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

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.

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

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.

Emerging trends and technologies

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/

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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

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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.

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