What is telehealth and is it right for me?

Have you been thinking about starting counseling and have wondered how telehealth works?

You’ve come to the right place!

In this article, I’ll answer the following questions:

• How does telehealth compare to in person visits?
• What even is telehealth?
• What are the pros and cons of telehealth?
• How does telehealth work?
• Is telehealth private and secure?
• Are there other options for telehealth?
• How do I know if telehealth is right for me?

Most of us didn’t think too much about the idea of telehealth before COVID.  While it’s been available in some settings for a long time, for most of us (including therapists) it felt kind of weird.  I know I was thrown off at first!  Luckily, I had A LOT of opportunities to practice and I can promise you this:

Telehealth is just as effective as in person for MOST visits, and is actually even better sometimes!

Here’s a great resource from the Agency on Healthcare Research and Quality that discusses the benefits of telehealth overall: https://effectivehealthcare.ahrq.gov/products/telehealth-expansion/white-paper

And here’s one from the American Psychological Association discussing telehealth for mental health care specifically: https://www.apa.org/monitor/2020/07/cover-telepsychology

So let’s figure out first what telehealth even is.

Telehealth (or telemedicine or teletherapy) is a catchall word that covers any type of healthcare that uses the power of technology instead of a traditional in-person visit.

Some telehealth care is “asynchronous” or not at the same time.  Instead, information is saved and forwarded.  In Alaska, this is more common in remote villages.  This also includes therapy services that are done via text message or emails (even though texting and emailing can definitely be pretty back and forth at times!).  “Synchronous” means the communication between the client and the counselor is happening at the same time, like on a video or phone call.  At Hopeful Path Counseling, I focus on video-conferencing.  Telephone visits can be used in certain situations for established clients, but only as needed.  For the type of work I do, respecting silence is incredibly important.  When you have silence in a phone call, it’s a lot less helpful because you get the inevitable “are you still there?” This can really disrupt a meaningful opportunity to sit with a feeling, so it’s my own personal choice to limit phone visits to extenuating circumstances only.

What are the pros and cons?

There are SO MANY benefits to telehealth!

It’s convenient

You don’t have to take extra time to leave home or work, drive who knows how far in terrible weather, AND sit in an office that might not actually feel that comfortable.  You’re a busy person that is ALSO going through a tough time, so let’s not waste energy on commuting when it can be put toward much more useful things.

It feels safer to be vulnerable

When you’re in your own home, snuggled up with a cup of tea, a fuzzy pet, or in your favorite pajamas, its SO much easier to talk about the tough stuff.  Feel free to lay in bed, sprawl out on your couch, or sit at the kitchen table with a notepad.  I’ve also had clients that LOVED the opportunity to keep a document on their computer with any notes of things they wanted to talk about, and it was super easy to take a look at it during sessions.  And if you just don’t have the energy to brush your hair, you know your therapist won’t judge you and you don’t have to see anyone else that you think will!

It can be easier to include your family

One of the biggest benefits I’ve seen in providing teletherapy is how easy it is for my client to grab their husband or wife because they wanted them to be a part of a discussion that came up.  The family member may not be able to come and sit in a waiting room, but can way more easily pop in from another room or from their device!

It’s more consistent

Being able to attend your sessions on whatever regular basis you and your therapist plan is so important in making the progress that you want.  We all know that life can get in the way: you get sick, your car is in the shop, or whatever else would keep you from travelling to an office.  You don’t need to worry about any of those things disrupting your session when you can join from home.

You have more options to find the right therapist

Telehealth expands the reach of the therapist, which means YOU have more people to choose between.  Do you just want a therapist that is close to you, or do you want one that specializes in what you’re going through?  Hopeful Path offers telehealth because I believe that people throughout the entire State of Alaska deserve access to specialized grief and loss counseling, not just people that live in my community.

However, like most things in life, telehealth isn’t for everyone.

Connection problems

For telehealth to be effective, you do have to have reliable internet or phone service.  Hopefully, interruptions are rare, but if you know the service at your home is spotty you may spend more time dealing with tech problems than actually focusing on what brought you there.

Extra effort to get in the right mindset

If you’re squeezing a session in during your lunch hour, or just escaped some of the chaos of home, it may take a bit more time to be in the right mental space to do the work.  This is easily fixable, but it does take a bit of extra attention.  Please make sure you have a quiet and private space for your session.  A car is totally fine, but not if you’re driving!  And we all need to grocery shop, but it’s probably best if you don’t try to do it during your session!

