Is "telehealth" therapy actually effective?
- Apr 15
- 4 min read
In recent years, a number of factors have both necessitated and encouraged the conducting of psychotherapy remotely, via telephone and video conference (known collectively as "telehealth" services). Not least of all, it allows people to consult with their therapist of choice who would otherwise be inaccessible physically, and attend therapy when they do not have the time to visit their therapist's office (such as in the midst of a work day). This provides our clients with greater choice of whom they choose to help them and may even be the deciding factor of whether they receive help. Some therapists may even choose to operate their practices entirely remotely, which in combination with other factors can make therapy more affordable in the long term and make it possible for more people to access it. With personal computing technology becoming more accessible, the benefits of remote therapy are accumulating ― and I myself take in earnest that clients outside of my state choose to consult with me remotely (apart from the local clients with whom I consult in-person). Simultaneously, there are still doubts and misconceptions about remote therapy. In this article, I will be discerning facts from opinions and providing my own perspective on this matter.
First, we must acknowledge that there are legitimate benefits to therapy conducted in-person. People do communicate via non-verbal means, such as body language and facial expressions. These obviously can not be detected via telephone, and may only be marginally detectable via video feed. These cues are almost always of great help for the therapist to observe, as they communicate nuances and discrepancies in the client's experiences which require examination to fully understand the problem in question. For this reason, some therapists may not feel comfortable operating remotely. Some clients, too, feel most effectively bonded with their therapists when they are physically present. Other clients may not have a place to attend remote therapy without an unwanted person listening to their conversations, in which case in-person appointments are the only safe option. There is no one correct answer to what the client should consider satisfactory; the client must ultimately feel safe, and choosing to only consult in-person is completely legitimate. However, this is different from the sentiment expressed by some professionals, therapists and otherwise, who claim that remote services are not as effective as in-person services. This is an invalid claim as it supposes that there is an objective lack of quality in remote services that applies regardless of the subjective experience of the client and therapist. Due to this subjectivity, I can not make claims on behalf of other therapists or clients, but I can reflect on my own experience.
My earliest experience as a counsellor, some years ago now, was operating a voluntary counselling service. I counselled people in different parts of our world, in cultural and linguistic situations starkly different from our own, via both audio call and typed instant messaging. One can imagine the challenges inherent in this, but it was massively insightful and fruitful. It forced me to be fastidious in observing the nuances in how people communicate linguistically, to analyse patterns of thoughts, emotions, and actions based on clients' reports, and to ask questions in a specific manner so that I could discern what was needed. When I began consulting with clients in-person, I found my observation of non-verbal cues happened naturally in addition to my linguistic analysis. Will this work for every person? Not necessarily. But choosing this unconventional pursuit exposed me to learning experiences to which most therapists are never exposed.
The nuances of this are of course more complicated than simply my own experiences can reflect, so one must use their own judgement. I will, however, unashamedly state that I have found great success in helping clients make profound changes when they have never even seen my face. I remember that my first ever client, whom I met all those years ago, spoke English as a second language, but we held consultations via instant messaging, and they eventually decided to pursue great aspirations after having been inspired by our discussions.
To finish, I would like to share with you the application which I use for video conferencing. I must emphasise that I am not affiliated with or sponsored by the developer, nor is this a recommendation as such. The application is Infomaniak's kMeet. Infomaniak is a cloud and web-hosting provider based in Switzerland, a country in which the privacy laws are lauded, with its own data centres located there. It costs no money to host video conferences and as far as I have found, it operates from popular browsers without the need to create an account (even for the host). I require whichever video conferencing software that I choose to present an easy experience for my clients (I do not want them to have to download any software or learn to use it minutes before the appointment), and to not charge me for features which I do not use. kMeet fulfils this requirement for me. It can be found here:
Thought of the month
If one denies the existence of mental illness in others and the real impact it has, I implore them to reflect on whether they may be afraid of their own.