Essential Guide to Setting Healthy Boundaries as a Caregiver

Essential Guide to Setting Healthy Boundaries as a Caregiver

by Ree Caregiving

Have you ever felt overwhelmed, stressed, or burnt out from your caregiving responsibilities? If so, you’re not alone. According to the National Alliance for Caregiving, 42 million Americans serve as unpaid caregivers, and 36% report high emotional stress. That’s why it’s so important to learn about setting healthy boundaries as a caregiver.

While caregiving can be deeply rewarding, it often comes with unique challenges that can lead to burnout. As a caregiver, you’re probably familiar with the challenges of balancing your loved one’s needs with your own. Let’s explore the importance of setting caregiver boundaries and learn practical strategies to implement them effectively.

Content

Why Caregivers Need to Set Boundaries

Signs of caregiver burnout and compassion fatigue

Nurse helps someone with a cane

Caregiving can be emotionally and physically demanding, often leading to burnout if proper boundaries aren’t in place. 

Common signs of burnout include:

  • Exhaustion and overwhelm
  • Mood swings or irritability
  • Neglect of your own health and well-being
  • Withdrawal from social activities and relationships

How poor boundaries affect mental and physical health

Without proper boundaries, caregivers often experience negative effects on their mental and physical health. Research shows that caregivers who report high stress levels had a 63% higher mortality rate compared to non-caregivers. 

Poor boundaries can lead to:

  • Chronic stress and anxiety
  • Depression and feelings of hopelessness
  • Weakened immune system and increased susceptibility to illness
  • Sleep disturbances and fatigue

Common challenges caregivers face in setting limits

Setting boundaries can be difficult for many caregivers. You may feel:

  • Guilt about prioritizing personal needs
  • Fear of disappointing or upsetting the care recipient
  • Difficulty saying “no” to additional responsibilities
  • Lack of support from family members or healthcare providers

Benefits of establishing healthy boundaries

2 hands holding an elderly person's hand

Implementing healthy boundaries can have numerous positive effects on both the caregiver and the care recipient. Benefits include:

  • Reduced stress and improved mental health
  • Better physical health and increased energy levels
  • Improved quality of care for the recipient
  • Enhanced relationships with family members and healthcare teams

Essential Caregiver Boundaries

To help you establish and maintain healthy boundaries, let’s explore some key areas to consider.

Time management and scheduling boundaries

Nurse shows her patient a tablet on the couch

Effective time management is crucial for maintaining a healthy work-life balance as a caregiver. Consider implementing the following strategies:

  • Create a structured daily schedule
  • Set aside dedicated time for self-care activities
  • Use a calendar or planner to track appointments and tasks
  • Learn to say “no” to non-essential commitments

Financial boundaries and resource allocation

Managing finances can be a significant source of stress for caregivers. Establish clear financial boundaries with these tips:

  • Create a caregiving budget
  • Discuss financial expectations with family members
  • Explore available financial assistance programs
  • Consider a caregiver contract
  • Seek professional advice for long-term financial planning

Physical space and personal privacy limits

Maintaining personal space is essential for both the caregiver and care recipient. Consider the following:

  • Designate private areas in the home for both parties
  • Establish rules for respecting personal belongings
  • Set clear guidelines for visitors and social interactions
  • Create a safe space for the caregiver to retreat when needed

Emotional boundaries and mental health protection

Source: CareVoyant

To protect your emotional well-being as a caregiver follow these sustainable caregiving strategies:

  • Practice self-awareness and recognize your emotional limits
  • Set boundaries on emotional labor and support
  • Develop healthy coping mechanisms for stress
  • Seek professional help when needed

How to Set Boundaries Effectively

Next, let’s learn the practical steps for setting healthy and effective boundaries for caregiving.

Woman giving a sick person pills
Source: Karolina Grabowska

Decide your personal limits and non-negotiables

To set effective boundaries, you must first understand your own limits. Think about:

  • Your core values and priorities
  • The activities or responsibilities that cause you the most stress
  • What you need to maintain your physical and mental health

Once you’ve identified your limits, make a list of non-negotiable boundaries that you’re committed to maintain.

Use clear and direct communication techniques

Effective communication is key to setting and maintaining boundaries. Try these techniques:

  • Use “I” statements to express your needs and feelings
  • Be specific and clear about your boundaries
  • Practice active listening when discussing boundaries with others
  • Avoid blaming or accusatory language

Deal with guilt and resistance from others

Source: Sustainable Caregiving

It’s common to experience guilt or face resistance when setting boundaries. Here are some strategies to cope:

  • Remind yourself that boundaries are necessary for sustainable caregiving
  • Educate others about the importance of caregiver self-care
  • Seek support from other caregivers or professionals
  • Practice self-compassion and acknowledge your efforts

Create structured caregiving schedules

A well-structured schedule can help reinforce your boundaries:

  • Create a daily or weekly caregiving routine
  • Schedule regular breaks and respite care
  • Involve other family members in the caregiving schedule
  • Use technology to streamline tasks and reminders

Working with Family Members and Healthcare Teams

Once you establish your personal boundaries, the next step is to discuss them with your family members and healthcare providers. 

