Finding a therapist you click with (and can afford) is often hard and even anxiety-provoking. But finding a therapist isn’t the only potential hurdle when it comes to looking after your mental health. Taking the time to trek to your appointment, spill your feelings, then commute to the next stop on your list can sometimes be even harder.
Enter teletherapy, also called telepsychology, which allows you to talk to a therapist remotely through technology. But how do you make the most of teletherapy? Here are the ins and outs of telepsychology, plus how to maximize your appointments.
Teletherapy can happen via basically any form of digital communication.
Because there are so many ways to connect digitally, it should come as no surprise that there’s also a slew of teletherapy options. According to the American Psychological Association (APA), teletherapy commonly happens over phone calls, text messages, live chats, and video conversations.
With that said, many therapists prefer video teletherapy over other forms. Seeing someone helps you connect with them verbally and non-verbally, Linda Baggett, Ph.D., a psychologist based in Long Beach, California, who sees patients via teletherapy, tells SELF. “I can see if a client is tearful, whereas I may not hear it. Similarly, if a client discloses something vulnerable, they can see that I am listening and expressing care and support by my facial expression or posture,” Baggett says. This level of context is typically missing from a phone or text session, though those can definitely be better than no therapy session at all.
Teletherapy can provide many benefits of IRL therapy without some of the hassles.
“My relationships with my teletherapy clients are just as nuanced and rich as those I have with my other clients,” Nicole Issa, Psy.D., a licensed clinical psychologist in New York and Massachusetts who sees some of her patients digitally, tells SELF.
Remote appointments do come with some unique perks. For one: The lack of a commute. This may lower your stress levels and allow you to better focus on your session, notes Issa.
Teletherapy also means you’re generally able to have sessions somewhere you are comfortable. Issa notes that the safety of being in your own space may help you open up emotionally. This is part of what Allyson N., a 31-year-old based in Boston, enjoyed about her experience with teletherapy. “A lot of the time I would get emotional during our [sessions],” Allyson tells SELF. “It is always more comfortable feeling that way at home rather than in an office that you know you have to walk out of.”
Additionally, teletherapy can make it easier to see a therapist who specializes in a particular issue but is physically far away, or to stay with a therapist you gel with even if you move. This was the case for Allyson, who used teletherapy with her therapist in Kansas after relocating to Massachusetts. “I had been searching for a good therapist since I was in high school. To have found one I trusted was huge for me, so I decided to continue seeing her through teletherapy rather than finding someone new,” Allyson says, noting that the two connected via the website Regrouptelehealth.com. “I always looked forward to seeing her. It was like FaceTiming a friend for an hour.”
Of course, it takes time to get to know anyone, whether through teletherapy or in real life. Still, it can be encouraging and comforting to know that no matter where you go, teletherapy allows for additional access to mental health support. “The best part of this whole experience is that I now know that I have a therapist wherever life takes me,” Allyson says.
With that said, teletherapy isn’t right for everyone. The APA’s guidelines for practicing teletherapy note that therapists should be prepared to recommend that a client seeks in-person treatment, like if they routinely experience mental health crises. The APA also notes that a therapist using telepsychology needs to learn about emergency resources in their patient’s area and discuss what to do in an emergency. Even with those precautions, it can make more sense to see a therapist in person if possible.
If you’re going to engage in teletherapy, you should make sure that you’re using a secure, encrypted, HIPAA-compliant system.
“‘HIPAA-compliant’ means the platform is compliant with the privacy laws that keep your health information secure,” Baggett explains. “Typically the only platforms that are secure are ones designed specifically for the delivery of telehealth.”
If you’re not certain about the security of the platform you’re using, Issa suggests asking the company or your therapist outright. According to the APA’s guidelines for practicing teletherapy, psychologists have a duty to educate themselves on how teletherapy could compromise patient confidentiality, inform their patients of those risks, and take steps to keep client information and data private.
Some teletherapy companies offer a short, free first session if you’ve never “met” with them before, and many providers offer quick chats to discuss why you’re seeking therapy before you dive in. Those are great times to ask how your privacy will be protected, if the platform is HIPAA-compliant, and what your therapist and the platform would do in the event of a data breach. You should ask other important questions, too, like your therapist’s availability and what their solutions are for technical difficulties.
You should also make sure you understand any costs on your end. Many teletherapy services advertise themselves as cheaper than standard therapy, but it all depends on how much they charge and how much your insurance would cover IRL sessions. Some teletherapy companies charge for monthly memberships or sessions and don’t take insurance. Other times, you may be able to use insurance to cover some or all of your teletherapy. But since every provider and company is different, you should call your insurance company first to confirm.
Lastly, if you think you might want or need a prescription for mental health medication, ask if your therapist does that remotely (some do and some don’t).
Here are a few ways to make sure your teletherapy sessions go well.
Going through these steps can help calm some of your pre-appointment nerves:
1. Before your sessions, jot down some notes on what you want to cover. “If you were traveling to a therapy session in person, then you would have some time to collect your thoughts or at the very least have a change of scenery while you travel to the session,” says Issa. “Some clients really enjoy a few minutes in their therapists’ waiting room to collect their thoughts. You can absolutely do the same thing at home.”
2. Make sure you’re in a private place where you can minimize background noise, interruptions, and distractions, says Issa.
3. Also make sure you have good cell and internet connection, Mariea Snell, D.N.P., an assistant professor of the online doctor of nursing practice programs at Maryville University in St. Louis, Missouri, tells SELF. “The major thing that hinders these sessions is connectivity,” says Snell, who sees patients with mental health concerns using teletherapy. If you can hold a conversation on FaceTime or stream a YouTube video, that’s a good sign.
4. Check that you’re using the best browser for the service you’re connecting through. Often, the company will state which one this is upfront. Make sure it’s up to date before your conversation. Same thing if you’re using an app.
If the idea of teletherapy makes you feel nervous or awkward, don’t let that stop you from trying it.
Even if you’ve never gotten phone anxiety or felt camera shy on FaceTime, the thought of connecting with a therapist digitally can be a little daunting, particularly the part where you can see your face and emotions right there on the screen while you’re pouring your heart out to a therapist.
If you have concerns or insecurities about teletherapy, voice them with your therapist. “The best medicine for anxiety is to expose yourself to what makes you anxious in a safe and supportive environment,” says Baggett. Being upfront with your therapist about these concerns will allow them to ask questions and put together a plan for how to help. It could even lead into important conversations about how you feel about your appearance or your self-esteem, notes Issa. Otherwise? “I sometimes recommend minimizing the window with the picture of yourself so that you aren’t staring at yourself,” says Issa.
Be patient, too. After a few sessions, Baggett explains, many people lose any feelings of awkwardness or discomfort, making appointments easier.