The Rise of Telepsychology

Telepsychology is more available than ever, and that's a really good thing.

It’s an understatement to say that COVID-19 has transformed how we go about our lives. And one of

those changes is the rise of telepsychology, which involves talking with a therapist on the phone or meeting online through a secure videoconferencing platform. (Texting is also a form of telepsychology, but we’re going to focus on therapy that happens online or over the phone.) Now this isn’t to say that telepsychology was never available. Before the pandemic, if you were looking for a therapist who was able to save you a trip to their office and meet with you virtually instead, you probably could have found one. The difference between then and now is that your options would have been more limited. In the world we knew before COVID-19, social distancing, and quarantines, evidence suggests that most psychologists weren’t integrating telepsychology into their everyday work. But in the present-day, if you’re looking for a therapist who can meet with you virtually, you’ll have a much more extensive array of clinicians to choose from, as virtually everyone is offering telepsychology.

Thank goodness for that. Among the innumerable tragedies that have emerged from this pandemic, there are a few bright spots, and in my view, the leap of telepsychology into mainstream use is definitely one of them. In fact, I hope clinicians never turn back and continue making virtual visits a part of their regular routine. But why would such a change be beneficial, and what does the scientific evidence on telepsychology tell us? Let’s take a closer look.

Does Telepsychology Work?

In a nutshell, yes. Research reveals that therapy is effective in addressing a range of issues (e.g., depression, adjustment, anxiety, post-traumatic stress) regardless of whether it takes place virtually (i.e., videoconferencing, the phone) or in person.

Does Telepsychology Impact the Therapeutic Alliance?

If you’re wondering what a therapeutic alliance is, you’re far from alone. It basically refers to the kind of professional relationship that a person has with their therapist. The therapeutic alliance is strong if that relationship feels warm, connected, friendly, and considerate, and if the individual (or couple) and their therapist have confidence in each other and feel like they’re a team and agree on what they’re working toward. Ample research shows that the therapeutic alliance matters when it comes to the benefits a person sees from their work in therapy. In other words, when you’re choosing a therapist, one of the most important things to consider is how you feel with that person and how they treat you. And because a strong therapeutic alliance is vital in therapy, researchers have wisely turned their attention to what the alliance looks like in a virtual space.

Not all research supports the notion that the alliance is equally strong in different formats. Some research suggests that even though therapeutic relationships are strong across in-person meetings and in videoconferencing sessions, the alliance is stronger for people who meet in person. However, on balance, research seems to suggest that the therapeutic alliance is similar regardless of whether meetings happen online (videoconferencing) or in person. In fact, there’s even evidence of something called “social presence” in videoconferencing sessions, which refers to a person feeling like they’re with the therapist even though they know they’re not literally in the same space. There’s also some evidence that the therapeutic alliance is comparable across not only video and in-person sessions, but across phone sessions as well.

All of this being said, a potentially important factor to consider is the perspective individuals and their therapists have toward virtual meetings. According to one study, a favorable outlook toward telepsychology among people in therapy was linked to a stronger therapeutic relationship. If this study’s results are generally true for most people and for their therapists, then how we all view telepsychology matters, making it even more vital for us to have accurate information about it. As one group of researchers astutely observed, “If telepsychology is not treated apologetically or defensively, like face-to-face therapy’s ‘poor cousin’ it can achieve positive therapeutic results.”

Are There Possible Advantages to Telepsychology?

According to both research evidence and psychotherapy scholars, telepsychology may offer some benefits that in-person sessions do not. Some of these advantages are logistical. For instance, you’re able to work with the therapist of your choice no matter whether you’re located in the middle of a city or off the beaten path. The only limiting factor for virtual sessions is that you and your therapist usually need to be in the same state (unless your therapist is also licensed in the state where you’re located). And when you get to choose from among all of the therapists in your state as opposed to only clinicians who you can commute to, that significantly enhances your ability to find the right therapist for you! You also don’t have to spend the money and time needed to get to and from appointments, and if you’re worried about being seen entering and leaving appointments, virtual sessions can ease that concern.

Other possible upsides of virtual sessions involve the felt experience of being in therapy. When someone is meeting with a therapist from their home, their private office, or their car, they’re talking with their therapist in their own territory rather than the therapist’s. This may lessen the disparity in power that exists between an individual and their therapist and allow that person to feel a greater sense of empowerment. Moreover, some people may feel more capable of opening up and exploring vulnerable feelings, thoughts, and experiences with a therapist who is not in the same physical location, as the physical presence of another person might feel too overwhelming otherwise.

If I Want to Try Telepsychology, What Can I Do?

As we talked about earlier, more therapists are doing telepsychology than ever before, making this a good time to give it a try. The first step would be to talk with your insurance company to verify that they cover telepsychology sessions, and be sure to ask about whether they cover videoconferencing sessions and whether they cover phone-based sessions. Although insurance companies generally don’t cover sessions over the phone (unfortunately), coverage for videoconferencing sessions is covered by some insurance plans and that coverage has only expanded during the pandemic. In other words, in all likelihood, your insurance is covering videoconferencing sessions, but double-check with them before you make an appointment to be sure. Second, look for a therapist on who accepts your insurance and does telepsychology. Psychology Today has an extensive directory of therapists, and the listings make it readily apparent which therapists offer virtual sessions; right now, most clinicians arguably do. And third, call or email potential therapists and ask them if they’ll offer a free phone consultation so you can get a sense of whether the two of you would be a good fit. Many therapists will do this, and when you talk to them, ask how they feel about telepsychology and whether they plan to continue offering telepsychology in the foreseeable future. This will give you a sense of the clinician’s perspective toward virtual sessions and whether they’ll continue to make those sessions available. And finally, be sure to listen to yourself as you embark on the journey of virtual therapy. You’re the best source of information you have.

Stay safe and healthy, and thank you for reading.