Divide and delegate responsibilities 

Person placing a cast on child's leg
Source: ThisisEngineering

Sharing caregiving duties can help prevent burnout and maintain healthy boundaries. Try these approaches:

  • Hold a family meeting to discuss caregiving responsibilities
  • Create a caregiving task list and assign roles based on individual strengths
  • Use online tools or apps to coordinate care among family members
  • Regularly reassess and adjust responsibilities as needed

Communicate boundaries to healthcare providers

Nurse helps older man off his couch

Clear communication with healthcare providers is essential for effective care. Some tips:

  • Prepare a list of questions and concerns before appointments
  • Express your limitations and needs as a caregiver
  • Ask for clarification on care instructions and expectations
  • Discuss options for respite care or additional support

Manage expectations with siblings and relatives

Family dynamics can complicate caregiving. To manage expectations:

  • Be open and honest about your limitations
  • Encourage family members to contribute in ways that suit their abilities
  • Set realistic expectations for care and family involvement
  • Address conflicts or disagreements promptly and respectfully

Build a support network and backup system

A strong support network is crucial for maintaining boundaries. Consider:

Getting Professional Support

This section discusses some professional healthcare options to consider.

Research respite care options

Respite care is a program that temporarily pays for care when family caregivers need to take a break or a short trip, and can be found via:

  • In-home respite care
  • Adult daycare centers
  • Short-term residential care facilities
  • Family and friends

Explore other caregiver support services

Nurse smiles at lady in wheelchair

Many organizations offer support services for caregivers:

  • Caregiver training and education programs
  • Home health aide services
  • Meal delivery and transportation assistance
  • Legal and financial counseling

Work with counselors or therapists

Therapist talking to teenager and their mom
Source: Vitaly Gariev

Professional mental health support can be invaluable for caregivers. 40% to 70% of family caregivers report having clinical depression. Some ways to cope include:

  • Individual therapy for stress management and coping skills
  • Family counseling to address caregiving dynamics
  • Cognitive-behavioral therapy (CBT) for managing anxiety or depression
  • Support groups led by mental health professionals

Find local caregiver support groups

Connecting with other caregivers can provide emotional support and practical advice:

  • Check with local hospitals or community centers for support groups
  • Search online for virtual support groups
  • Explore condition-specific organizations (for example, Alzheimer’s Association)
  • Ask healthcare providers for recommendations

Maintaining Boundaries Long-term

Regular boundary check-ins and adjustments

Boundaries may need to evolve as caregiving needs change. Plan by using:

  • Monthly self-assessments of your current boundaries
  • Open discussions with family members about boundary effectiveness
  • Adjustments to boundaries based on changing circumstances
  • Celebrations of successes in maintaining healthy limits

What to do when someone violates your boundaries 

When someone crosses your boundaries, here’s how to address it right away:

  • Restate your boundary and explain its importance
  • Use “I” statements to express how the violation affects you
  • Offer alternative solutions or compromises when appropriate
  • Be consistent in enforcing consequences for repeated violations

Self-care strategies and stress management

Pregnant woman sitting on map outside meditation
Source: Styled Stock Society

Prioritizing self-care is essential for long-term boundary maintenance:

How to adjust boundaries when caregiving routines change

Be prepared to adjust your boundaries as circumstances evolve:

  • Assess the care recipient’s changing needs
  • Communicate with healthcare providers about care plan updates
  • Involve family members in discussions about boundary modifications
  • Seek professional advice when facing significant changes in care requirements

Conclusion

Whether you’re caring for an aging parent, a child with special needs, or a partner with health challenges, learning to establish and maintain boundaries can help you provide better care while protecting your own well-being.

Setting and maintaining boundaries as a caregiver isn’t selfish – it’s smart and necessary. you can create a sustainable caregiving arrangement by establishing clear limits, communicating your needs, and prioritizing self-care. 

Identify one boundary you need to set, and make a plan to clearly communicate it. Start small, be consistent, and remember that healthy boundaries lead to better care for both you and your loved one. 

