Center for Digital Health

Reflecting on the Expansion of At-Home-Therapy as as Result of COVID

Teletherapy as a result of COVID-19 has expanded access to mental health services for those who need it.

teletherapyIn the early months of the COVID-19 pandemic, questions arose about the efficacy of teletherapy. Many months later, it has shown to be quite effective.  Video conference-style remote therapy has been shown to be just as effective as in-person therapy, particularly for post-traumatic stress disorder, depression, and anxiety.  46.6 million Americans struggle with their mental health, yet only 42.6% are currently seeking treatment.  Teletherapy has potential to shrink this gap in care.  

Mental health support at first glance seems as though it is a form of care that must be done in person, as it depends heavily on the physical relationship between those in the room.  How can a therapist tell if a patient is uncomfortable or anxious by a tapping foot or a clenched fist, if only a face is visible in a zoom call?  How exactly can you show compassion and care for a patient remotely?  How can you pass a patient a tissue or a glass of water if they are crying during a remote session?

These are some of the questions that arise when you begin to compare teletherapy and therapy in person.  In practice, while some may miss this human interaction, there are a variety of benefits to at home therapy for patients  Furthermore, patients have expressed that digital health interventions as a whole have allowed them more flexibility in their access to care.

New studies display that lack of access to mental health care is the leading cause of the mental health crisis in the United States.  Teletherapy can increase the feasibility of accessing care for a large portion of the population.  The Department of Veteran’s Affairs expresses that teletherapy could greatly expand access to care.  Many veterans live in remote locations, and the physical commute to a therapist is challenging for any number of reasons.  Patients have expressed that the ease in reaching a provider remotely alleviates the stress that would have occurred during a long commute.  For a remote appointment, not only is there no pressure of arriving on time, but there is also less time to stress and ruminate about the upcoming appointment.  

Teletherapy also has the unique potential to allow for better continuity of care, since the transfer of a provider to a new facility or location would not affect the commute time for a patient.

Some providers have also found it helpful to work with patients in their element.  Video conferencing allows the provider a small glimpse into the physical environment of the patient.  Therapists have expressed how great it is that they are able to help patients in real time.  One therapist explained that they were able to help a child get over her fear of her dolls coming alive right from the girl’s bedroom, where said dolls were located.

It is important to note that while teletherapy can expand access to care to many Americans, it still would not be able to provide universal care.  One of the main components in question for the future of teletherapy is the cost.  COVID-19 offered an opportunity to patients, under which there was an expansion of coverage for teletherapy.  There is no saying how long will this be an option for patients who have financial barriers.  Furthermore, the technology itself is a cost to the patient, who may not have access to the smartphones or computers needed to support the telehealth platforms.  

 

References:

  1. A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341527/
  2. Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681642/
  3. New Study Reveals Lack of Access as Root Cause for Mental Health Crisis in America. https://www.thenationalcouncil.org/press-releases/new-study-reveals-lack-of-access-as-root-cause-for-mental-health-crisis-in-america/
  4. Teletherapy, Popular in the Pandemic, May Outlast It. https://www.nytimes.com/2020/07/09/well/mind/teletherapy-mental-health-coronavirus.html?searchResultPosition=1
  5. Online Therapy, Booming During the Coronavirus Pandemic, May Be Here to Stay. https://time.com/5883704/teletherapy-coronavirus/