While telebehavioral health services have been around since the 1950s, they have not been generally accepted (in the eyes of the public) or widely utilized. COVID-19 has brought (and will continue to bring) with it a tremendous amount of changes. One such change is how people are accessing healthcare. Below I speak to a few pieces of information about telebehavioral health that I hope helps some people make a more informed decision about if such services are appropriate for their needs.
The Elimination of Barriers
Some people who have sought psychological services have experienced barriers to engagement. A non-exhaustive list can include geographical restrictions, transportation and financial barriers, social isolation, stigma associated with receiving mental health services, access to specific expertise, mobility (e.g., client or clinician vacations), and practical limitations (e.g., people with changing weekly schedules). Telebehavioral health has made seeking and receiving appropriate and effective care possible, whereas before the above barriers made consuming such services either incredibly difficult or impossible.
When is it Indicated, and When is it not Indicated?
Telebehavioral health is not clinically indicated for everyone in search of a therapeutic process. It is not recommended for people who are unable or unwilling to reliably utilize the required technology, or for those who struggle with moderate depression, current suicidality, homicidality, or psychosis, or those with a high need for crisis or non-appointment care. For those who the above criteria do not apply, then it is likely that telebehavioral services may be appropriate. As with many things in life, it is best to make a collaborative decision (client to provider) on a person-to-person basis.
Telebehavioral Health’s Evidence Base
Since the reopening process began, there have been several people who have called asking if I had resumed in-person sessions. I have not (till this point) resumed in-person sessions. When I reflect that there is an evidence base to telebehavioral health services and add that I have been conducting such services for the past several years, many people say that they are hesitant to engage through the remote medium. I believe a portion of this reasoning is because of the assumption that remote-based therapy services are not as effective as in-person therapy services. I can certainly understand such an intuition; after all, therapy is an intimate process, and the therapeutic connection and relationship play a significant role. The evidence supporting telebehavioral health’s efficacy, however, is robust and compelling.
A 2013 literature review found that telebehavioral health was an effective form of assessment and diagnosis across multiple populations of people (Hilty et al., 2013). Further, a 2018 compilation and review of telebehavioral health studies published in peer-reviewed journals found that the service improved access to and cost-effectiveness for treatment and had positive therapeutic outcomes. As an aside, if interested, there are hundreds of peer-reviewed articles on https://telehealth.org/bibliography/ for further education. In addition to the existing empirical base, I have experienced how impactful and effective telebehavioral health can be, even with therapy-ambivalent young men. The relationship can still be strong. After all, the content discussed and process is the same, the only difference is the client and provider are in different locations.
Above and beyond providing therapy services, I have recently enjoyed engaging with prospective clients, fellow professionals, and, well, anyone who cares to listen about the efficacy and legitimacy of telebehavioral health services. If you are motivated to learn more because you, or someone you know, is interested in engaging in therapy, please contact me. I am happy to discuss the possibility of working together. Lastly, while telebehavioral health is unlikely to return its former unpopular and uncommon status, I too, look forward to being able to see people in person, although not a minute before we all feel safe in doing so.