References

8 ways for caregivers to balance work and family. (2023). Randstad. Retrieved from https://www.randstad.com.sg/career-advice/tips-and-resources/8-ways-caregivers-balance-work-family-caregiving/

Alexy, J. (2018). How to set boundaries as a caregiver. Áegis Living. Retrieved from https://www.aegisliving.com/resource-center/set-boundaries-as-a-caregiver/

Caregiving in the U.S. 2020. (2020). National Alliance for Caregiving and AARP.  Washington, DC: AARP. Retrieved from https://press.aarp.org/2020-5-14-Caregiving-in-the-US-Report

Compassion Fatigue: Why It’s Important to Recognize. (n.d.). California Caregiver Resource Centers. Retrieved from https://www.caregivercalifornia.org/2023/04/03/compassion-fatigue-why-its-important-to-recognize/

Could You Benefit from Counseling? (2022). Caring Together Santa Barbara County. Retrieved from https://fsacares.org/counseling-fore-caregivers/

Help! I need a break! How can I find respite care? (n.d.). Family Caregiver Alliance. Retrieved from https://www.caregiver.org/faq/help-i-need-a-break-how-can-i-find-respite-care/

Madison. (2019). How to Set Boundaries with Your Aging Parents. MeetCaregivers. Retrieved from https://meetcaregivers.com/setting-boundaries-with-difficult-elderly-parents/

Maintaining Boundaries as a Caregiver: Go From Guilt to Glow. (n.d.). Mental Health America. Retrieved from https://mhanational.org/maintaining-boundaries-caregiver-go-guilt-glow

Navigating Mental Health Challenges in Home Care Patients: A Guide for Caregivers. (n.d.). Retrived from https://www.carevoyant.com/home-health-blog/navigating-mental-health-challenges-in-home-care-patients

Schier-Akamelu, R. (2023). 2023 Caregiver Burnout and Stress Statistics. A Place for Mom. Retrieved from https://www.aplaceformom.com/senior-living-data/articles/caregiver-burnout-statistics

The Benefits of Caregiver Contracts: Ensuring Clarity and Boundaries. (2024). HumanCare. Retrieved from https://www.humancareny.com/blog/caregiver-contracts

What is Respite Care? (n.d.). U.S. Department of Veterans Affairs. Retrieved from https://www.va.gov/geriatrics/pages/Respite_Care.asp

Wilbanks, T. (n.d.). Empowered Caregiver Support System. Sustainable Caregiving. Retrieved from https://www.sustainablecaregiving.com/empowered-caregiver-support-system/

Wilbanks, T. (n.d.). Sustainable Caregiving: Boundaries. Sustainable Caregiving. Retrieved from https://sustainablecaregiving.com/sustainable-caregiving-boundaries/

Woodruff, L. (2024). How to Set Boundaries as a Family Caregiver. AARP. Retrieved from https://www.aarp.org/caregiving/basics/info-2024/caregiver-boundaries.html

Chronic Pain Management Apps: The Best Digital Health Tools for Relief

Chronic Pain Management Apps: The Best Digital Health Tools for Relief

by Ree AI Health Tech Med Tech

Living with chronic pain can be a daily struggle, affecting millions of people worldwide. According to the CDC, an estimated 20.9% of U.S. adults experienced chronic pain in 2021. Fortunately, technology has stepped in to offer innovative solutions, like chronic pain management apps.

These digital assistants are powerful, accessible tools to help pain sufferers track symptoms, manage medications, and find relief. In this article, we’ll discuss chronic pain management apps in detail, outlining the ways they can help improve quality of life for those who experience chronic pain.

Contents

Overview of chronic pain management

First, let’s take a look at the various digital tools available to help manage chronic pain.

Woman wearing a VR headset in a coworking space

Types of digital tools for chronic pain

Many digital tools on the market can help assess and treat chronic pain, and improve how patients access and engage with their care (Rejula et al., 2021):

  • Artificial Intelligence (AI): AI is being used more in healthcare, including for diagnosing and managing treatments. For chronic pain, AI can use data like breathing rate, oxygen levels, and heart rate to estimate pain levels and changes.
  • Remote Patient Monitoring (RPM): Tools like smartphone apps, sensors, and wearable devices can help doctors collect and track patient symptoms between appointments. 
  • Digital therapy: These are devices and methods that give patients frequent advice to improve their behaviors and habits. Most of these use an approach called cognitive behavioral therapy (CBT).
  • Virtual patient engagement: Digital communication tools can help patients be more involved in their care, no matter where they are.

Definition of chronic pain management apps

Senior woman with leg pain in chair

Chronic pain management apps are mobile applications that help people with chronic conditions like diabetes, cancer, and fibromyalgia track and control their pain. They serve as a digital companion, offering features like pain diaries, medication reminders, and educational resources. The main goal is to empower users to take control of their pain management, providing insights that can lead to better health outcomes.

