There has been an increasing use of technology in the delivery of mental health services. Applications have been developed for smart phones that remind patients when to take their medication. Reminders also convey information on how to calm and self-soothe regarding incidents involving increase of symptoms for Anxiety and Post-Traumatic Stress Disorder. Now there is also the emergence of providing psychotherapy services online using a computer, headset, camera, etc.
For some, this movement into embracing cyber or digital therapy may feel a bit disconcerting. Where is the human contact here? Does seeing someone on a computer screen really mean that you know exactly what is going on in the room, let alone what is going on with the patient?
Of course, the argument in favor of utilizing technology assisted services (TAS) has been that more people can be served, especially those who live in isolated locations and who lack transportation to get to an outpatient office appointment.
Further research has indicated the following:
Here are some other notable studies that validated the efficacy of online therapy in recent history:
· 2004: Computerized cognitive behavioral therapy led to greater satisfaction with treatment than traditional therapy, according to a study by Columbia University.
· 2006-2010: A study demonstrated the positive effects of teletherapy on more than 98,000 mental patients.
· 2009: Therapy can be effective when delivered online, according to a study published in The Lancet.
· 2014: A study from the University of Zurich proved online therapy can be comparable to in-person therapy.
2017: A study from Columbia University validated the positive effects of text-based online therapy. The History of Online Therapy - Talkspace Online Therapy Bloghttps://www.talkspace.com/blog/2017/07/history-online-therapy/
Adriana Gil-Wilkerson M.S. LMFT-Supervisor and Dr. Stephanie Gabel-Zepada PH. D LMFT of the Houston Galveston Institute, Houston, TX have discussed the use of several online psychotherapy platforms such as SimplePractice.Com, WeCounsel.Com etc. These programs provide efficient methods of documenting clinical sessions, setting up future appointments, handling billing, etc. These programs are also HIPAA and HITECH compliant, meaning that safeguards have been installed to protect confidentiality.
Yet, one of the concerns regarding digital therapy has been what if there is a breach in the system? What happens if someone hacks a therapy platform? Wilkerson and Zepada advocate that clinicians develop a Risk Analysis Harm Plan that can be included in the HIPAA privacy management folder on their computer. So, if a breach in the system occurs, there can be a methodical efficient way to let clients/patients know about this type of disclosure.
Digital therapy also presents challenges regarding reimbursement from insurance companies. Will clinicians receive equal reimbursement for online sessions versus in- person sessions in an office? Will insurance companies slate lower reimbursement rates for phone sessions versus in office sessions? How will this effect decision making by therapists regarding who should receive online services versus traditional face- to- face therapy services?
You can see a person smile over a digital screen but you can’t shake their hand. Will therapists and patients feel more comfortable with this practice even though it may diminish some human contact ? How can we preserve the “I-Thou “relationship (Martin Buber) instead of reducing a service encounter to “I-It? Due to the costs of utilizing technology equipment for technology assisted services (TAS), there may be temptation to book as many online psychotherapy sessions as possible in one’s given practice.
How do you balance the embrace of technology and of humanity?
How will combating social isolation and fostering development of social skills be helped by the utilization of this medium?
How do we keep the spirit, heart and soul during this important work?
As online psychotherapy becomes more prevalent, may we mindful as to how we can retain our human touch now and always.
May it be so.