Like so many other things, the way we receive healthcare changed dramatically during the pandemic, especially for those seeking mental health services.
A 2021 report from the U.S. Department of Health and Human Services (HHS) revealed that the massive increase in telehealth calls during COVID was highest among behavioral health providers. Before these extenuating circumstances, telehealth appointments for mental health care services were rare. Demand for virtual appointments soared during COVID—a trend that doesn’t appear to be reversing anytime soon.
Even those not known for embracing mental health care in the past have warmed to virtual visits because they provide greater access and an increased comfort level. Talking to a counselor from the comfort of your home instead of in an unfamiliar office helps put some people at ease.
Mental health providers who were offering virtual sessions before the pandemic struck were ahead of the curve. Brianna Weber, a local therapist specializing in virtual counseling, has offered online assistance to her clients since 2015. When she first launched her virtual counseling services, she worked through platforms like BetterHelp and Talkspace.
“In the beginning, I offered chat-style sessions and eventually moved into providing teletherapy via video conferencing,” she explained.
In May 2020, Weber and her colleague, Nichole Sakmar, launched Viaggio Counseling and Wellness. “At a time when most counselors were navigating how to transition their practices to virtual sessions in response to COVID-19, Nichole and I had been providing these services for years and were experts in providing high-quality therapy in a virtual environment,” said Weber.
Patients in their practice can now choose between in-person or virtual sessions.
Beth Healey, director of development and marketing at Samaritan Counseling Center in Sewickley, said that before the pandemic, the center had two counselors experienced in providing virtual therapy. However, most insurance companies didn’t pay for telehealth counseling services then, so very few clients requested the option.
“A week after sheltering in place had been ordered, all 14 of our therapists had transitioned to offering virtual therapy,” Healey said, adding that the therapists were trained on a HIPPA-compliant platform, set up appropriate workspaces off-site, and were outfitted with the security and technology needed to ensure patient confidentiality.
“The fact that insurance companies started covering virtual therapy was a huge help for our clients,” she added. “It was an extremely difficult time for so many people of all ages. They desperately needed help, and we truly felt blessed to be able to serve them this way during their time of greatest need.”
At the height of the pandemic, Weber said that requests for virtual counseling were high. “People were isolated, depressed, anxious, and had very few outlets to express their feelings,” she explained.
In the fall of 2020, when in-person sessions resumed, some people made the transition back to face-to-face counseling. “I think people really wanted human interaction at a time when it was very hard to find,” Weber said. “Now that restrictions have loosened and people are able to find additional outlets for human connection, I find that many of my clients that I had originally seen in person are requesting to transition to telehealth sessions for the added convenience.”
Approximately 60 percent of Weber’s patients now use the virtual option.
Now that it’s an option that most insurance companies cover, Healey said that more than half of the center’s clients request virtual sessions. “We serve 1,200 men, women and children annually, and now have 17 therapists on staff who provide telehealth therapy, which is available to any Pennsylvania resident,” she noted.
There are both advantages and disadvantages to using telehealth counseling. One of the biggest benefits of virtual sessions is convenience.
“You don’t have to take time to drive into an office,” said Weber. “Also, for clients who are homebound or who don’t have reliable transportation, it allows them to gain access to a resource that they wouldn’t have access to otherwise.”
Healey said that virtual options are ideal for patients with anxiety issues that can be exacerbated by the process of leaving their homes and commuting in traffic to have an in-person appointment in an unfamiliar environment.
“According to feedback, our patients feel virtual therapy is just as effective as in-person therapy. The key is the relationship between the therapist and the client—the trust and rapport they build. When that works, it works both virtually and in-person,” she said.
Virtual sessions aren’t just beneficial for patients. Therapists glean valuable information about their patients by observing them in their natural environments. “I have been able to gather information about a client by asking about the things in their room—a family photo, a book they are reading. In a traditional therapy setting, that information would not be available to me,” said Weber.
For all of the advantages, there also are downsides to virtual counseling sessions. Telehealth compromises nonverbal communication by making it more difficult for a counselor to observe body language and other physical reactions. “The client may be fidgeting out of nervousness or engaging in some kind of negative behavior—skin picking, scratching—that I would not be able to observe and in turn, address,” said Weber.
Technology failures can be the biggest obstacle to a successful virtual therapy session, said Healey. “As long as the client’s Internet and computer are working, virtual therapy works. If someone lacks the technology or finds it challenging to get to a private, quiet place in their home for a therapy session, then those can be disadvantages.”
Patients who decide to try teletherapy sessions can prepare for the experience in a few ways. Both therapists advise patients to arrange a quiet, private space that avoids disturbances during the session. It is important to feel safe discussing anything with your counselor, so if you live with other people, ask them to be respectful of your privacy during this time. Using a white noise machine and earbuds can help add a level of privacy.
“Rest assured that your therapist is trained and experienced in working with people virtually,” said Healey. “This includes counseling you from a quiet, private office space using HIPAA-compliant applications.”
Therapeutic rapport is the most important factor in ensuring a successful therapeutic experience, said Weber. “If you aren’t feeling a connection with your therapist, or feel that the therapist isn’t hearing you, understanding you, or meeting your needs after a few sessions, try out a new therapist with a different style.”