How they’re different from general health apps

While general health apps focus on overall wellness, chronic pain management apps are tailored to address specific pain-related issues. They offer specialized tools like pain mapping and flare-up prediction, which are not typically found in standard health apps.

Key features and functions

Timed pill box

Chronic pain management apps come packed with features to make pain management easier:

  • Pain tracking: Users can log pain episodes, noting intensity, location, and triggers. This helps in identifying patterns and potential triggers.

  • Medication management: Apps often include reminders to take medication, ensuring adherence to prescribed treatments.

  • Educational resources: Many apps offer information on pain management techniques, such as deep breathing exercises and guided meditation.

  • Integration with wearables: Some apps sync with wearable devices to provide real-time data on physical activity and sleep patterns.

Benefits of using digital tools for pain management

Why should you consider using these apps? Here are some benefits:

  • Improved self-management: By tracking pain and related factors, users gain insights into their condition, leading to better management.

  • Better communication: Sharing app data with doctors can lead to more informed treatment decisions.

  • Convenience: Having a digital tool at your fingertips means you can manage your pain anytime, anywhere.

Top Features of Effective Pain Management Apps

When choosing a pain management app, certain features can make a big difference in how well it works. Let’s explore what to look for.

Elderly hands on smartwatch

Pain tracking 

Effective apps allow users to log pain episodes in detail. This includes noting the intensity, duration, and location of pain, as well as potential triggers. A study found that detailed pain tracking can help users identify patterns and adjust their management strategies accordingly (Zhao et al., 2019).

Medication reminders and management

Medication adherence is crucial in pain management. Apps with reminder features ensure users take their medication on time, reducing the risk of missed doses and improving overall treatment effectiveness.

Customizable pain scales and body maps

Customizable features allow users to personalize their pain assessment. This means they can adjust pain scales to better reflect their experiences and use body maps to pinpoint pain locations accurately.

Integration with wearable devices 

Integration with wearables provides real-time data on various health metrics, such as heart rate and activity levels. This data can offer insights into how lifestyle factors affect pain, allowing for more informed management decisions.

Let’s take a closer look at some of the most popular chronic pain management apps available today. These apps offer various features to help users track, manage, and understand their pain better.

Note: Prices listed in this section are accurate as of August 2024. Visit the app’s website to confirm their current pricing.

1. Pathways Pain Relief

Pathways app
Source: Pathways

Pathways Pain Relief is a web-based app created by chronic pain sufferers and pain specialists at Pathway. It aims to help users manage their pain through mind-body therapies and comprehensive pain education.

Key Features:

  • Mind-body pain therapy program

  • Meditation and mindfulness exercises

  • Physical therapy area

  • Pain and wellbeing tracking
ProsCons
Comprehensive approach to pain managementWeb-based only (no mobile app)
Created by pain sufferers and specialistsRequires internet connection
High user rating (4.6/5)

Cost: $79 (flat fee).

Use case

A chronic pain patient looking for a holistic approach to pain management, combining physical therapy, mindfulness, and pain education.

To learn more, visit:

Pathways Pain Relief

2. Curable

Curable app
Source: Curable

Curable is available on iOS, Android, and web platforms. It was founded by three individuals who recovered from chronic pain and now aim to help others access similar treatments.

Key Features:

  • Mind-body pain therapy program

  • Meditation and mindfulness area

  • Chatbot for personalized guidance
ProsCons
Available on multiple platformsLower user rating compared to some competitors (4.2/5)
Personalized guidance through chat bot
Founded by chronic pain recovery stories

Cost: $11.99 per month.

Use case

Someone interested in exploring mind-body connections in pain management, with a preference for guided, personalized experiences.

To learn more, visit:

Curable

3. Manage My Pain

Manage My Pain app
Source: Managing Life

Manage My Pain, an app created by Managing Life, is available on iOS, Android, and web platforms. It focuses on detailed pain tracking and analysis to help users understand their pain patterns.

Key Features:

  • Comprehensive tracking of pain and well-being

  • Export statistics for healthcare providers

  • Easy-to-read charts and graphs
ProsCons
Detailed pain tracking capabilitiesMay be overwhelming for users seeking simpler solutions
Shareable reports for healthcare providers
High user rating (4.4/5)

Cost: $4.99 per month for reports and educational content.

Use case

A patient who wants to keep detailed records of their pain experiences to share with their healthcare team and identify patterns over time.

To learn more, visit:

Manage My Pain

4. Migraine Buddy

Migraine Buddy app
Source: Migraine Buddy

Migraine Buddy, developed by Aptar Digital Health, is specifically designed for migraine sufferers. Available on iOS and Android, it helps users track and manage their headache and migraine symptoms.

Feedback on Migraine Buddy says the app is great for people with migraines (Gamwell et al, 2021). It lets users share info with doctors, track what causes their migraines, and what helps relieve them. It can also calculate how much migraines affect a person’s daily life. 

