What You Need to Know Before Choosing Online Therapy
Hoping to make your life easier? Wondering if online therapy might help?
You’re not alone. Ever since the COVID-19 pandemic came onto the scene, therapy clients have been logging onto Zoom or other platforms, rather than traveling to an actual office. Whether you call it teletherapy, virtual therapy, online therapy or something else, it’s here to stay.
But if you haven’t tried it, you probably have some questions. What factors should you be considering? What do you need to know?
In this post, we’ll explore considerations in choosing an online therapist. We’ll also discuss other common questions about online therapy… its safety and effectiveness, how it’s different from in-person therapy, and how to get the most from it.
While it technically includes texting, chat rooms, email and other Internet-based options, here “online therapy” will refer to the video format.
What should I look for in an online therapist?
So you’ve decided to find an online therapist. You pick up your phone or laptop and do some googling. That leads to pages and pages of results. Endless scrolling.
You think to yourself, “Oh man, there are so many!” You click on some websites. Your eyes are drawn to peaceful photos. Inspiring photos. Language that motivates you. Rousing calls for you to “take that next step.”
Okay, you’re ready to contact someone, but who? There’s a few that sound good, but who’s going to help the most?
Read on for help in narrowing it down.
The therapist’s “style” and approach should fit well with online therapy.
Does their therapeutic approach translate to online therapy?
Every therapist works differently, in terms of their methods and techniques. By now, many have successfully adapted their work to a video format. During an initial consultation phone call, you might want to ask, “Can you tell me a little about your approach, and how that works over video?”
Do they make you feel comfortable?
As you may be discussing difficult stuff from time to time, you’ll want to feel comfortable in the therapist’s presence. Hopefully, they convey warmth and understanding. If you get the sense that they “get you,” even better. Although it can be more challenging over a screen, it’s their job to put you at ease. You want to be yourself, without having to censor yourself.
Does it feel like they’re really present with you?
“Zoom fatigue” is a thing. The thought of being on video chats all day makes some of us want to barf. Some say they create a distant feel. The online therapist should use their demeanor and their overall vibe to make you feel like you’re in the same room with them, collaborating and interacting freely.
Can they “read” you pretty well over video?
To truly read someone, words alone are not enough. Things like posture, gestures, movements and other nonverbal cues are so valuable. A skilled therapist picks up on this stuff and makes use of it. Of course, that’s easier in person. Over video some of this data is hidden, as many folks sit close enough that the bottom of the camera frame is around their shoulders.
Are they open to feedback?
A good online therapist should show they care what the session is like for you. In fact, they should actively ask how it’s working for you, and be open to realistic modifications.
The video format should be secure and unobtrusive.
Because you’ll be relying on a video platform, here are some questions you’ll want to consider:
Is the video platform HIPAA-compliant?
As you may know, anyone who stores or transmits protected health information must comply with privacy and security standards under HIPAA (the Health Insurance Portability and Accountability Act). Because you’ll be using a third-party platform for the calls, you’ll want it to be HIPAA-compliant. For instance, Zoom for Healthcare is HIPAA-compliant; FaceTime and Skype are not.
Is the video connection good enough?
You’ve probably been on video calls where the video freezes, or there’s a delay between the video and audio. Yes, it’s understandable and unavoidable, but should be the exception and not the rule.
Does the therapist use the technology effectively?
The therapist should be able to start the session on time. You should be able to clearly see and hear them, and vice versa. Things like lighting and sound should be figured out before the call. If they’re adjusting settings for a few minutes, or looking into the camera to fix their hair or pick spinach from their teeth, then the technology may be getting in the way.
The therapist should be licensed in your state.
Therapists must be licensed in the state where the client is located, to provide psychotherapy. At the beginning of the COVID-19 pandemic, many states waived those restrictions, allowing for telehealth across state lines. Those waivers are set to expire in most states. Bottom line: check with the therapist that everything’s kosher.
How do I get the most out of online therapy?
You’re seeking out therapy for a reason, right? You want to make some progress. Here’s how you can derive the maximum benefit:
Make sure it’s the right fit. Many therapists offer a complimentary phone or video consultation; take them up on it. Get a sense of them, and see if you feel comfortable chatting with them. See if it seems like they’ll be able to help.
