, while an in-office appointment may be delayed by paperwork and other bureaucratic hurdles.
The inconvenients
Non-verbal communication. A therapist may not pick up on a patient’s nonverbal cues during a virtual appointment. Dr. Alvord explains that a large portion of our communication is non-verbal. However, Henderson points out that the proximity of the camera lens during video dates can provide more visual communication through facial expressions than during an in-person date where greater physical distance exists between the therapist and client.
Limited effectiveness for some. Certain patients, such as certain children or people with autism spectrum disorders, may not respond well to virtual therapy, notes Dr. Alvord. Individuals with dementia or other cognitive issues may also not function well in virtual sessions without modifications, such as having a caregiver present with the patient, Dr. Shore says.
Technology. Some people’s homes may not be equipped with high-speed internet service, or the patient may not be comfortable with technology, making virtual therapy difficult or impossible to achieve.
Insurance cover. In some cases, your health insurance provider may cover an in-person therapy session, but not a virtual session. However, these policies are constantly evolving, particularly in light of the COVID-19 pandemic. Speak to an agent at your insurance company to confirm what your coverage currently includes.
