Video chatting, text messaging, or using your mobile app of choice have become part of our day-to-day lexicon for communicating with friends and family in the 21st century.
But is click, tap, and chat entirely appropriate when it comes to psychotherapy?
Mental-health experts are still divided over whether online psychotherapy — where counselors hold sessions with their patients over the Web — is a legitimate way to diagnose and treat depression.
Proponents believe that it’s just as effective as traditional psychotherapy, if not more so. By offering patients a familiar, accessible way to connect with their therapist, online therapists can help ease them into counseling and get them to open up, particularly if they are reluctant to seek traditional mental health treatment.
Many therapists believe it aids them in better pinpointing, identifying, and treating certain depressive symptoms.
“Psychotherapy does not require that two people be in the same room as one another to experience benefits,” says Dr. Julie L. Futrell, a licensed clinical psychologist. “What is transformative about psychotherapy is the patient saying aloud anything and everything to the psychotherapist, who then listens for unconscious patterns and manifestations of which the patient is unaware. This can occur via teleconferencing or in-person.”
Bringing therapy into the Skype and Snapchat age may also be a boon for people in rural or isolated areas far from a therapist’s office. Rather than abandon therapy, they can take advantage of a remote alternative: Just log in and the doctor is in.
Carolyn Wagner, a licensed professional counselor who specializes in treating postpartum depression, says there’s a rapport and connection that’s easier to maintain online that can’t often be cultivated in person.
“Pregnant and postpartum moms are some of the people who can benefit most from online psychotherapy,” Wagner says. “High-risk pregnancies come with a great deal of stress and anxiety, and women experiencing one could benefit greatly from therapy. However, these pregnancies also often require bedrest or prolonged hospital stays, which means they can't get to my office easily or safely. Online psychotherapy is perfect in these situations.”
But skeptics aren’t entirely convinced. Online therapy is not appropriate for all conditions and all patients – particularly those who are suicidal, they say.
Psychiatrist and author Carole Lieberman says that online therapy removes the much-needed urgency for treating clients in crisis mode; a liability, she believes, that’s too risky to take.
“Online psychotherapy is dangerous, especially for depression, which sometimes results in suicide,” Lieberman says. “Therapy works because of the one-on-one relationship that the patient develops with a compassionate, knowledgeable therapist. It is the human interaction that is key, not a human-to-‘Siri’ type relationship that can only be available when the therapist – albeit a live therapist – is inside your smartphone.”
Plus, there’s a potential anonymity factor. Momentum may stall, clients may lose interest in their progress, and sessions may fizzle out without a real, personal connection that many people crave in a therapist.
Larkr is a mental healthcare app designed to address these shortcomings and take advantage of the anytime-anywhere advantage of online therapy.
“Many of the most prevalent mental health challenges faced in America today can’t wait,” says Larkr’s co-founder and CEO, Shawn Kernes.
“If you’re someone suffering from impulse issues or panic attacks at 3 o’clock in the morning, there are issues you can’t wait weeks for,” he says. “It’s a big part of why we’re designing our marketplace to be more on demand.”
Kernes adds that any mental health professional who uses Larkr must be licensed and must comply with HIPAA rules.
Still, Kernes notes that e-therapy was never designed to replace a live, in-person dynamic.
“By no means are we saying we want to do away with traditional therapy,” he says.
Online therapy may work best as a supplement or temporary replacement to live therapy. It may also particularly well suited for use as a preliminary diagnostic tool to help determine if a patient needs therapy, and to what degree.
It may be most appropriate for individuals who don’t need an in-person connection, but not for others, like those with serious psychoses, or requiring more hands-on attention or medication.
The agoraphobic afraid to venture outside, for instance, may find mobile therapy helpful until it becomes comfortable enough to leave home and meet a therapist in person.
Even so, many questions still surround the use of online therapy. What about tracking efficacy, maintaining legal compliance and setting standards?
Still, With few concrete regulatory measures in place yet, it might burden patients, and to an extent, lawmakers, in gauging the success of online therapy — in ways comparable to early online M.D. consultations, which have become increasingly common in recent years.
Currently, the American Psychological Association has a brief telepsychology guideline on the books. The American Counseling Association also took to updating its code of ethics on distance to reflect legalities and issues of confidentiality protection, according to Dr. David Kaplan, the ACA’s chief professional officer.
“Our position is that you can use any electronic means for communicating with clients as you wish, as long as whatever you do is within the code of ethics,” Kaplan tells Newsmax Health.
In light of the many grey areas, pros, and cons of online therapy, what’s the take-home message for patients considering it?
Use your discretion and best judgment when entering an online therapy relationship, Kaplan advises. It may be ideal for some, and not for others.
“What to say to someone who’s skeptical [about online therapy] is: don’t do it. You don’t have to,” he says. “But you don’t have to tell other people not to do it, either.”
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