Support from a distance: How to find and see a remote therapist

A therapist weighs in on how to navigate the brave new world of remote mental health care

Published August 2, 2020 10:00AM (EDT)

Close up of young woman getting online medical help and advice during videocall with doctor (Getty Images)
Close up of young woman getting online medical help and advice during videocall with doctor (Getty Images)

If you are anxious, stressed, or depressed about the coronavirus pandemic, you're in good company. Many of us could use some professional counseling right now, but social isolation practices have made therapists' offices inaccessible just about everywhere. The solution? Teletherapy. 

Teletherapy (or "telemental health") is therapy conducted through video conferencing. Right now, it may be the safest way to receive counseling.  Typically, you won't need to purchase any special equipment or software; if your computer or phone has a front-facing camera and a microphone, you have everything you need.

But talking to a therapist in front of a screen may seem weird, especially for those of us who are used to in-person healthcare. As a clinical psychologist, part of my work lately has been helping assuage concerns and answer questions about teletherapy, and letting people know what to expect. I've assembled a list of common questions I hear from patients about the process.

Is teletherapy as good as face-to-face therapy?

Overall, the science says yes. In several studies comparing teletherapy and face-to-face therapy, clients' symptoms improved equally with both types of treatment for a variety of problems. These may include depression, trauma, and panic attacks.

Clients sometimes wonder whether they'll be able to bond with a new therapist through video chat. Fortunately, research indicates that ­the so-called working alliance – the strength of the emotional bond and working relationship between therapist and client – is equally strong in teletherapy and face-to-face therapy.

Will my insurance cover it?

Possibly. Some insurance companies covered teletherapy before the pandemic and others are adding coverage in response to it. To find out if you're covered, check your benefits booklet and look for a section labeled "telehealth." If you need help, call the customer service or member services number on the back of your health insurance card.

How do I find a therapist if I do have insurance coverage?

I recommend Psychology Today, a search tool that can filter therapists by clinical specialty, therapy modality, insurance network participation, and availability for online sessions. This site will suggest therapists near your zip code, but for teletherapy, you will likely be able to see anyone licensed in your state. Feel free to expand your search beyond your zip code.

Personal referrals to therapists can also come from friends, neighbors, colleagues, or your primary care doctor. Avoid seeing your best friend or family member's therapist, however. Therapists will typically decline to work with new clients who are close with their existing or recent clients.

You can also use the provider search tools on your health insurance company's website or call the company's member services number and ask for their assistance.

How do I find a therapist if I don't have insurance coverage?

If you don't have health insurance, or if your plan does not cover teletherapy, you can pay out of pocket. If money is tight, you can often find private practitioners who offer lower prices based on client need; look for terms like "reduced fee," "sliding scale," or "scholarship sessions" on their websites.

Open Path Psychotherapy Collective lets you search online for therapists offering sessions between $30 and $60, after paying a one-time $60 membership fee. They ask that clients only use their service if they are either uninsured or unable to afford their in-network mental health benefits.

Some community resources also provide inexpensive or free counseling to those with financial limitations. To learn about options in your area, call 2-1-1 or visit 211.org. The National Alliance on Mental Illness also offers a huge list of resources for free and low-cost services, including online/teleconference support groups, crisis lines, and warmlines (for non-emergency support).

What if I don't have a private space to talk?

For those who live with family members or roommates, social distancing has made privacy scarce. You can collaborate with others in your household, or get creative with your living space, to reserve a time and place for therapy. If you don't have a room to yourself, you can use a walk-in closet, a basement, or even a parked car. To create sound insulation in any space, do what therapists do: place a white noise source outside the door. You can use a fan or any device with a free white noise app. Person Centered Tech offers additional advice about preparing your space for teletherapy.

What are the downsides?

Technology glitches can interrupt sessions occasionally, especially if you don't have a strong internet connection. It can also be harder for therapists and clients to see each other's body language and facial expressions.

Teletherapy isn't a good fit for every problem or every person. Clients who are uncomfortable and unfamiliar with video conferencing technology may find the experience less valuable. And many (though not all) therapists also advise against telehealth for more severe mental health conditions, like psychosis.

* * *

Humans are social animals, so it's natural that social distancing will take a toll on us.

But remember that distancing need only be physical, not mental. Your support network, friends and therapists alike, are still there for you — in many cases, just a few clicks away.

By Halley Farwood

Dr. Halley Farwood is a clinical psychologist in private practice in Portland, Oregon. She specializes in treating depression and anxiety. 

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