The Washington Post - USA (2022-05-26)

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2022

coverage of telehealth visits and

allow out-of-state providers to

participate, are expiring. And

some private insurance compa-

nies have begun rolling back tele-

health coverage.

But now is the time that the

teletherapy option, in particular,

is vitally needed, many experts

say. T he prevalence of anxiety a nd

depression has increased by

25 percent worldwide since the

start of the pandemic, while, at

the same time, there’s an alarm-

ing shortage of therapists taking

new clients.

The use of teletherapy by psy-

chologists increased from about

7.1 percent of their work pre-

pandemic to 85.5 percent of their

work during the pandemic, ac-

cording to a national study led by

researchers at Virginia Common-

wealth University and published

in American Psychologist. And

research indicates that it can be

as effective as in-person treat-

ment, said Ashley Batastini, a

psychologist and assistant profes-

sor in the counseling, educational

psychology and research depart-

ment at the University of

Memphis.

Batastini analyzed two dec-

ades’ worth of data comparing

teletherapy and traditional treat-

ment, for a range of diagnostic

criteria that included depression

and eating disorders. “We didn’t

find any evidence that there’s a

difference between videoconfer-

encing and in-person mental and

behavioral health interventions,”

Batastini said. In fact, based on

the data, some women appear to

have better outcomes using video

therapy than in-person treat-

ment, although Batastini says

that further study is needed.

The American Psychological

Association supports the contin-

ued use of telepsychology, in a

secure and private way, said Lynn

Bufka, associate chief of practice

transformation for the APA.

“We’ve had the big experiment for

two years, and we’ve seen that it

works.”

Bufka added that the organiza-

tion was “advocating that tele-

health should continue to be an

option that is paid for equivalent-

ly, since there’s no difference in

the quality of the services that are

delivered.”

Timothy Heckman, senior as-

sociate dean for research and

faculty affairs at the University of

Georgia, co-authored a study that

found that teletherapy produced

large improvements in patient

outcomes that persisted for sev-

eral months after treatment end-

ed and were no different than the

reported outcomes from clients

who received in-person therapy.

However, more research is need-

ed with a more diverse group of

clients, including those with post-

traumatic stress disorder, Heck-

man said.

The efficacy of teletherapy is

not the only reason it should

continue, patients and practitio-

ners say. The convenience of tele-

therapy is also a lifeline for people

who have challenges getting to

in-person appointments — such

as people who live in rural areas

where practitioners are scarce,

those who live in traffic-choked

urban areas, those who have been

exposed to or have symptoms

of covid-19, and those who are

disabled.

Pedro Ventura lives in Los An-

geles and is a quadriplegic be-

cause of a spinal cord injury.

Before his 2019 injury, the result

of gun violence, he attended ther-

apy in person, both in New York

City and Los Angeles. In New

York, he often commuted an hour

and half by subway to get to his

appointments.

Now, Ventura doesn’t have to

spend time getting to an in-

person appointment, and he also

doesn’t h ave to worry whether his

therapist’s office is too small to

comfortably accommodate his

BY AMY ETTINGER

As I drove my husband of
18 years to the emergency room
last November, he apologized for
the inconvenience. “I’m sorry,”
Dan said. “I just can’t believe this
is happening.”
Dan had been struggling with
sleeplessness, depression and
anxiety for months. Persistent
negative thoughts plagued him,
until they crowded out every-
thing else. He was suffering from
the second epidemic that’s raging
throughout the world right now:
the mental health crisis.
After several weeks of minimal
sleep, Dan finally got an emergen-
cy telehealth appointment with a
psychiatrist. After 10 minutes of
talking with him, she had me join
the Zoom call and told me I
needed to take Dan to the nearest
ER for a psychiatric evaluation
immediately.
That v irtual intervention saved
his life, but the stress of helping
my h usband began to wear on me.
I needed a therapist for myself,
but I didn’t want to see one in
person. I have always been anx-
ious about going into doctors’
offices, a condition often referred
to colloquially as “white coat syn-
drome.” My blood pressure rises
and my h eart pounds when I need
to see any medical professional.
Besides, I have a busy schedule
with work and parenting.
After months of searching, I
found a provider who offered the
option of online therapy. I decid-
ed to give it a try, even though I
was skeptical about revealing my
feelings through a Zoom call. I
worried that virtual sessions
would ruin the intimacy of one-
on-one counseling and that a
therapist would be just another
talking head on a screen.
But right away, I began to no-
tice the benefits. For the first time
in my l ife, I felt no anxiety b efore a
therapy appointment. I found it
comforting to talk to my counsel-
or while wearing fuzzy house slip-
pers. And to my surprise, I was
able to share my emotions
through a screen much more easi-
ly than I’ve ever been able to with
an in-person psychotherapist.
I realize that my experience
pushes back against prevailing
cultural ideas about the “return
to normalcy” and the need to
reestablish analog experiences.
It’s true that many therapists and
patients have been eager to get
back to in-person sessions. Oth-
ers who would prefer to continue
telehealth appointments, howev-
er, are finding the option being
curtailed. Emergency orders es-
tablished by states as the pan-
demic took hold, which mandate

wheelchair. “You don’t think

about it when you’re not in a

chair,” Ventura said, “but accessi-

bility in an office is not always a

given.” Finding a new therapist

was also easier online, because he

didn’t have to travel to multiple

offices to interview potential

counselors.

Ventura said he doesn’t miss

being in the physical room with

his therapist. “I feel like I can

open up about the same on the

screen. A good therapist is a good

therapist.”

Los Angeles-based therapist

Maria Evans sees all of her clients

remotely, in part because she

wants them to avoid the hassle of

traffic. At the start of the pandem-

ic, Evans helped train more than

10,000 therapists and social

workers who needed to transition

to teletherapy.

In some cases, Evans believes

that clients would be better

served going to an office to meet

— if they don’t feel safe in their

homes, for example, or don’t have

privacy. But in most cases, she

thinks teletherapy will suffice;

she has even had long-term pa-

tients she has never met in per-

son. When they parted, she said,

“there were a lot of tears. This

shows we’re still able to build as

in-depth connections as we

would in person.”

Although convenience is a

huge factor, another important

benefit of teletherapy is the in-

creased comfort patients feel,

which may allow them to open up

even more. For me, it’s my fuzzy

slippers; Santa Monica,

Calif.-based therapist Ashley Gra-

ber said she has clients whose

companion animals join them for

sessions. She also said online

therapy helps her have better

insight into a patient’s home life.

And it doesn’t h ave to be all one

way or the other. Some patients

benefit from a hybrid course of

treatment. My husband, for ex-

ample, prefers to see his therapist

in person, feeling as if he benefits

from the connection. But he still

has many behavioral health ap-

pointments online, which saves

him hours of driving each week.

I, however, will continue my

therapy online as long as my

insurance reimburses for it,

choosing healing from the com-

fort of home.

Amy Ettinger is the author of “Sweet

Spot: An Ice Cream Binge Across

America.” Find her at

amyettinger.com.

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PERSPECTIVE

In some areas, telehealth is being curtailed. But it is still needed.

Wellness

ISTOCK

Research shows that the use of teletherapy by psychologists increased from about 7.1 percent

of their work pre-pandemic to 85.5 percent of their work during the pandemic.