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The transition from in-person to Online Therapy and its benefits

Endri Farka

Teleheath has humble beginnings, and began before you might have realized. In 1959, the University of Nebraska began a pilot project using video technology, as a way to create appointments between patients and physicians. But the system was expensive and remained an idea, never placed into practice.

Many psychologists and psychotherapists over the years would not accept online meetings as a means of delivering patient care, believing that being physically near to the patient was most important.

Lori Gottlieb, a Los Angeles based practitioner and author of the book “Maybe You Should Talk to someone” said “The online therapy seemed to go against the core of what I do as a therapist, which is to be present, literally and figuratively, with my patients. It’s not just the words people say or even the visual cues that therapists notice in person — the foot that shakes, the quivering lower lip, the eyes narrowing in anger. Beyond hearing and seeing, there’s the energy in the room, the being together in a shared space with no distractions,” she says in an opinion for Washington Post.

The offering up of a cup of water, is a small gesture in which there is a whole constellation of meaning: concern, care, generosity and protectiveness. It’s something that maybe happens only when two people are in the same room, sharing the same place, face to face.

But in difficult times, such as the present, intimacy with a patient is not only a near impossibility — given the anti-Covid measures imposed by each government — but also possibly dangerous to the well-being of the patient and healthcare provider. As such, virtual psychotherapy sessions have become accepted, and mainstream, via different social networks like Skype, Zoom, or Google Meet.

Gottlieb says that there is a difference between online meetings and the ritual of delivering care in the same spot, on the same couch, in the same office. “This ritual is very important for people, because it makes them feel safe”.

As a consequence of our pervasive virtual world, telemedicine connects doctors with patients at a distance — delivering effective care without the need for close contact and placing people at risk.  They can meet in a virtual office, solving real world health problems.

We all know that there are a lot of health problems that require hands-on contact, such as palpation, auscultation, and other — and while these present challenges for the healthcare provider, there are solutions cominig out into the marketplace.  Telepsych, however — with its talk-and-listen simplicit — is a different matter. If ever there was a caring discipline that was poised to jump aboard the telemedicine train, it’s mental health, says TIME Magazine.

Even before Covid-19, telepsychiatry was beginning to become widely available, says Jay Shore, the chairman of the American Psychiatric Association’s Telepsychiatry Committee. “After Coronavirus pandemic outbreak, the online meetings came like a tsunami”.

The American Psychiatric Association made a survey of its members to check on how frequently they held telepsych sessions both before and after the pandemic. The results were shocking: Prior to COVID-19, 63.6% of respondents did not use virtual sessions at all. After the pandemic the numbers went to 1.9%.

There are some silver linings to online therapy: a 50 minute session is truly a 50-minute session. You don’t have to spend extra time waiting for travel to and from the appointment, waiting in the waiting area for your turn, extra money for transportation, etc. This holds true for rural settings (where it is many miles to an office), or in cities (where there is congestion and traffic).

The pandemic and the changes it has brought, has made even the doubters try to adopt and accept the new ways of doing things.

Therapists are becoming used to the idea that patients find their privacy in anusual places — some talking from their cars, bathrooms, or other places that would never before have been considered therapeutic areas. Kids are sometimes playing, dogs barking, objects flying across the screen, intrusive family members — all new dynamics for the practitioner and patient to learn to adapt to.  Nevertheless, the results have shown that this has not lost the sense of intimacy between practitioners and patients, nor the value such help and interactions bring.

What to do during an Online Therapy?

1- Find a quiet place. Somewhere where you’re least likely to be disturbed. We know it’s difficult, especially if you live in a shared home. Consider going outside, to a garden, or perhaps to a park.

2-Treat it like a real face-to-face session. At the beginning this may seem a bit strange, but behaving like you are at a physical appointment will make things seem more familiar and normal. Dress in a way you feel better and stay in a comfortable place.

3-Don’t be idle — try to keep busy in a constructive manner.  Before or after the online therapy, try to read as much as you can things that help with your wellbeing. Follow workout sessions, read instructions that help you stay active and improve your mood.

References – TIME – Washington Post – Very Well Mind – The Atlantic – Health Line


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