Online Therapy—Does it Work?

I can help you address your issues and concerns . . . even by phone

In anxious times, we seek connection, reassurance, and a sane and rational point of view. We want to speak with a therapist who can help calm our fears and reorient our perspective. We need support so we can manage our own emotions and be there for our loved ones. But today, our desire for more assistance comes at the exact time we are being instructed to “shelter in place” and engage in social distancing. Fortunately, online therapy is available. But for many, the idea of online therapy is suspect: How can someone I’ve never met in person help me? How effective is it to communicate only by phone or video? How can I know what I say will be kept private and confidential? Does online therapy work for couples or families? How will a virtual therapy experience fulfill my need for human contact and authentic compassion?

It is natural to be apprehensive about whether online therapy (also known as telehealth) works. For people who have never before sought help from a counselor or therapist, the idea of embarking on online therapy can be daunting. And for those who have experienced in-person therapy before, the prospect of therapy by phone or video can feel awkward and strange. Online therapy is different from a face-to-face meeting with a therapist. It can feel distant and artificial because we are used to having in-person conversations with other people, particularly when we talk about sensitive topics or emotional issues. When you meet a therapist by phone or video that you’ve never met in person, you may wonder how this person can help.

How can someone I’ve never met in person help me ?

It’s normal to question whether you’ll be able to connect with a therapist you have never met in person. In meeting anyone new, we rely on a variety of visual and auditory cues to collect information, and we use our intuition to develop a “felt sense” of the individual. If we meet a therapist in person and observe their office, it augments our impression.

Of course, much of the in-person data we use to appraise an individual is not available when we meet someone by phone. Even with video, the visual information we receive is limited, and sometimes can be skewed by inadequate lighting or camera distortion. However, whether your first meeting with a therapist is in person or online, the same questions arise: Do I like this person? Can they can understand me? Can they help me? Are they attentive, caring, and responsive? You ask the therapist questions and reflect on the answers. You notice the therapist’s words and tone of voice, and you observe your own inner response.

When you meet a therapist for online therapy, you don’t have the luxury of letting your eyes roam around their office as you settle into the space. However, you instinctively notice the therapist’s words and tone of voice. You feel the quality of the connection. You ask questions about the therapist’s experience or approach, and you consider the answers. Developing trust in a therapist, just as in anyone in a social or business relationship, takes time. We get to know another person as we reveal more of ourselves and reflect on their responses. Often, we can’t know in one session whether or not the therapist is a good fit for us, but that is true whether we are meeting a therapist in person or for online therapy.

When I work with you by phone or zoom, just as if I were meeting you in person, I give you time to say what is on your mind, to describe your thoughts in detail, and to express your feelings. I empathize with your pain, respond to your concerns, and ask clarifying questions. As I come to understand  you and your dilemmas, I can guide you to view yourself and your situation with more depth, clarity, and kindness. Our relationship evolves over time as the process of therapy unfolds.

How effective is it to communicate only by phone or video?

Therapy by phone or video has both drawbacks and advantages. Naturally, in-person contact feels more comforting than remote connection. Visual interface, when it’s available, offers a kind of connection beyond the spoken voice, but visual information isn’t necessary to form a meaningful relationship with a therapist. Even by phone, you can experience the therapist’s attunement and presence. Support lines—phone based crisis services, hot lines and warm lines—have provided valuable care and connection for those in need for many decades. For several years in the early 2000s, I led tele-classes—groups that met by conference call—for mothers whose daughters were suffering from eating disorders. Because we met by phone, women from different parts of the country were able to access the calls. Each mother was grappling with the pain of witnessing and caring for a child in the throes of a self-harming, life-threatening disease. The mothers who participated in the conference calls told me that they appreciated the support, connection, and guidance that I provided  during the calls. While I wish that I could have met with each mother in person (and I did have local, in-person groups as well), I was grateful these mothers were able to benefit from the calls.

A benefit of using phone- or video-based therapy is that it relieves you of travel annoyances—driving and finding parking, or using public transportation, to get to a therapist’s office.  Also, you do not need to be geographically close to the therapist with whom you work. It is fortunate that current technology makes online therapy possible, particularly at a time when many people feel more urgency about getting help than under “normal” circumstances. I appreciate the opportunity to connect with current or new clients by phone or video.

How can I know what I say will be kept private and confidential?

It is important that you feel safe and know that what you say will be kept between you and your therapist. Therapists are ethically bound to maintain the confidentiality of their clients.

A therapist generally will provide you with a written consent form to read and sign, acknowledging that you understand. The form explains confidentiality, and describes the few situations in which the law requires them to break confidentiality, in order to protect your welfare or that of another person.

To keep your online session confidential, the therapist will speak to you from a private setting. You need to ensure privacy on your end. This may mean making special  arrangements with family members or roommates, and perhaps also negotiating for internet access during your session time, if household internet is limited. Beyond the constraints imposed by your own situation, there is nothing inherently less private about online therapy than when you see a therapist in person. When I work with clients remotely, I talk from a room that is private. In addition, I often use air pods, which ensures that  what you say is audible only to me.

Does online therapy work for couples or families?

Online therapy with more than one participant can work well, although logistics may require some consideration. If two or more family members are in the same house, speaker phone is an option if everyone can be in the same room. Alternatively, if you are using video, one or two family members can be on the same iPad or computer, or on separate devices, with sufficient distance between them to avoid electronic interference. If family members are not living under one roof, online therapy can be an excellent option, because travel does not become an issue. In pre-Covid-19 days, when I worked with families whose members were geographically separated, therapy by conference call or video made family therapy more accessible. I suspect phone and video conferencing may be more common in post-Covid-19 times than before, because some people will appreciate its convenience.

How will a virtual therapy experience fulfill my need for human contact and authentic compassion?

A therapist, whether communicating with you by phone or on a video screen, can hear your concerns and reply with understanding and empathy. If you share with a therapist what is real and meaningful for you, the therapist can respond to you with authenticity and caring. Remote connection does not mean that the therapist will be reserved, aloof or detached. You’ve doubtless experienced phone or facetime connection with friends and family over the years, and felt a strong emotional connection with the other person, even though they were not physically present. Similarly, a therapist can provide you with a genuine experience of being met emotionally, heard, and understood. Of course, we all yearn for in-person contact, but rather than isolating and deciding your problems aren’t the kind a therapist can handle by phone nor video, know that online therapy provides a valuable and easily accessible resource for help.

I  am experienced working with individuals, couples and families by phone, on video, and in person. I am a seasoned therapist, thoughtful, compassionate, and a good listener. I am available to help you and your loved ones with whatever struggles you are facing. “Sheltering in place” brings its own challenges, as well as sometimes making space for dormant issues to surface. In these uncertain times, know that I am here to help you.

You don’t have to face your problems alone. Help is available. Please call me today at 415-602-1403.