Key Features:

  • Migraine tracking and analysis

  • Community support features

  • Educational resources on migraines
ProsCons
Specialized for migraine sufferersNot suitable for other types of chronic pain
Strong community support
Very high user rating (4.6/5)

Cost: $0 for MigraineBuddy; $12.99 per month or $89.99 per year for MBplus.

Use case

A migraine sufferer looking to track their symptoms, identify triggers, and connect with others who have similar experiences.

To learn more, visit:

MigraineBuddy

5. CareClinic

CareClinic app
Source: CareClinic

CareClinic is available on iOS and Android. It offers a comprehensive approach to symptom tracking and treatment planning.

Key Features:

  • Symptom and treatment goal tracking

  • Daily habit monitoring

  • Medication and appointment reminders
ProsCons
Comprehensive tracking of symptoms and treatmentsMay require significant time investment for data entry
Goal-setting features
High user rating (4.6/5)

Cost: Free; they also have monthly and annual plans for premium features.

Use case

A patient managing multiple chronic conditions who needs to track various symptoms, medications, and treatments in one place.

To learn more, visit:

CareClinic

6. PainScale

PainScale app

Boston Scientific Corporation created PainScale, a highly-rated pain management app with a range of features for tracking and managing chronic pain, and educational articles. It’s available on iOS, Android, and the web. 

Gamwell et al (2021) noted that PainScale includes the very helpful techniques for managing pain, and is easy to use for various types of chronic pain. It has a daily diary where users can track their symptoms, triggers, and medications, and can be share this info with doctors. 

Key Features:

  • Pain tracking and analysis

  • Personalized pain management plans

  • Educational resources
ProsCons
Comprehensive pain management featuresLimited information available about cons
Personalized approach
High quality score in research studies

Cost: Free

Use case

A chronic pain patient looking for a well-rounded app that combines tracking, personalized plans, and education.

To learn more, visit:

PainScale

How to Choose the Right Pain Management App

Selecting the right app can be overwhelming. With so many options available, how do you pick the right app for your needs? Here’s how to make an informed choice.

Woman holding her temples

Assess your specific needs and pain conditions

Start by evaluating your specific pain conditions. Are you dealing with neuropathic pain, or is it more related to a chronic condition? Choose an app that offers features tailored to your needs.

Consider ease of use

An app should be easy to navigate. Look for a user-friendly interface that allows you to access features quickly and efficiently.

Review data privacy and security features

Data privacy is crucial. Ensure the app complies with relevant data protection regulations and offers secure data storage.

Check compatibility with other devices

Make sure the app is compatible with your smartphone, tablet, or wearable devices. Compatibility ensures seamless integration and use.

When comparing these apps, consider what features are most important to you. Do you prefer detailed tracking, or is community support more valuable? Each app offers unique benefits, so choose one that aligns with your needs. Remember to consult with your healthcare provider about incorporating these tools into your overall pain management plan.

Integrating Apps into Your Pain Management Plan

Once you’ve chosen an app, the next step is to make it a regular part of your pain management routine.

Man holding his knee in pain

Work with healthcare providers to use app data effectively

Share app data with your healthcare provider. This collaboration can lead to more informed treatment decisions and better pain management outcomes.

Combine app use with other pain management strategies

Apps should complement, not replace, other pain management strategies. Combine app use with physical therapy, medication, and lifestyle changes for optimal results.

Set realistic expectations for app benefits

Understand that while apps are helpful tools, they are not a cure-all. Set realistic expectations for what an app can achieve in managing your pain.

Tips for consistent app usage and data logging

Consistency is key. Regularly update the app with accurate information to track your progress and adjust your management strategies as needed.

Conclusion

Chronic pain management apps offer a ray of hope for those grappling with persistent pain. These digital tools empower users to take an active role in their pain management, providing valuable insights and support. However, these apps shouldn’t replace professional medical advice. 

By choosing the right app and integrating it into your overall pain management strategy, you can gain a better understanding of your condition and find more effective ways to cope. Embrace these technological advancements and take the first step towards a more manageable pain experience.

