Does online therapy work?
One of the biggest concerns about online therapy is that therapists don't have an opportunity to observe the patient—something that is usually integral to an assessment and diagnosis. The tone of voice, body language, and overall demeanor provide insight into an individual's well-being.
A major component of effective therapy involves the relationship between the therapist and the patient. As online therapy is impersonal (often, it's completely anonymous), many people have raised concerns about whether digital communication can provide skills, tools, and healing power to individuals staring at a screen.
Despite the concerns, research consistently shows that online treatment can be very effective for many mental health issues. Here are the results of a few studies:
A 2014 study published in the Journal of Affective Disorders found that online treatment was just as effective as face-to-face treatment for depression.
A 2018 study published in the Journal of Psychological Disorders found that online cognitive behavioral therapy is, "effective, acceptable, and practical health care." The study found the online cognitive behavioral therapy was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.
A 2014 study published in Behaviour Research and Therapy found that online cognitive behavioral therapy was effective in treating anxiety disorders. Treatment was cost-effective and the positive improvements were sustained at the one-year follow-up.
The Potential Benefits of Online Treatment
Online therapy offers some benefits over traditional face-to-face treatment:
People in rural areas or those with transportation difficulties may have easier access.
Many online therapy sites allow users to sign up with "nicknames" which can entice people who are embarrassed about getting services under their real names.
Most online therapy services cost less than face-to-face treatment.
Scheduling is more convenient for many people.
Studies show online therapy requires 7.8 times less of a therapist's time than face-to-face treatment—meaning therapists can often treat more people online than they can in-person.
Clients don't have to worry about seeing people they know in the waiting room.
It can be easier for some people to reveal private information when they're sharing it online.
Individuals with anxiety, especially social anxiety, are more likely to reach out to an online therapist.
The Potential Drawbacks
Online therapy isn't for everyone. Here are some potential risks and drawbacks:
Online therapy isn't meant for people with certain problems or conditions (such as suicidal intent or psychosis).
Without being able to interact face-to-face, therapists miss out on body language and other cues that can help them arrive at an appropriate diagnosis.
Technological issues can become a barrier. Dropped calls, frozen videos, and trouble accessing chats aren't conducive to treatment.
Some people who advertise themselves as online therapists might not be licensed mental health treatment providers.
Sites that aren't reputable may not keep client information safe.
It can be difficult to form a therapeutic alliance with someone when meetings aren't face-to-face.
It can be difficult for therapists to intervene in the event of a crisis.
How to Find an Online Therapist
If you are interested in online therapy, there are many options to choose from. Think about what type of services you want most—phone therapy, video chats, live chats, audio messaging, or text messaging.
You may find a local therapist who offers online services, or you might find you prefer a large organization that offers a substantial directory of therapists to choose from.
But do your homework and shop around for the service and price plan that best suits your needs.
Find the full article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
COVID 19 & Teletherapy
Seeing a therapist used to imply being in the same room with them, but not any longer. Teleconferencing has made it possible to see a mental health professional from a distance.
With recent requirements for social distancing, many therapists and clients have had to either pause their work or make other arrangements, including meeting by video conference.
I've been providing teletherapy services for a few years now. Here are some common questions and issues that come up when thinking about making the transition.
Will My Therapist Agree to Online Sessions?
Some therapists (myself included) are enthusiastic about using teletherapy, some won't use it at all, and a large number of therapists approach it with some reservations. I've been surprised how many therapists are now moving to it with the COVID-19 outbreak and resulting social distancing. Most therapists generally seem to find that it's a very beneficial approach.
Even among therapists I know who were skeptical about online sessions in the past, the majority have opened to the idea. They seem to recognize it as a good option to avoid an untimely break in the therapy relationship, and to provide continuity of care.
Will It Be Weird?
If you're generally comfortable with communicating through a screen (e.g., Skype, FaceTime), you'll probably be comfortable moving to online therapy. If you can't stand this form of communication, you'll likely have a harder time with it. Of the dozens of clients I've treated through teletherapy, most seem to find the transition to be smoother than they expected. Therapy tends to be intense, and quickly enough you're likely to forget about the medium and focus on the work.