Attend consistently. Weekly sessions build momentum. But when you’re working from home, sitting at the same computer you use for work, it can be easy to forget that you have a session scheduled. Setting calendar reminders may help you form a habit.
Take notes. Hopefully sessions will yield insights or tools that you’ll want to remember. Write them down in the Notes app on your phone (or in a journal), so that you can use this stuff!
Give it time. As you know, change doesn’t happen overnight. As you and your therapist get to know each other and solidify what you’re working on, you’ll get into a groove.
Ask for what you need. This may sound a little customer service-ey, but “your experience matters.” It really does. As you’re looking at your therapist, you’re taking in the angle of their camera, how far they are from the camera, the lighting, anything in the background, etc. You’re picking up the loudness or softness of their voice, and any sounds in the background. You’re also taking in anything they’ve said. Let them know if you need anything to be modified.
Take it seriously. You’re putting time, energy and money into this, so why not approach it with a sense of purpose? Before the first session, download whatever video platform you’ll be using, and check your WiFi and the video connection. You may want to wear headphones to ensure privacy and help you focus. If you live with anyone, you may want to invest in a white noise machine, or consider asking them to wear headphones as well.
How is online therapy different from in-person therapy?
As teletherapy has become so common, therapists have adapted how they work to give you the best experience possible. Still, you might notice some differences:
It’s easier to miss nonverbal cues. This includes body language and even some facial expressions. A skilled therapist can overcome this by asking questions that bring out your experience.
On a related note, over video you may find yourself accidentally talking over each other, which can be distracting. When the therapist is reading you well, this may be less likely.
It may feel less “formal.” Picture it… you’re at home, sitting on your couch, all comfy and casual… It’s easy to forget that you’re not just kickin’ it with your friends. Of course you don’t want it to feel overly formal or stuffy, but to really benefit you might want to pretend you’re in the therapist’s office.
Seeing your own face on the screen can be distracting. On a typical video call, you’re able to see the other person and yourself. If this leads you to feel self-conscious, you’re not alone. Research shows that our eyes are drawn to the image of our own face, especially as compared to other faces. Consider adjusting the settings to click off (minimize) your own video.
Is online therapy safe?
By the time a therapist sees their first client ever, they’ve received extensive education and training. They’re governed by ethical codes set forth by state legislatures and regulatory bodies. Their primary responsibility is to keep you safe. But you can do your part as well, by:
Making sure they’re legit. How? By checking that they’re licensed in the state(s) in which they practice. For example, in California, the profession of Marriage and Family Therapy is regulated by the Board of Behavioral Sciences, and you can “verify a license” on their website.
Making sure the video platform is HIPAA-compliant. Again, Skype and FaceTime are not HIPAA-compliant. Nor is regular Zoom. But Zoom Healthcare, VSee and Doxy.me are all HIPAA-compliant.
Using your own computer. To ensure privacy and confidentiality, if you have your own computer or smartphone, use that instead of a shared device. Make sure to check for security updates.
Discussing (in advance) how crises will be handled. If issues of safety arise, an online therapist may be limited in how much they can help. It’s wise for you and your therapist to plan how crises will be dealt with.
Is online therapy effective?
You betcha. While some researchers point out the need for more expansive studies, many of the existing findings are promising:
Client satisfaction has been found to be comparable to in-person therapy.
It’s been found to be effective across different age groups and ethnicities, with a variety of mental health concerns, such as depression.
A recent review of 279 peer-review investigations over six years found that “clinical videoconferencing has been used to deliver feasible, acceptable, safe, and effective evidence-based care for anxiety and depression to patients across the life course.”
The American Psychiatric Association states on its website that this form of therapy is “equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction.”
Reach out for a complimentary 15-minute consultation!
So there you have it. Now you can make an informed decision before getting started.
I’ve been specially trained in telebehavioral health, and am a TBHI-Certified Telebehavioral Health Practitioner. I offer individual therapy and couples therapy to California residents over Zoom Healthcare, a HIPAA-compliant platform. To learn more, or to schedule a complimentary 15-minute phone consultation, hit me up!