References

FDA Authorizes Marketing of Virtual Reality System for Chronic Pain Reduction. (2021). U.S. Food and Drug Adminstration. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-virtual-reality-system-chronic-pain-reduction

Gamwell, K. L., Kollin, S. R., Gibler, R. C., Bedree, H., Bieniak, K. H., Jagpal, A., Tran, S. T., Hommel, K. A., & Ramsey, R. R. (2021). Systematic evaluation of commercially available pain management apps examining behavior change techniques. Pain; 162(3), 856. doi.org/10.1097/j.pain.0000000000002090

Orlovich Pain MD. (n.d.). The Power of Pain Management Apps: A New Frontier in Chronic Pain Relief. Retrieved from https://orlovichpainmd.com/the-power-of-pain-management-apps-a-new-frontier-in-chronic-pain-relief/ 

Rejula, V., Anitha, J., Belfin, R. V., & Peter, J. D. (2021). Chronic Pain Treatment and Digital Health Era-An Opinion. Frontiers in Public Health; 9, 779328. doi.org/10.3389/fpubh.2021.779328

Rikard, S. M., Stahan, A. E., Schmit, K. M., & Guy Jr., G. P. (2023). Chronic Pain Amonf Adults – United States, 2019-2021. MMWR Morb Mortal Wkly Rep 2023;72:379–385. dx.doi.org/10.15585/mmwr.mm7215a1. Retrieved from https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm

Zhao, P., Yoo, I., Lancey, R., & Varghese, E. (2019). Mobile applications for pain management: An app analysis for clinical usage. BMC Medical Informatics and Decision Making; 19. doi.org/10.1186/s12911-019-0827-7

Telehealth Mental Health Therapy: A Comprehensive Guide

Telehealth Mental Health Therapy: A Comprehensive Guide

by Ree AI Health Tech Med Tech

Telehealth mental health therapy has become increasingly popular, offering a convenient and accessible way for people to receive mental health support. This article will explore the world of online therapy, its benefits, challenges, and best practices for both providers and patients.

Contents

What is Telehealth Mental Health Therapy?

Telehealth mental health therapy (also known as telemental health, teletherapy, telepsychiatry, or online therapy) is the delivery of mental health services through digital platforms. It allows patients to connect with licensed mental health professionals remotely using video conferencing, phone calls, or text-based communication.

Definition and key components of telehealth mental health therapy

Woman in green sweater talking to doctor on Zoom

Telehealth therapy encompasses a wide range of mental health services provided through technology. The key components include:

  • Video conferencing sessions

  • Phone therapy sessions

  • Text-based therapy

  • Online mental health assessments

  • Digital tools and resources for mental health management

Types of mental health services offered via telehealth

Telehealth platforms offer various mental health services, including:

  • Individual therapy

  • Couples counseling

  • Group therapy

  • Psychiatry and medication management

  • Crisis intervention

85% of mental health providers offered telehealth services during the COVID-19 pandemic, with many saying they’d continue offering them services in the future (Pierce et al., 2021).

In an AAP study, 85% of pediatricians said they use telehealth for mental health visits, and over 80% of them said telehealth was very or moderately effective for mental health visits.

Platforms and technologies used for online therapy sessions

Several platforms and technologies are used to facilitate online therapy sessions:

  • HIPAA-compliant video conferencing software (Zoom for Healthcare, Doxy.me)

  • Secure messaging platforms

  • Mobile apps for mental health support

  • Virtual reality (VR) platforms for exposure therapy

For examples of how some organizations have successfully used telehealth in treatment programs for people experiencing homelessness, substance abuse disorders and mental disorders, review Chapter 4, “Examples of Telehealth Implementation in Treatment Programs from the Substance Abuse and Mental Health Services Administration (SAMHSA). 

Benefits of Online Mental Health Support

Telehealth mental health therapy offers numerous advantages over traditional in-person therapy.

Improved accessibility for rural and underserved populations

Telehealth therapy greatly improves access to mental health care for people in remote or underserved areas.

A 2024 study noted that many health providers had reduced no-show rates for behavioral health, and increased patient adherence to recommended behavioral health visits. One reason why is the potential for telehealth to mitigate anxieties that can surround in-person visits (Azar et al., 2024).

Lin et al (2018) found that health centers located in rural areas were more likely to use telehealth for mental health care, compared to those in urban areas.

A 2019 study found that telehealth significantly improved access to mental health care for rural populations, with a 45% increase in utilization of mental health services (Barnett et al., 2019).

Flexibility in scheduling and location

Online therapy allows for greater flexibility in scheduling appointments and choosing a comfortable location for sessions, which is beneficial for:

  • People with busy work schedules

  • Parents with childcare responsibilities

  • Individuals with mobility issues or disabilities

Less stigma 

Telehealth therapy can help reduce the stigma associated with seeking mental health support. Allowing patients to receive care from the privacy of their own homes removes the potential embarrassment of being seen entering a therapist’s office.

Cost-effectiveness compared to traditional therapy

Online therapy can be more cost-effective than traditional in-person therapy. A 2020 study found that telehealth mental health services were about 53% less expensive than in-person services (Lattie et al., 2020).

Challenges and Limitations of Telehealth Therapy

While telehealth therapy offers many benefits, it also comes with its own set of challenges and limitations.