That said, expect some differences with teletherapy. It's different when you're not in the same room with someone, and you're experiencing them in two spatial dimensions instead of three. It can also be harder to pick up on body language through a video. And while most of my clients seemed to be comfortable with making the switch, a few were not, or found the transition to be quite challenging. Occasional tech issues come up (like a delay in the audio and video), but typically can be handled with a little patience and humor.
Is It Effective?
Research suggests that therapy by video conference can be very effective, which has also been my clinical experience. It depends on you and your therapist, of course, but in general you should expect it to be helpful if you were finding in-person therapy helpful.
Personally, some of the most powerful clinical experiences I've witnessed have occurred through teletherapy. In my own practice, I've seen it work for people dealing with things like depression, anxiety, obsessive-compulsive disorder, insomnia, relationship issues, grief, and trauma.
Will Insurance Reimburse Me?
A growing number of insurance providers seem to be willing to cover online therapy sessions. They'll probably require the standard things for reimbursement: your identifying information, the provider's license and so forth, a diagnostic code, and a session (CPT) code. Check with your insurance provider before starting your sessions if you'll depend on reimbursement to cover the sessions.
How Does It Work?
You and your therapist will agree on a platform to use (or in some cases may decide to forego video and simply speak by phone). Some rely on Skype or FaceTime, although those options are not HIPAA compliant. More secure platforms include VSee, Zoom, and Doxy, among others. There may be a fee for your therapist to use the technology depending on the service, but it should be free for you (aside from your therapist's session fee, of course).
How Should I Prepare for My Sessions?
Some important and finer points about the logistics of teletherapy:
Do a test of the software beforehand for your own peace of mind and to be sure it will work, and verify that you have your therapist's contact information (e.g., VSee username).
Find a place in your home where you'll have as much privacy as possible. This could be a challenge if kids are out of school or other family members are always home (or work from home).
Along those lines, I recommend ear buds for privacy and also better sound quality. That way your therapist's voice won't feed back into your microphone and out their speakers.
Make sure you're sitting somewhere you'll be comfortable for the length of your session.
Have your screen on a stable surface, since excessive movement can create a feeling of seasickness for your therapist. If they're new to teletherapy and their screen is bouncing around, ask them to do the same.
A finer point: try to have the top of your head near the top of your video screen, rather than in the bottom half of the screen. That way when they're looking at your face they'll be looking more or less into their camera (assuming it's at the top of their computer), so it will feel like they're looking at you.
Be sure to close email and turn off notifications that could be distracting and dilute the experience for you. You'll want to have your full attention focused on your session.
Also close programs that could slow down your computer's processing ability and interfere with the quality of the video.
You may also need to work out payment arrangements with your therapist if you generally pay in person. Some therapists will keep a credit card on file for you; others will ask that you mail a check. Find out what they prefer.
Are There Other Advantages to Online Therapy?
One plus of online therapy you'll notice right away is that there's no travel time involved, so your sessions will probably take up much less of your day. With that in mind, you may want to build in some transition time into and out of therapy, since travel time often provides a buffer before and after your session. It might be challenging, for example, to return directly to childcare after an emotional session. Even a 10-minute break to process and digest the session can make a big difference.
You'll also never have to cancel for weather (assuming you have electricity and Internet), and there are no concerns about whether you could pass along a sickness to your therapist (or vice versa) if you're well enough to meet but possibly contagious. It's also possible to see your therapist when you're traveling, just as I've been able to see clients when I've been on the road.
What If My Therapist Won't Do Online Sessions?
If your current therapist isn't open to doing teletherapy, you might consider speaking with a new therapist who does offer online sessions. Obviously it's not ideal to have to start over with someone new, especially if you've been seeing your therapist for a while. But it may be your only option if you're committed to continuing therapy with as little interruption as possible.
If you don't want to start with a new person, consider other resources during the hiatus from seeing your therapist (and work with them on the plan, if possible). For example, there may be books, brief online courses, or other resources that will help you to continue the work. Your therapist might be open to having brief phone check-ins during this time.
Seek out additional support from loved ones, as well, and be sure to take care of your basic needs like sleep, nutrition, and movement to keep your body and mind healthy. You might find journaling to be helpful during this time, as it's been shown to be an effective way to process thoughts and emotions.
Keep in mind that there could be unexpected benefits to taking a therapy vacation. While it may not be ideal, an unplanned break from therapy can lead to surprising growth, as the work you've done settles in and takes hold.