May not meet the needs of every person

Remember when I said it’s just as effective for MOST things?  Well there’s always exceptions to that.  Someone that is incredibly uncomfortable using technology may not be able to get past that fear and have a meaningful session.  A person with physical or cognitive limitations may need the extra support of an in-person visit.  Telehealth can also be more of a challenge with children, though there are certainly therapists out there that can do it and do it well!  Outside of mental health, some medical care obviously needs to be done in person.  It would be pretty impressive if you could get your teeth cleaned through your cell phone from home!

So how does this even work?

There’s a few different ways you’ll join a telehealth appointment, depending on what your provider uses.  Some offices have a dedicated app that you’ll download.  Others, including Hopeful Path Counseling will give you a secure link via text, email, or client portal that you can click on to join your session.  Next, you’ll need to make sure you give your phone or computer permission to use your camera and microphone – this is a really important step!  Then, you’ll be placed in a virtual waiting room and your therapist will let you in as soon as they’re ready.

You don’t need to be a tech wizard!  As long as you can operate an email or text, a web browser, and can click “yes” when your device asks to use video and audio, you are good to go.  If you’re uncertain, you can always practice joining your session beforehand to work out any confusion.  A practice run might also help calm any jitters you’re experiencing!

If you’re feeling a bit nervous, you’re not alone.  A lot of people feel a little worried or uncomfortable about their first therapy appointment and using video conferencing may add to that.  Your therapist, however, is a seasoned pro at helping you to feel comfortable.  If you feel extra nervous, go ahead and let your therapist know!  He or she will be more than happy to answer any questions or concerns you have.  And trust me, we’re pros at helping people feel safe and welcome!

Is telehealth private? Is my information secure?

Video conferencing for healthcare uses software that’s a bit different than what you’d expect from Facetime or Skype.  Everything is encrypted and the company that provides the software has a Business Associate Agreement (BAA) with your therapist.  A BAA makes sure to cover what each party (the software company and the therapist) is responsible for in keeping your personal information safe and sound.

Here’s a thorough (but super boring) explanation of BAAs: https://www.hhs.gov/hipaa/for-professionals/covered-entities/sample-business-associate-agreement-provisions/index.html  If you are looking for some light reading 🙂

No one else can join your session without the link.  The waiting room is an added piece of security that makes sure no one can “accidentally” pop in without you and your therapist knowing.  Additionally, your sessions at Hopeful Path Counseling are never recorded (audio or video).  Some other platforms may allow for recording, but you’re always told that a recording has been started or ended so you can be fully informed.

What else is out there?

You might be thinking, ”Now Sarah, when I’ve looked into virtual therapy options, I found places like BetterHelp and TalkSpace. Why are you any better than them?”  I’m so glad you asked!  Let me hop up on my soapbox real quick- When you go to therapy, you want someone that is able to completely individualize their services to you, your problems, and your goals.  You want to trust that the insights, comments, and questions you get from your therapist are well thought out and intentional.

Those giants that sell you on getting your needs met through text messages leave out that there’s a lot that goes on behind the scenes in how the therapist gets paid based on those messages.  Do you want a therapist to say more words just so they get paid more, even if what they’re saying isn’t useful?  Do you want that same therapist to have to limit how much information they give because of the number of words you used in your message?  I know I don’t and I bet you don’t either.  Okay, now I’m off the soapbox.

Ultimately, it’s really important that you decide whatever is the best fit for you.  But, to do that, you have to know that there are some elements in that kind of treatment model that may not ultimately be in your best interests.

How do I know if it’s right for me?

Well, just like the cliché, you never know until you try.  But, here’s some good indicators that telehealth will be a great fit for you:

• You are ready for counseling, but know it needs to fit into your busy life
• You are ready, willing, and able to create a private and quiet space for your visits
• You know counseling is hard work, and you want some of the extra comforts of your home to help keep you grounded
• You want a therapist that excels in working with the reason you’re seeking counseling, not just the person closest to home
• You have reliable access to technology
• You have the basics down in using your phone or computer to access links and open them in a web browser

So, if you’re ready to dive in and “heal your heart from home,” go ahead and make that first appointment.  You are so worth the effort and you’ll never regret investing in yourself.

Take good care of yourself,

Sarah