Software and internet connectivity issues

One of the most common challenges in telehealth therapy is technical difficulties. These can include:

  • Poor internet connection

  • Audio or video quality issues

  • Software glitches

Younger generations tend to find virtual doctor visits easier than older generations. In any case, minimize these issues with a backup plan, like switching to a phone call if video conferencing fails.

Privacy and confidentiality concerns

Ensuring privacy and confidentiality in online therapy sessions is crucial. Therapists must use HIPAA-compliant platforms and take steps to protect patient information. patients should also be aware of their surroundings and ensure they have a private space for sessions.

Difficulty reading non-verbal cues

In video therapy sessions, it can be challenging for therapists to pick up on subtle non-verbal cues that might be more apparent in person. 68% of therapists reported difficulty in observing non-verbal communication during online sessions (Stoll et al., 2018).

Limitations for certain types of therapy or severe mental health conditions

While telehealth therapy is effective for many mental health conditions, it may not be suitable for all situations. Some limitations include:

  • Severe mental health conditions requiring in-person monitoring

  • Certain types of group therapy

  • Some forms of play therapy for children

How to Choose a Telehealth Mental Health Provider

If you’re considering telehealth therapy, here’s what to look for when selecting a provider for the best therapy experience.

Licenses and credentials

When choosing a telehealth therapist:

  • Verify the therapist’s license and credentials

  • Check if they are licensed to practice in your state

  • Look for specialized training in telehealth therapy

Platforms and security measures

Ensure that the therapist uses a secure, HIPAA-compliant platform for sessions. Ask about their privacy policies and data protection measures.

Insurance coverage and payment options

Check if your insurance covers telehealth therapy services. Many insurance providers have expanded their coverage for online mental health support in recent years. The Kaiser Family Foundation’s 2023 Employer Health Benefits Survey found that 91% of large employers included telehealth coverage in their health plans.

Assessing the fit between therapist and patient in a virtual setting

Finding the right therapist is crucial for successful therapy. Consider:

  • The therapist’s areas of expertise

  • Their approach to therapy

  • Your comfort level during initial consultations

Many telehealth platforms offer free initial consultations to help you find the right fit.

Best Practices for Effective Telehealth Therapy Sessions

To get the most out of telehealth therapy, therapists and patients should follow certain best practices.

Older woman using tablet

Set SOPs

Before starting telehealth services, the American Psychiatric Association recommends that providers assess their needs for training, space, and types of services. Organizations offering online mental health care should create standard procedures (SOPs), including quality improvement plans and ways to document provider credentials. 

Create a suitable environment for online sessions

Set up a quiet, private space for therapy sessions. This might include:

  • Using headphones for better audio quality and privacy

  • Ensuring good lighting for video sessions

  • Minimizing potential distractions

Prepare your tech and make backup plans

Before each session:

  • Test your internet connection

  • Ensure your device is fully charged

  • Have a backup plan (e.g., phone number) in case of technical issues

Establish rapport and trust

The American Psychological Association recommends developing a standard method for identifying both patients and providers at the start of each session. This could involve the provider stating their name and credentials, and asking the patient to provide their name and location. These guidelines help ensure professional and effective telehealth mental health services (Palmer et al., 2022).

Building a strong therapeutic relationship is just as important in online therapy as it is in person. Therapists should:

  • Use active listening techniques

  • Maintain eye contact by looking at the camera

  • Encourage open communication about the online therapy experience

Do therapy exercises and homework remotely

Woman touching cell phone with pink fingernails

Many therapeutic techniques can be adapted for online sessions. This might include:

  • Screen sharing for worksheets or educational materials

  • Using online tools for mood tracking or journaling

  • Assigning and reviewing homework through secure messaging platforms

A 2020 study found that 89% of patients were satisfied with their online therapy experience when therapists effectively adapted their techniques for the virtual setting (Wind et al., 2020).

Carry malpractice insurance

The American Telemedicine Association recommends telehealth providers to get malpractice insurance that covers online therapy (Palmer et al, 2022). 

When providing behavioral health care via telehealth, consult the American Psychological Association and American Psychiatric Association standards of care to ensure you’re providing ethical, quality care (Palmer et al., 2022).

The Future of Telehealth in Mental Health Care

The field of telehealth mental health therapy is rapidly evolving, with exciting developments on the horizon.

Some emerging trends in telehealth mental health care include:

  • AI-powered chatbots for initial assessments and support

  • VR therapy to treat phobias and post-traumatic stress disorder (PTSD)

  • Wearable devices for real-time mood and stress monitoring

Integration with traditional therapy models

Many mental health providers are adopting a hybrid model, combining in-person and online therapy sessions. This approach allows for greater flexibility and personalization of care.

