With an abundance of online therapy providers and programs today, anyone can find a treatment option that works for them. anyone can find a treatment option that works for them. Yet many are hesitant to try virtual counseling.
Teletherapy has been available for a long time, even before the 2020 pandemic forced many people to go into full work from home mode. But the COVID-19 pandemic greatly impacted the telehealth market. A 2021 study conducted by Ashley Bastini, PhD, an assistant professor at the Department of Counseling, Education Psychology and Research at the University of Memphis, found that “...overall, [...] in-person and virtual interventions produced similar outcomes.”
Even when we try new methodologies, we often don’t do it effectively because we use the same approaches that we applied to older techniques. Scientists call this behavior functional fixedness. When we learn one way of functioning, we tend to apply it to other settings, even when new ways of operating might better suit those different settings.
When you have a hammer, everything looks like a nail
Clients frequently bring their mindset from traditional therapy into teletherapy without considering the differences between the two. They often use cognitive biases to make their decisions. These mental blindspots impact how we make choices in all areas of life, including those about our own mental health.
Fortunately, recent research has shown that there are effective strategies to overcome these potentially harmful judgment errors. Armed with the knowledge of your own possible cognitive biases, you can learn to make the best decisions for yourself and hopefully, get the most out of your online therapy.
Trust the Science
Extensive research shows that, for most patients, online therapy has the same benefits as in-person counseling.
For instance, a 2014 study published in the Journal of Affective Disorders reported that online treatment was equally effective as face-to-face treatment for depression. The Journal of Psychological Disorders published a 2018 study that showed how online cognitive behavioral therapy was just as effective as in-person treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.
When the COVID-19 pandemic forced even the most solid in-person supporters to convert to teletherapy, psychologists worried that patients with serious mental health conditions would be less likely or able to convert to digital counseling. Yet research from Counselling Psychology Quarterly in 2020 found that those with severe mental illnesses such as schizophrenia, bipolar disorder, severe depression, PTSD, and even suicidal tendencies converted to teletherapy at about the same rate as those with less severe mental health challenges.
It’s important to note though that this form of psychological treatment is not suitable for everyone, even if the research tends to imply the opposite. For example, adolescents had the most varied response to teletherapy, according to a 2020 study in Family Process. Some teens adapted quickly and easily, while others found it awkward and anxiety-inducing.
Another 2020 study, this one in Volume 110, Part 2 of Child Abuse & Neglect, found that children who have experienced trauma don’t respond well to online therapy. Similarly, a research paper published in the Journal of Humanistic Psychology in 2020, found that online psychoanalysis may not be as effective for those suffering from loneliness, stating, “[w]here individualism and the loneliness epidemic are already having significant negative consequences, permanently replacing face-to-face counseling with teletherapy after these measures are over, would further contribute to our overwhelming isolation.”
Leverage the Strengths of Online Therapy
Digital treatment for mental health is much more accessible than meeting a psychologist in person, as long as you have a decent internet connection, webcam, and microphone, as well as some experience with a computer. Online therapy also affords flexibility of time and space; you don’t need to make a trip to your therapist’s office, saving precious hours and money. You can also schedule the sessions for a time that works for you, even in the middle of your work day.
If you live in a rural area, digital programs like Cerebral and Its alternatives, provide access to many specialized kinds of counseling that you may not be able to access locally. You can avoid the long waits for in-person sessions that have become prevalent around the U.S. by signing up for treatment online. Furthermore, virtual meetings with a therapist are often cheaper than face-to-face ones. Since the onset of the pandemic, many insurance providers have started covering online therapy.
Getting counseling online can also help combat the stigma of therapy that, unfortunately, still persists. You can get treatment in a completely private environment - no waiting rooms, no awkward conversations with strangers. Additionally, speaking with someone from the comfort of your home may make sharing easier and less stressful.
You can use a variety of communication tools suited to your needs at any given time. Video calls can help build a relationship with a new therapist, or be used to have more intense or nuanced discussions. But they can also be draining, especially if you have social anxiety. Voice-only calls are a good option for less-intense discussions. Less obvious are written options: email offers a useful option for long-form messages that are less time-sensitive, while texting is useful for quick, in-the-moment questions, answers, and reinforcement.
Address the Weaknesses of Online Therapy
One area for improvement when it comes to virtual counseling is needing the right technology and skills. Another is the difficulty of forming a close relationship with your therapist. Non-verbal communication is limited and your therapist won’t be able to read you as well, which means you’ll need to be more deliberate in self-expression and self-analysis.
While this article covers the many positive aspects of having therapy in your home, the opposite argument can also be made: the neutral space of a therapist’s office might be helpful when you’re sharing personal challenges. You need research to who is offering virtual counseling services to make sure they’re reputable, licensed and have a clear and transparent pay structure.
Finally, some mental health treatments need in-person interactions, such as EMDR (Eye Movement Desensitization and Reprocessing).
Be Intentional About Being Your Own Advocate
The first and most important step of any therapy journey is figuring out what goals you want to achieve. Consider how, within the context of your objectives, you can leverage the benefits of telehealth while addressing the weaknesses. Write down and commit to achieving your goals.
Remember, you need to be your own advocate, especially in the less-regulated space of online therapy, so focus on being proactive in achieving your intended targets.
Figure Out Who's Your Ideal Mentor
Every online therapy journey involves a mentor who guides the treatment seeker. Think about who your ideal guide would be and write out their top ten characteristics, from most to least important.
For example, you might want someone who is:
- Empathetic
- Caring
- A good listener
- Logical
- Direct
- Questioning
- Non-judgmental
- Organized
- Curious
- Flexible
Create your list based on the challenges you’re facing, your personality, and your preferences. When you’re matched with a therapist, evaluate how well they fit your list of traits.
Fail Fast
When you first match with a therapist, try to “fail fast.” This means instead of focusing on getting treatment, focus on figuring out if the psychologist is a good match for you. This strategy will help you to determine if your new therapist is a good fit and lets you move on quickly if they’re not.
Be honest with your new psychologist about your goals, story, and your vision of an ideal mentor. Ask them whether they think they're a match and what kind of treatment plan they suggest based on the information you’ve provided. Observe them in your initial interactions, focusing on whether they’re the right fit for you.
Often, you’ll find that your initial vision of your ideal mentor is incomplete, and you’ll learn through experience what kind of therapist is the best fit for you.
Choose a Small, Meaningful Sub-Goal
This small sub-goal should be meaningful and impactful in improving your mental health, but not a big stretch for you to achieve. It should be a way for you to evaluate whether the therapist is a good fit for you, and whether their treatment plan makes sense.
Take Control
Too many people allow their therapist to completely manage their treatment plan. Especially in online therapy, you need to be organized. Take notes on your progress and re-evaluate how you’re doing every month with your psychologist.
Know When to Wrap Up
As you approach the end of your planned work and note whether you’re reaching your goals, talk to your therapist about how to wrap up. A quote from Jeffrey E. Barnett, PsyD in When therapy comes to an end (Abramson, A., (2022, July 1) Monitor on Psychology, 53(5)) states “[w]henever possible, there’s a need to have a termination phase of treatment, consolidating gains and preparing the client to continue independently.”
Ending therapy can be intimidating. In fact, some less scrupulous therapists may take advantage of this, insisting that the sessions should never end and that you should stay in treatment longer than you need to. Avoid falling for this line. When you reach your goals, start thinking about moving on from therapy, unless you discover a serious new reason to continue.
Set up occasional check-ins every three to six months, to give yourself an opportunity to reflect and ensure that you are continuing to uphold the work you and your therapist have done together.
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