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Should You Pursue Teletherapy During COVID-19?



This article will explore why you would choose to start therapy during the COVID-19 outbreak, why you would want (or need) to engage in therapy via telehealth, and how you can choose the best therapist for teletherapy.


Before we begin, I am a therapist who provides teletherapy services in Seattle during the novel Coronavirus outbreak. I have practiced and trained in telehealth, both before this outbreak and because of it. I believe that it can work well. Obviously, I am a bit biased on this topic. However, I’ll try to provide some important information that will help you decide whether to pursue teletherapy and what to look for in a provider—whether it be myself or another clinician.


Why Start Therapy during the COVID-19 Outbreak?

This might seem like a terrible time to start therapy. Folks are not short on reasons: “I’m supposed to stay in my home!” “The market is terrible right now—I could lose my job!” “I’m exhausted already—I don’t have time for therapy.” These are all understandable concerns and might be legitimate reasons not to start therapy now. However, for some folks, these might actually be reasons to start therapy as soon as possible. Let’s address them in order.


1) Stay at home—of course, this is why we’re talking about telehealth. Usually, the process of starting therapy includes finding a therapist, taking time out of your workday each week, travelling to the therapist’s office, and finding parking. All of this, and you might find that the clinician is a bad fit for you. Social distancing and shelter in place orders actually provide some opportunities regarding these: because of these, (a) most therapists now provide telehealth, which means (b) you can meet therapists more easily, schedule more flexibly, and get a sense for whether they will be a good fit without such an investment. As everyone begins to stay at home, that means therapy at home becomes more easy to access.


2) Worried about my income—this is a big one. Before trying therapy, it might seem like an expensive luxury. After therapy, many folks tell me that they wish they had done it sooner. Why do people think it was a worthwhile investment? There are a ton of reasons, but for young professionals especially, therapy is a chance to invest in your career. Worried you might lose your job? Therapy itself is associated with higher income, can help you develop emotion regulation (also linked to higher income), can help you manage anxiety, and can help you sleep. If you are worried about your financial security, and find yourself stressed, anxious, or tired—therapy might be a relatively cheap way to invest in keeping your job. Of course, nothing can guarantee that anyone keeps their job in a difficult economy—but therapy may help you develop the skills and the calm to make you a top performer at your company when that matters the most.


3) I’m exhausted and have no time—Maybe you have kids. Maybe you have a partner who is having a difficult time. Maybe your job expects even more from you now that you’re working from home. One of the most consistent pieces of feedback I get as a therapist is that therapy became a unique time for someone to take care of themselves. Partners understand, kids can get it, and even employers respect doctor’s visits. Therapy can help you sleep, help you self-soothe, and help you manage your time. Much like time spent exercising, therapy often feels like it gives you time, rather than takes from it.


Why Engage in Telehealth?

Mental health services count as an essential service, so you can go even during a shelter-in-place. So why proceed with telehealth? First, and I believe this is crucially important, preventing the spread of the disease as best we can is the most socially responsible action we can take. Yes—I think the therapy I provide is important. However, it can be done from a distance using HIPPA-compliant, synchronous video conferencing software—so I will as long as needed. (See more about my reasoning here). Second, as mentioned above, there are benefits to telehealth: convenience, reduced/eliminated travel time, and being able to stay comfortable in your own home. Third, this is a uniquely easy time to start telehealth. HIPAA enforcement is being temporarily relaxed (though I maintain HIPAA compliant services myself), giving clinicians more options to communicate with you. Further, many more therapists are available online than just a few months ago. I have been providing limited telehealth for two years and continue to defend its efficacy (though I prefer to meet in person). Many clinicians have joined me since COVID-19 became so disruptive!


How to Choose a Teletherapist

Most therapists may be available online right now, but not all of them know what they are doing. So how do you choose? The easiest way is to ask some questions: how they ensure their telehealth is confidential, what they recommend to make the most of it, and if they have any training in telehealth (many trainings on telehealth are currently free or discounted, so there isn’t much excuse for therapists not to have at least some training in telehealth).


Trained teletherapists should provide you some information about the process. They should inform you of the limits of teletherapy, such as the potential loss of nonverbal communication, the limited amount of research on teletherapy (the research indicates that teletherapy is likely just as effective, but the internet is much newer than therapy in person), and the need to plan for emergencies. Speaking of emergencies, there should be a plan for who to contact and what to do if you are at risk of harming yourself or others. Third, despite the lax HIPAA enforcement, most competent teletherapists will still use HIPAA-compliant communication platforms (I use Doxy.me but others exist). I think your privacy is still important during a pandemic. Fourth, they should have a conversation with you about what will be most conducive to therapy—such as removing distractions, feeling comfortable, making sure you aren’t worried about someone overhearing you. You want to be completely free to talk about anything that comes to mind. Last, they should provide you with an informed consent about telehealth. In Washington, patients actually do not need to sign this document, but I find it best practice to ensure all parties know and accept what they are engaging in.



So…should you start teletherapy during the COVID-19 crisis? Only you can really know. It’s never been more easy to start therapy at home. Many of the reasons to not start therapy now, if you dig into them a bit deeper, might actually be reasons to begin. And, after reading this, hopefully you have an idea what to look for in a teletherapist. Of course, nothing can substitute for an initial call or a few sessions for finding a competent therapist who feels like a good fit. Contact me if you are interested in therapy in Washington—we can chat and either schedule a session to meet or I can provide some names of providers who I know and trust.


I hope this was helpful for you and I wish you the best during these trying times.

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