After I moved back to my parents’ house in March 2020 from the pandemic epicenter of NYC, I found myself lost trying to reclaim my childhood space. An overwhelming sense of displacement crept into my life. I had come back to my bumbling and bustling hometown in New Jersey to find no characteristic of its previous vigor on the streets; I felt no nostalgia or recognition of the city I once knew. The desolate streets, the empty NJ Transit station, and the lack of human connection saturated the air with a grim aura. However, there was a warmth I associated at home: warm, home-cooked foods and my sister’s presence. I felt that time sped while I stood still.
For many, these psychological changes were coupled with the turmoil of filing taxes, paying rent, postponing weddings, finding an internship, holding down a job, fighting systemic racism, and maintaining friendships. Now, more than ever, our mental strength is being challenged. Yet we are faced with a problem: the inherent need to openly talk about our feelings in an isolated environment with limited physical contact. Therapy services have seen a growth in investment, usage, and need during the pandemic.
Arrival of Telehealth
Telehealth uses technology to facilitate communication and diagnoses between a patient and health care professional. It is the generic term that encompasses telemedicine but goes beyond clinical medicine to include the care one receives from non-MD/DO professionals such as therapists. This is called teletherapy or distance therapy. Their services manifest in various forms, including messaging/chatting services and virtual therapy appointments.
Historically, policies discourage distance therapy services.
“The therapist had to register their office space as an official site where they would conduct video sessions, but you couldn’t do it anywhere else. So therapists couldn’t do therapy from their home,” says Valera Health program manager Israa Nasir.
[Read Related: Telemedicine in the era of Coronavirus]
The lack of funding and interest in this industry was caused by restrictions like a consumer’s hesitation toward downloading encrypted technology. Furthermore, mental health professionals may find it challenging to connect with their patients in distance therapy.
“What if someone is suicidal? What do you do?” said Nasir. “People are just really afraid of the distance that technology creates. Even though suicidality is a small portion of individuals with mental illness, you just need to happen once for it to go wrong.”
Shift to Online Atmosphere
Therapy appointments have been pushed online since the start of the pandemic, and there has generally been an increase of interest in seeing the field grow. This could mean using an existing chatting service or using Zoom. Much like clinical appointments, when in person, the therapist can easily pick up on body language and voice fluctuations. The patient becomes familiar with the therapist and surroundings to open themselves up to harder conversations easily.
“There’s a lot of nuances and body language. And, very fleeting facial expressions,” says Nasir. “There is a sense of intimacy that you can only get when you sit in the same room with somebody. So there is a difference in the way you feel, both as a clinician and as a consumer of the service.”
Treatments are reimagined as accessible and convenient. From the comfort, safety, and familiarity of your home, you can receive treatment from top therapists. The rise of teletherapy has even helped to drive down costs per appointment. From a therapist standpoint, rent saving costs have driven down the cost of online sessions. Also, whereas insurance companies did not previously reimburse costs for online therapy, there are now relaxed guidelines and more insurance providers entertaining mental health and therapy as part of their coverage plans. Many large carriers that cover telehealth have also waived copays.
Privacy + Safety
Despite being an overall positive experience, some can struggle with the concept of distance therapy. Therapists need to be aware of new technology software and the nuanced experience of each patient, ensuring privacy and safety.
Jasmin Rahman, a certified therapist from New Jersey, vehemently advocates for a safe space to conduct calls.
“If you have confidential calls, having white noise in the background has been my savior,” she says. “Another best practice is panning the camera at the beginning of the session to show that you’re in a safe place and nobody’s listening.”
Like many young adults, Rahman also had a serious talk with her family to ensure that her sessions would go uninterrupted. She says the number one barrier between patients and a seamless distance therapy experience is the privacy and space to do these calls.
“We [as therapists] have to make sure they’re in a place where they’re safe to conduct their session because it’s supposed to be confidential,” says Rahman.
Among her South Asian clientele, Rahman suggests finding alternative ways for distance therapy sessions.
“You can go for a walk, sit outside, sit in your car, or drive a little bit into your neighborhood and park your car and do your session,” she said.
The shift to online-only appointments has been an adjustment to all parties involved. Still, much like the clinical telemedicine industry, mental health technology has spotlighted the pandemic days. Investments have had a whopping 65 percent year over year funding. It indicates that more attention and resources are being placed on a historically overlooked and stigmatized industry. Several corporate companies continue to provide mental health resources and encourage employees to take time off for themselves and their families during these times.
“It’s appropriate for mood and anxiety disorders. It’s appropriate to support eating disorders, it’s appropriate for remission from your psychosis, or if you are in relapse prevention for your substance use. It’s certainly not appropriate for substance use disorder, and psychotic disorders,” says Nasir.
Much like clinical medicine, there is a line beyond which virtual medicine may not prove helpful. Although not all mental health illnesses can be solved with technology, the strides made in this industry cannot be overlooked during the pandemic. Many therapists see a benefit from teletherapy and will be offering services even after the pandemic is over.
From young school-going children to grandparents at a retirement facility, to front line workers, this pandemic has affected everyone in some capacity. Remember to check in with your friends and families, use distance therapy, and take time for yourself. Together we can emerge from this a more promising community, brought together by the technology and resources around us.