By Deborah Jeanne Sergeant
For patients in need of mental health help, assistance may be as close as their smartphone.
According to a recent report from Behavioral Health Workforce Research Center in Michigan, nearly half of providers in 2018 offered telehealth at least part of the time in 2018, favoring direct videoconferencing over phone calls or email.
So why go online instead of in person?
Erin Sweeney, licensed clinical social worker at Quiet Mind Therapy Services in Rochester, has offered remote sessions. She feels doing so definitely increases access for many patients. “It’s helpful for individuals who are sick, have childcare issues or transportation issues. With bad weather, this is helpful and convenient for both the provider and the client,” she said.
A few clients who have seen her in person did not think they would care for a telehealth session; however, once they tried it, they liked it much more than they thought they would.
If a client is traveling or lives in the South during the winter, they can keep up their sessions and not lose any progress they’ve made.
Of course, HIPAA law requires confidentiality about health matters. That’s why Sweeney uses the Doxy.me app, which is HIPAA-approved and easy to use. The app sends clients a link. Clients don’t have to download anything. They log onto the portal with a smartphone, desktop or tablet and it connects to Sweeney in seconds.
Mark Fischer, licensed marriage and family therapist at Rochester Counseling in Rochester, said telehealth decreases the barrier of entry for people. “Going to therapy can be anxiety-inducing for some and if they already have anxiety, that could worsen it.”
Some people feel stigmatized for seeking therapy; however, obtaining care remotely increases their privacy, Fisher said.
Geographic barriers hamper some as well. Living a two-hour’s drive or more round-trip from the nearest therapist (or the therapist covered by their health insurance) can make it very difficult to seek help while working and caring for family members.
It may also help people who have mobility issues that prevent them from easily leaving home.
Fischer said that remote sessions don’t always offer the same level of eye contact and interaction as those conducted in person. For example, people tend to look more at themselves instead of the other person when video chatting. It can also be more challenging to pick up on physical cues, such as body language, movement, grooming and clothing, that can help a therapist understand the client better.
“As therapists, we know that one of the biggest predictors of good outcome is the connection to the therapist,” Fischer said. “If a client feels you care about them in a real way, you’ll do better.”
Fischer prefers meeting clients first, though since he’s licensed to practice in New York, he can offer telehealth to anyone with permanent residency in New York.
Some clients may not be good candidates for telehealth. Those who eschew technology may not feel as well connected to the therapist. Some lack reliable high-speed internet connections.
With family or couple’s therapy, any delay in speech or movement is magnified since more people are involved.
“It’s so nuanced,” Fischer said. “One word said the wrong way when people are struggling can tank a session. If I miss that because of a delay in speech or movement, I can’t do my job as well. There’s still some ground to be made up.”