Part I: Technology and Its Impact on the Therapy Room

01/31/2018

Sigmund Freud, the father of psychoanalysis, would be turning in his grave if he knew technology was changing the way some do therapy. To him and others who have followed his path, talking freely and openly without restraint was the cure and the gateway to the unconscious, or those repressed parts of ourselves (e.g., fears and conflicts), that have been out of our awareness. As I’ve been thinking about my year and looking to what’s ahead, I couldn’t help but reflect on technology’s impact on the therapy room.

Technology is changing the therapeutic landscape and has evolved to impressive measures since the death of Freud. One of the greatest technological advances has been what is called teletherapy. Teletherapy, also known as online therapy, is a type of therapy occurring at a distance and over an internet connection. This could include therapy via a live video or the use of a texting platform. Honestly, it’s a bit weird for me to be writing about this topic, but in hearing this, I’m sure Freud would have something to say about these technological advances. So far though, the data is showing some promising results. Although many therapists are partial to face-to-face psychotherapy, myself included, that doesn’t mean online therapy doesn’t have some advantages. Let’s take a look at the pros and cons.

There are a handful of advantages worth highlighting. Namely, and one most often cited, is the access to therapeutic services despite location, which can be especially beneficial for someone who lives in a rural area. This choice will also save your time traveling to your therapist. Instead, you can receive treatment in the comfort of your own home, at work, or on the road. This is perhaps a good choice for those who have difficulty leaving the house due to agoraphobia. Importantly for some, this method is usually less expensive. If this is a chosen route, I’d recommend the video option over texting. And I’ll get to why in just a moment.

The disadvantages outnumber the advantages for a variety of reasons. If you choose the texting/typing route, less is usually said, and thus, less information for the web-based therapist and you to work with. It’s more challenging to communicate more complex thoughts, feelings, and ideas, and you can’t read body language in this medium. Thus, why the video option would be more ideal here. Because of the above issues, a greater likelihood of miscommunication. It’s also more difficult for your web-based therapist to intervene when you have an urgent need or are in a crisis. There are increased privacy issues when using computers and web-based platforms. The downside is, you’ll likely need to pay for services out of pocket. And if you haven’t done your research, you may be at a higher risk of receiving services from an unlicensed web-based therapist or the like. You may be wondering about a life coach. A life couch does not get licensed, they get certified. This means they are not held to the same ethical and legal standards as a licensed mental health professional. And most importantly, an unreliable and untrustworthy internet connection may disrupt the delivery of services and/or breach your confidentiality. Obviously, there are increased ethical and legal issues, but that is for a different post.

Now that you have the knowledge to evaluate online therapy, the next step is to decide whether it’s a good fit for you. In pursing online therapy, you’ll first want to explore whether you’re a candidate for online therapy. Being a candidate for online therapy may depend upon the severity of your symptoms and/or presenting problem. Clear this first with the potential web-based therapist before moving forward. If you’re interested in this route, make sure the web-based therapist is licensed in your state. In Indiana, click the following link to verify your therapist’s licensure status: https://mylicense.in.gov/everification/Search.aspx. This is to protect you legally should you have any sort of recourse to take against your web-based therapist. Also, you’ll know that your web-based therapist has met your State’s standards for becoming a licensed mental health provider. Make sure the platform is HIPAA-compliant. This means, ask to see the business associate agreement between the web-based therapist and the platform being used. And any electronic platform that is to be HIPAA-compliant must adhere to The Privacy and Security Rule as well as the HITECH Act in regard to Protected Health Information (e.g., any information that may identify you). It’s also ideal that the platform be using encryption services as an additional safeguard.

If Freud were alive, he’d be happy to say the pros of online therapy don’t outweigh the cons, at least at this time. But if you choose the route of a web-based therapist, know what you’re signing up for. Unless it’s an absolute must to choose this route, therapy via a live video would be the preferred approach. If preventable, online therapy should not be a replacement for face-to-face work. And despite some of the promising results of online therapy, more research needs to be done to support this approach to psychological treatment.

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