Potential for AI and machine learning in mental health support

AI and machine learning can revolutionize mental health care by:

  • Analyzing patterns in speech and facial expressions to detect early signs of mental health issues

  • Providing personalized treatment recommendations based on large datasets

  • Offering 24/7 support through AI-powered chatbots

Ongoing research and development in the field

Researchers continue to study the effectiveness of telehealth therapy and develop new technologies to improve mental health care. A 2022 meta-analysis of 56 studies found that telehealth therapy was as effective as in-person therapy for treating a wide range of mental health conditions (Fernandez et al., 2022).

Conclusion 

Telehealth mental health therapy can be a convenient, effective, and accessible way to access mental health support, especially in rural and underserved areas.

Whether you’re considering online therapy, or just curious about its potential, the growth of telehealth mental health services marks an exciting development in the field of mental health care. Take the first step towards better mental health today by exploring the telehealth options available to you.

References

AAP Research. (2023). AAP study shows telehealth use common in pediatric care. American Academy of Pediatrics (AAP). Retrieved from https://publications.aap.org/aapnews/news/23772/AAP-study-shows-telehealth-use-common-in-pediatric

American Psychiatric Association. (2022). Best Practices in Synchronous Videoconferencing-Based Telemental Health. Retrieved from https://www.psychiatry.org/getattachment/b87211d5-81bb-4d4f-af73-9caa738c2a1c/Resource-Document-Telemental-Health-Best-Practices.pdf/

Azar, R., Chan, R., Sarkisian, M., Burns, R. D., Marcin, J. P. , Gotthardt, C. De Guzman, K. R., Rosenthal, J. L., & Haynes, S. C. (2024). Adapting telehealth to address health equity: Perspectives of primary care providers across the United States. Journal of Telemedicine and Telecare; 1-7. doi:10.1177/1357633X241238780

Barnett, M. L., Ray, K. N., Souza, J., & Mehrotra, A. (2019). Trends in Telemedicine Use in a Large Commercially Insured Population, 2005-2017. JAMA; 320(20), 2147-2149.

Berger, E. (2021). No-Cancel Culture: How Telehealth is Making it Easier to Keep That Therapy Session. Kaiser Family Foundation (KFF) Health News. Retrieved from https://kffhealthnews.org/news/article/no-cancel-culture-how-telehealth-is-making-it-easier-to-keep-that-therapy-session/

Dr. Josh. The Impact of Telemedicine on Mental Health. SmartClinix. Retrieved from https://smartclinix.net/the-impact-of-telemedicine-on-mental-health/

Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2022). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy; 29(4), 1307-1321.

How do I use telehealth for behavioral health care? (n.d.). Health Resources & Services Administration (HRSA). Retrieved from  https://telehealth.hhs.gov/patients/additional-resources/telehealth-and-behavioral-health

Kaiser Family Foundation. (2023). 2023 Employer Health Benefits Survey. Retrieved from https://www.kff.org/report-section/ehbs-2023-summary-of-findings/

Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2020). Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review. Journal of Medical Internet Research; 22(7), e15396.

Lin, C. C., Dievler, A. , Robbins, C., Sripipatana, A., Quinn, M. & Nair, S. (2018). Telehealth in Health Centers: Key Adoption Factors, Barriers, and Opportunities. Retrieved from https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05125

Macmillan, C. (2021). Why Telehealth for Mental Health Care is Working. Yale Medicine. Retrieved from https://www.yalemedicine.org/news/telehealth-for-mental-health/

Palmer, C. S., Brown Levey, S. M., Kostiuk, M., Zisner, A. R., Tolle, L. W., Richey, R. M., & Callan, S. (2022). Virtual Care for Behavioral Health Conditions. Primary Care; 49(4), 641-657. doi.org/10.1016/j.pop.2022.04.008

Pierce, B. S., Perrin, P. B., Tyler, C. M., McKee, G. B., & Watson, J. D. (2021). The COVID-19 telepsychology revolution: A national study of pandemic-based changes in U.S. mental health care delivery. American Psychologist; 76(1), 14–25.

Stoll, J., Müller, J. A., & Trachsel, M. (2018). Ethical Issues in Online Psychotherapy: A Narrative Review. Frontiers in Psychiatry, 9, 698.

Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders. (2021). Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved from https://store.samhsa.gov/sites/default/files/pep21-06-02-001.pdf

Telehealth in Mental Health Counseling: Benefits and Barriers. (2023). Walsh University. Retrieved from https://online.walsh.edu/news/telehealth-mental-health-benefits-barriers/

What is Telemental Health? (n.d.). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/what-is-telemental-health

Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pandemic: The ‘black swan’ for mental health care and a turning point for e-health. Internet Interventions; 20, 100317.