Clients are already overwhelmed with choice when looking for a therapist (options that were previously explored here, here, and here). Now, they have to decide whether they want to seek services in-person or through telehealth. What are the barriers to care that you experience and would telehealth eliminate those barriers? How can you know what to choose?
How much time out of your day can you set aside for a weekly appointment? Telehealth may be useful to you if you can fit an hour between a busy schedule, but can’t budget two hours (let’s say there’s a half hour drive to and from the office). What about childcare? Maybe you’re home with the baby and though they regularly nap, you aren’t be able to leave them while you go to the office, but can get a session in while you’re in the other room. Maybe your schedule is such that therapy occurs late at night or early in the morning when it would be quite inconvenient to travel. You may have a 45 minute lunch break—and no more. Therapy could happen via telehealth, but may have a more difficult time fitting into your lunch break if you have to travel to an office.
If you are in a small town, there is a good chance that there is a therapist within walking distance. However, if you are in an area that is more spread out, or if you are seeking out a therapist with a particular speciality, they may be further away than you are able to travel, especially if you don’t have a mode of transportation. Ultimately, telehealth maybe a lower cost option than in person therapy if you factor in the cost of transportation. Access to telehealth may also be cost prohibitive as an internet connection is often required, and if not, a telephonic connection.
Physical Ease of Access
Either with a broken foot or a lifelong disability, telehealth may be useful as it requires minimal physical exertion to attend session. Additionally, mental health issues like agoraphobia or social anxiety may keep you from attempting to begin therapy, and telehealth may mitigate symptomatic fears. (However, over the course of treatment, it may behoove the client to begin to seek care in-person in order to maintain progress).
Travel and Relocation
While therapists are only able to practice in states in which they are licensed, if a client is traveling or moves within that state (or to another state where their therapist holds a license), the client and therapist are able to continue their work together with minimal interruption.
What is lost?
While video can capture some nonverbal communication, it certainly does not maintain the full picture of the ways in which the body is communicating. There is a “je ne sais quoi” around in-person contact that cannot be reproduced online. There is a feeling in the room—sometimes tension— that is quite different. There is also the ritual of physically going to the office, which is a neutral territory. Neither the client nor therapist’s home. It may be a safer space for some to bare difficult truths. For others, being in the familiar may prove more fruitful.
For both therapists and clients, beginning treatment in-person or through telehealth is an individual decision to be weighed based on your specific needs. As with many things, there is no right answer. If you’d like to discuss tele-therapy options, feel free to contact me.