By Dr. Richard W. Shoup, D. Min., The Counseling Center

Feb. 3, 2021: As Covid-19 has continued its relentless assault on our public health, and economic wellbeing, more people are suffering anxiety, stress, and loss.  Many have reached out to The Counseling Center and found the comfort and support they need—even though, for safety, a number of them are choosing not to meet their therapist in person. Yet others may be reluctant. Even if therapy seems a good choice, the idea of meeting a therapist virtually may make new clients hesitate, uncertain whether effective therapy is possible through the phone, Zoom, or some other remote platform.

At The Counseling Center we have found that although teletherapy poses drawbacks for some people, for most, it is enormously successful.  And as the pandemic has continued to impact peoples’ lives in profound ways, clients in greater numbers seek out our services.  Many specifically request teletherapy.

No doubt, being alone in a room with the therapist can be a warmer experience than teletherapy.  Some people feel the difference more keenly than others. Virtual set-ups sometimes feel artificial, or produce the sensation that there isn’t a real person beyond the screen.  Clients may feel as if they’re watching television, and fail to emotionally engage with the therapist. Some people find that the technology gets in the way of genuine feeling. Zoom fatigue can also be a concern.

Teletherapy can lead to more distractions.  Pets or family members might inadvertently intrude on the session, or noises from nearby activities may be more obvious than in a therapist’s office that has been designed to muffle such interference.  For some, virtual platforms create distortions. The therapist’s voice or appearance might seem unnatural, or the angle of the partial view might shorten or elongate certain features--rarely in flattering ways! 

For most people, however, teletherapy provides an effective back and forth with their therapist, a successful “talking cure,” as Freud called it.  Most often clients arrive with specific issues to address and stories to tell. Therapists listen, express an idea, and the client can reflect on the interpretation that’s been offered, just as if they were in the room together.  It’s still possible for a therapist to convey warmth, concern, and care for their client.

If looking at one’s own image on Zoom is disorienting, you can switch to “speaker view,” or even turn off the video component.  Many clients and their therapists are happy conducting sessions over the phone precisely because it eliminates distractions. Clients’ anxieties aren’t compounded by concerns over how they look, and therapists can focus on verbal nuances and clues.

Clients who prefer teletherapy often cite the huge advantage of convenience.  We all know how difficult it is to schedule appointments, considering the competing demands of work and family. Finding a mutually convenient time for an online appointment can be a big relief. Saving the time once spent getting to and from the therapist’s office, avoiding the anxiety caused by over-thinking the session on the way there, and even casting aside the need to dress up for the occasion, can all make it easier for therapist and client to come together. 

Couples and family therapy can be especially difficult to schedule if all the parties want to be in the same room together; instead, a lot can be accomplished by simply getting them onto the same screen together. In fact, for many couples, whether they commute to work or simply have demanding work and care-giving obligations, the ability to meet by teletherapy can mean the difference between being able to see a therapist or not seeing one at all.  This suggests that in the future there will be more teletherapy, not less.

A survey from the American Psychological Association reports that during the Covid-19 pandemic, 75% of clinicians have been meeting only through teletherapy, and 16% have been combining it with in-person sessions.  

According to last July’s New York Times article, “Teletherapy, Popular in the Pandemic, May Outlast It,” by Jeff Wilser, most people find virtual therapy as effective as in-person sessions, and peer-review studies support this belief. Many of these studies were conducted by the Department of Veterans Affairs, which used teletherapy well before the pandemic to expand its outreach to veterans living in remote areas.  Arthur C. Evans, Chief Executive of the American Psychological Association, is quoted as saying, “The research shows that clinicians can be as effective in a telehealth environment as they are in face-to-face.”

Some therapists at The Counseling Center are meeting a number of clients in the office, both wearing masks and often with the window open. The waiting room is closed and surfaces are regularly sanitized.

Therapists still enjoy being in the same room with their clients, but many have begun to ask: does the advantage given to the therapist in actual face-to-face sessions, of better intuiting what a client is expressing non-verbally, outweigh the sheer accessibility of teletherapy? And as therapists have adapted to the new situation, they’ve become even more adept at communicating with clients via screens—sharing insights, working through concerns, deepening communication. 

No matter what virtual platform you and your therapist choose, experience suggests that during this long, difficult pandemic, teletherapy can successfully provide the essential help you need now.  Therapy can guide you through this tough time and prepare you for brighter days to come. In fact, long after Covid-19 has retreated into the shadows, and some clients have returned to the therapist’s couch, teletherapy will remain a welcome choice.

Photos courtesy The Counseling Center