Since the COVID-19 pandemic began, technology has played a more significant role in mental health counseling. Counselors can use their professional skills and apply them in a virtual environment. Teletherapy can be flexible and convenient and reach people who might not otherwise engage in counseling. However, this model has some drawbacks as not everyone can access online services.
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While it is possible to do teletherapy by email or phone, the current practice typically uses video chat. Digital technology can provide virtual therapy sessions using webcams and dedicated software. Counselors can use these sessions to deliver a diagnosis, mental health care, counseling and support. Video sessions are similar to in-person sessions; the counselor asks questions and takes notes, and the patient and counselor can see each other.
During the pandemic, the safety precautions and restrictions caused most counselors’ in-person interactions with clients to come to an abrupt stop. To continue treating clients, many counselors started using teletherapy even if they had not used it before. A system built around in-person therapy shifted to almost exclusively online. In 2020, research showed that nearly all treatment was being conducted online. After the pandemic, online therapy continued to be used more widely. The nature of counseling changed with the implementation of teletherapy. The role of technology in therapy has increased with various therapeutic technologies being incorporated into practice. There are challenges and concerns when integrating technology with counseling, and these must be identified to ensure service is as beneficial as possible.
Technology has enhanced the delivery of counseling in many ways and made it more accessible to many people. This can include people who are housebound, disabled, chronically ill and those who live in remote areas. Clients with chronic illnesses experiencing a flare-up may have had to cancel in-person appointments but feel able to join an online session from the comfort of their homes.
Individuals can join support groups that may not be available in their local vicinity. People who live in rural areas may have no access to mental health treatment because there are few or no mental health practices in their area. Teletherapy can provide therapy and remove the need for significant time spent on long journeys.
Virtual appointments can be arranged outside of regular working hours, and people engaging in text therapy can message their counselor anytime, without waiting for the next session. Online meetings can be attended from anywhere, such as during a lunchtime break at the office or home. This can benefit those with social anxiety or who struggle to attend face-to-face sessions. Online therapy can be a first step for people apprehensive about using these services. Technology means that counseling is available to more people; reliable internet services are more widely obtainable.
There are many benefits to online therapy, but there are also concerns and challenges. Some people may not take to online services and may be more comfortable with face-to-face meetings. For teletherapy sessions, the client and the therapist need reliable access to the Internet or WiFi and a digital device, such as a tablet, computer, laptop or smartphone. Some people do not have a device or the internet. People who are often underserved by the mental health care system are the least likely to be digitally literate. Older people may struggle to use virtual platforms even if they have quality internet access.
Teletherapy would not be suitable for people with serious addictions or psychiatric illnesses, although it could be used in conjunction with in-person meetings. Online therapy would not be used for more complex situations as they would require immediate and direct treatment.
It can be more challenging for counselors to read body language when working in an online environment. During in-person meetings, counselors use their skills to interpret their patient’s non-verbal cues. This can still be done with online therapy but in a different way. Counselors pay more attention to the client’s face, eye movement, playing with hair, pausing when speaking and word choice.
Some counselors feel their online sessions with clients are more equitable than the clients coming to their offices. It puts both participants in the same position, entering an online platform, and some clients seem more at ease with this situation.
Overall, research indicates that teletherapy works as well as traditional in-person therapy in several situations. An example of a research study on teletherapy was conducted by Acierno et al. (2014). They studied the use of teletherapy with veterans enduring post-traumatic stress disorder (PTSD). One hundred and thirty-two veterans were asked to measure their PTSD on a scale and then were put into two groups, with one group having teletherapy and the other in-person therapy for 10 to 12 sessions. Three months later and then at six months, the veterans were asked to measure their PTSD on a scale. At both points, the teletherapy group showed similar improvements to the in-person group. They found a reduced burden on those patients regarding travel time, travel cost, lost work and stigma without loss of efficacy. They concluded that teletherapy delivered straight to the patient’s home could significantly increase the reach of therapy without losing effectiveness.
The pandemic meant that most in-person therapy had to stop, and counselors had to use teletherapy to continue seeing their clients. After the pandemic, teletherapy continued to be part of counseling practice. Research has found virtual counseling, in many situations, to be as effective as in-person counseling. Despite some drawbacks, online therapy has many benefits, and it seems that it will continue to play a part in counseling practice.