The Bottom Line
If you're considering teletherapy, talk it over with your therapist and see if it's worth giving a try. You don't have to know in advance if it's the right decision for you—you can always plan to do a limited number of sessions to see how it goes. If it works well, it could be a convenient and time-saving way to continue the important work of therapy.
Find the fill article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
Breaking the Cycle of Fear
In every moment, you have the power to create your future. The “failures” you’ve had in the past don’t define your future or mean that you are going to “fail” again. You have the power to define who you are, what you want, and how to get there. Every day, remind yourself: I am not going to let my past define me. I am going to define me. I am going to create my future.
Get Comfortable with being Uncomfortable
Change is uncomfortable, but it’s also the only constant in life. The world around us—our relationships, jobs, living situations, friends, everything—is constantly changing and influencing us. Amid all of this change, why would we expect that we would stay the same? We’re constantly changing. Honor that. A lot of people feel that a change of heart is a negative thing. That it reflects a fickle nature. It doesn’t. You don’t have to prove yourself to anybody. You have to find what fits for you—right now, at this time in your life.
When we don’t honor the ways in which we’ve changed, we end up sticking with something just because we don’t want to quit. We end up stressed, overworked, and miserable, holding on for dear life to a dream we don’t even want anymore. This is dangerous—but as long as you’re still breathing, as long as you’re still alive, you have the opportunity to change your situation and find a dream that’s worth the gamble. Each breath is an opportunity to change. Each breath is an opportunity to be better than we were before. With each breath, we choose our future.
Lesson: You always have the opportunity to grow if you’re willing to change.
Stretch Yourself
The body is often naturally tight, and that’s okay. Breathe into your muscles and they will loosen. The same thing happens in life. Breathe into your fears and they will loosen their grip on you, opening you up to new opportunities. The more you breathe into your fears, the easier it gets to do so, and the more flexible you will become in trying new things.
Change is happening all around us and inside of us. If you’re flexible, you’re able to move easily with those changes and find your flow. If you’re not, you’ll get stuck, be unable to shift and adapt, and live in a way that isn’t working for you anymore.
The more flexible you are and the more you keep moving, the less likely you are to get stuck in your fears, doubts, and worries.
Lesson: Stay flexible and available for new opportunities.
Never Call It Failure
Things don’t always work out the way we want or plan. When a deal falls through, a client goes to a competitor, a job opportunity vanishes, a relationship ends, a proposal is rejected, or an experience falls short of your expectations, don’t call it a failure. Shift your mind-set. Stop asking, How did I fail? How can I stop failing? Instead, ask, How did that situation make me stronger? What can I learn from that experience?
It’s important to do a reality check. Do you want to keep pursuing this goal, or do you want to stop? Ask yourself: Is this something I want to push forward, or do I want to let it go and put my energy in another direction? Am I happy on this journey?
Lesson: You can’t fail if you don’t stop trying.
If you’re comfortable being uncomfortable, stretching yourself, and not calling fears failure, you’ll see opportunities for growth daily. Embrace growth, embrace change, and find your flow.
Read the full article on Goop.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Accepting Unwanted Emotions
Emotions: according to the dictionary, the definition of an emotion is, “a conscious mental reaction (such as anger or fear) subjectively experienced as strong feeling usually directed toward a specific object and typically accompanied by physiological and behavioral changes in the body”.
But emotions serve us in a variety of ways. For example, they give us valuable messages (e.g., fear in an unsafe situation), reveal how important something is to us (e.g., you have stronger emotions in your romantic relationship than you do when you’re shopping for cereal or having a casual conversation with a stranger), and prompt us to act (e.g., you stroke a partner’s face with love or turn away from spoiled food in disgust).
But the story of emotions is a bit more delicate and complex, as it isn’t simply about what we feel in response to what happens around us. We tirelessly size up our inner world and place value judgments on it. Depending on the circumstances we’re in and the messages we’ve received along the way about what we’re allowed to feel, emotions (or at least certain ones) may get tagged as acceptable, healthy, or reasonable, or they might get labeled as wrong, crazy, or threatening. For instance, researchers at the University of Oxford highlighted the following categories of disapproving beliefs when it comes to painful emotions:
Emotions are too powerful and can’t be managed.
