This article originally appeared in The New York Times.
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The 10-year-old girl was afraid that her American Girl dolls — buried in the bedroom closet — would come alive and attack her. As the girl pointed her iPad at the scary closet door in a remote therapy session, her therapist, Daniela Owen, was able to coach her in real-time to conquer the fear of the dolls.
“This wouldn’t have been as effective in my office,” Owen, a psychologist based in Oakland, later explained. “Being able to do the exposure in her room was so much more powerful.”
Owen, like the overwhelming majority of therapists, switched from in-person to remote therapy during the coronavirus shutdown. According to a recent survey from the American Psychological Association, three-quarters of clinicians are doing only teletherapy, and another 16% are doing a combination of remote and in-person sessions.
Many therapists were initially reluctant. Tamara Greenberg, a San Francisco-based psychologist, dreaded the pivot, for example, because she worried it “wasn’t as real a form of therapy.” And now? “I would say it’s really been one of the most surprising, and in many ways pleasurable, experiences of my professional career,” she said. Interviews with more than 20 therapists reveal similarly positive experiences, even as they also acknowledged some downsides, and that they missed seeing patients in person.
As the nation gingerly begins to reopen, many providers say that remote therapy is working so well and offers such convenience to their patients that they will continue with it even after the pandemic.
Peer-reviewed studies have shown that remote therapy — or “teletherapy,” which is generally done through videoconference — can be just as effective as in-person therapy for treating post-traumatic stress disorder, depression and anxiety, according to Leslie Morland, director of the Regional TeleMental Health Program at the San Diego VA Health Care System. “There’s always a contingent who are pretty convinced that they have to have their patients in the room with them, even though that’s not supported by the data,” Morland said.
Much of the research was driven by the Department of Veterans Affairs, which sees telehealth as a way to expand access to therapy for veterans who live in tough-to-reach areas. “The research shows that clinicians can be as effective in a telehealth environment as they are in face-to-face,” said the chief executive of the American Psychological Association, Arthur C. Evans. Teletherapy could bring therapy to millions of people who need it. A 2017 study from the Substance Abuse and Mental Health Services Administration found that of the 46.6 million Americans with a mental health issue, only 42.6% received treatment. Morland says telehealth can help close the gap.
In addition to the obvious benefits of convenience and flexibility, video sessions can give therapists a literal window into the patient’s home. Teletherapy can offer “a much deeper level of knowing the child, and understanding what their world might really be like,” said Lisa Dion, president of the Synergetic Play Therapy Institute, based in Boulder.