The Challenges of Online Therapy

challenges of online therapy

In light of the coronavirus pandemic, online therapy has become a popular option for many who are struggling. Mental health issues have understandably been on the rise as a result of the pandemic, with the biggest increases in depression and anxiety taking place during the periods of strict lockdown, which comes as no surprise. These mental health issues can be tied specifically to the pandemic itself, such as thoughts and feelings related to the current and potential long-term effects of the virus – and these kinds of anxious and depressive thoughts and feelings about the virus are indubitably fed by the 24-hour news coverage of the pandemic and how easy it is to access this constant coverage.

The pandemic is also worsening mental health through its effects on society, namely increased social isolation, job and financial losses, housing insecurity, loss of coping mechanisms (e.g. close contact with friends and family), and reduced access to mental health services. Despite stretched mental health services, many people have been able to start or continue therapy online. Regular online therapy can prove to be extremely beneficial for those who are struggling right now, and it’s lucky we have the video chat software we do, as it makes therapy much easier and more effective than it would be if it could only be done over the phone. There are also benefits that online therapy has over in-person therapy, such as convenience and the time it saves. Online therapy may be cheaper too. Working remotely, therapists will have fewer overhead costs, such as renting office space, meaning they’re in a position to offer clients a reduced fee.

On the other hand, there are challenges of online therapy that deserve discussion. If you’re considering online therapy, it’s important to be aware of some of these challenges, so you can decide whether it’s worth it.

Is Online Therapy as Effective as In-Person Therapy? 

While online therapy may be easier to fit into your schedule than in-person therapy, which involves considerations like travel, many people using online therapy would agree that it’s not quite the same as face-to-face therapy. Face-to-face therapy is still taking place, but since remote therapy is an option for most therapists and clients, it is deemed safer to have sessions online. True, it’s easy to be at a safe distance from a therapist in his or her office, but you’re still both inside, where it’s easier for the virus to spread. You can reduce this risk of transmission if you both wear a mask, but then you significantly reduce the ability to communicate through body language. In terms of being as safe as possible, online therapy is preferred over in-person therapy.

But just as wearing a mask in therapy can impact body language, so can online therapy. After all, you don’t tend to see a person’s whole body in a video chat, and so a therapist may miss out on important visual cues from you that signal how you’re feeling in the moment. Also, the image on a screen will never be clearer than interactions in person, and with less-than-ideal image quality and bad lighting, this can mean missing out on valuable facial cues. These cues can be key factors in establishing an empathetic connection. Talking via video chat simply lacks the intimacy and nuances of real-world interactions. There is definitely something to be said about being in the physical presence of a therapist; it can add a lot of value to the therapeutic process.

If you don’t think online therapy will be as effective for you as in-person therapy, or you’re already doing online therapy and you find this to be true, this may be an issue when it comes to cost. As already mentioned, online therapy may entail reduced fees but not always. When clients move from in-person therapy to online therapy, the fee can stay the same. And if you’re experiencing less effectiveness in the online therapy, it can feel unfair to still pay the same fee. However, this issue can always be discussed. If a therapist can’t reduce the fee for online sessions, there are online therapy services, such as BetterHelp, which can be more affordable. Low-cost counselling and therapy is another option: in this case, you would pay a fee significantly lower than in normal therapy, because your therapist would be in training.

Technical Issues 

Online therapy can entail some annoying technical issues at times. For example, you or your therapist’s internet could go down and your webcam or microphone could malfunction before or during the session. This is problematic for all sorts of reasons. Firstly, it can make therapy harder to access; secondly, it can add frustration and stress to your therapy sessions; and thirdly, if the video and/or audio are malfunctioning during the session, this can lead to communication issues.

If the video is freezing and the audio is distorted, this can ruin the natural flow of a conversation. You don’t want you or the therapist to have to keep repeating yourselves or try and fix a technical issue in the middle of the conversation, especially when you’re sharing intimate and vulnerable details and your therapist is trying to respond accordingly. Nonetheless, provided both you and the therapist test the webcam, microphone, and internet connection, it’s unlikely you’ll run into any major technical issues during the sessions.

Privacy Issues 

Privacy is another major issue associated with online therapy. Since information is being transmitted online, privacy hacks and leaks become more of a concern. This is not something you have to worry about with in-person therapy. Zoom is one of the most common video chat platforms used for online therapy. But the company has been routinely criticised for a range of privacy issues, such as collecting users’ data and sending it to Facebook for advertising purposes, as well as not encrypting calls (despite claiming otherwise). Some problems have been fixed, such as stopping hackers from entering Zoom calls, but many privacy issues remain.

Using Zoom for online therapy may be off-putting for these reasons. Since you’re sharing highly sensitive, personal, and confidential details about yourself, it’s understandable you’d want to ensure no one else besides your therapist would be privy to such information. If Zoom’s privacy issues concern you, there are alternative video chat platforms you can use that appear to be superior in terms of privacy. If a therapist only offers the option of Zoom, it’s worth discussing your privacy concerns with them. It’s a legitimate point to raise. If you don’t feel comfortable opening up during a Zoom call, out of concern for your privacy, then this will impact the therapeutic process. You can discuss the possibility of using an alternative app for your sessions and if this isn’t possible, for whatever reason, then you might need to find an alternative therapist who can accommodate you.

These challenges of online therapy exist in other forms of online mental health support, such as peer support groups. Nevertheless, many people using both online therapy and online support groups find that the challenges don’t make these forms of support useless. In fact, the challenges can seem insignificant in the greater scheme of things, as the benefits of empathetic connection and emotional support are still present, and this can be integral for protecting one’s mental health.

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