Emotions are bad and/or ridiculous.
Emotions are defective and make no sense.
Emotions are unproductive.
My emotions could sabotage me or other people.
My emotions might spread to other people and I can’t let that happen.
What’s thorny about this is that if we have a negative outlook on our emotions, we’ve got a whole new load to carry—we’re more likely to have another negative emotion layered on top of the one we’re already experiencing. The emotions we have about how we feel are known as meta-emotions. For example, let’s say we see sadness as a sign of personal weakness and inadequacy. Because of this viewpoint, we might feel shame or fear in response to our sadness. And it’s not just uncomfortable emotions that get a bad rap. People can feel nervous about pleasant emotions too.
Our ideas about our emotional life don’t just impact how we feel about our emotions, but the steps we take to respond to them as well. To illustrate, let’s stay with our example of sadness. We regard it as a signal that we’re weak and defective in some way, and this idea stirs up intense shame. The big question now: What do we do with all of this? Considering that we’re treating sadness as intolerable and we feel ashamed of it, we’re relatively unlikely to talk about it with someone else, to be kind to ourselves in the face of it, or to allow ourselves to feel sad and see what happens. No, instead we’re probably going to be more inclined to react to sadness in other ways, such as:
Mentally beating ourselves up for feeling it
Racking our brains over why we feel this way and why we can’t get over it and feel happy like everyone seems to feel
Trying to cover it up when we’re around other people
Self-medicating with alcohol or other substances
How we choose to respond to our emotions also has an impact on how we feel and on our quality of life. If we criticize ourselves all the time, that harsh voice gets stronger and we’ll continue unintentionally manufacturing more shame. We could mull over why we feel the way we do and question why we can’t make it go away, but this approach is more likely to leave us feeling even worse. If we try to hide our sadness and mask what feels so unspeakable, we’re liable to bear the cost of this strategy, experiencing more distress, less comfort, and more detached relationships. And although we can try to escape through alcohol and other substances, this opens the door to use disorders and other problems.
There are a variety of other ways in which rejecting what we feel sets the stage for giving us more of the very thing we don’t want. For instance, when people are scared of emotions, this forecasts difficulty managing anger, feeling more upset, drawing from pleasant memories to feel better, and symptoms of posttraumatic stress disorder (PTSD). Moreover, people who view uncomfortable emotions as bad are also less likely to be empathic toward themselves. And the idea that painful emotions are hazardous is related to lower odds of naming such emotions for one’s children, a valuable step in emotional skill-building.
So if it doesn’t serve us to treat our emotions as off-limits, what’s the alternative? When we accept distressing emotions as being a universal, natural part of life, it’s ironically linked to experiencing them less and, in the long run, having better emotional health.
But why might this be? Why would accepting the emotions we don’t want generally be connected with them dwindling rather than growing? Researchers have proposed several possible explanations:
Rumination can make people feel worse, and individuals who accept upsetting emotions don’t tend to ruminate over them as much.
Efforts to avoid what a person feels can go awry and have a boomerang effect, furnishing them with more of what they tried to push away.
Individuals who accept their emotions may be spared an extra layer of emotional pain by not having to feel upset about feeling upset.
Disquieting emotions that we meet with acceptance are less likely to have as much staying power.
Acceptance is a mindset, an approach of giving ourselves permission to experience our emotions and taking the perspective that they’re human rather than silly, weak, crazy, wrong, dangerous, or beyond our power to ever be able to manage. It’s about challenging that self-critical inner voice that says we can’t feel what we do, or that an emotion will harm us or be a badge of our inherent fault or shame. Acceptance is about giving ourselves the space to listen to ourselves in a nonjudgmental way.
Read the full article on Psychology Today.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Growth during Life Transitions
Experiencing change is inevitable - changing of the seasons, changing jobs, relationships, etc. Although change can be scary at times, it’s an opportunity to grow and come out the other side stronger than before. Here are a few tips to help you cope with change:
be flexible
re-establish your personal goals
make you your number one priority
unplug from negativity
instead of fearing the unknown, embrace it
I know many of these are easier said than done. Don’t let change knock you down. On the other side of this process is a new opportunity to grow and to become a better person.
Therapy can be helpful when going through a change or life transition! I provide a complimentary consultation. Contact me now to see if we might be a good fit to work together!