I had originally written this article prior to the outbreak of Covid-19. The pandemic however has put a spotlight on this topic and has added some urgency to the discussion.
The internet offers us many conveniences. From online banking, to ride sharing and food delivery, the internet is not only making things more convenient for us, it is also providing us with life changing opportunities that previously did not exist. During a global pandemic, the internet has allowed many services to continue functioning in a way that would not have otherwise been possible. Virtual or digital service platforms have allowed clients to access mental health care services without interruption/with minimal disruption. This has no doubt provided a lifeline for many people who are experiencing challenges with their mental health that may have been exacerbated by the pandemic.
As a therapist, I have spent a large part of my career providing services to clients over the phone and using digital technologies (email-based counselling, live chat and video counselling). The demand for mental health services that are more accessible is growing steadily, as is the recognition by therapists that not all clients are well served through in person counselling.
There are a few reasons why clients request online services:
- In a country as large as Canada, location can often be a challenge. Most mental health services tend to be concentrated in urban areas. If services exist in smaller communities, waiting lists can be long and often the service provider is personally known to clients, making them feel uncomfortable with accessing service and disclosing personal things.
- Convenience is also an important consideration. The need for a client to travel to a therapist’s office can pose significant challenges including cost, time and physical barriers for clients with mobility issues
- Demographics: there is a generation of people who have grown up doing almost everything online. The online world is their comfort zone and being able to access mental health services online can significantly increase the likelihood of them doing so.
Even prior to the pandemic, there was demand for online services, but many therapists were resistant and or uncomfortable. This resistance to digital services could be attributed to a few different thought processes.
- Some therapists believed that therapy at its core is a process that must occur in person. Physical presence is vital, and without it the therapeutic process cannot be effective.
- Some therapists also held the view that online services can be complementary to but cannot replace the in-person experience.
- Lastly, some therapists do not feel sufficiently skilled with technology to deliver quality therapeutic services effectively.
Since the onset of the pandemic, I have spoken to many therapists who have had to confront and have successfully overcome the aforementioned criteria and are themselves surprised by how much they enjoy a virtual medium and how effective it is for clients. Many therapists have advised that even when they are able to resume in person practise, they will likely devote some portion of their practise to online service delivery.
Outside of the restrictions placed on us by the pandemic, virtual therapy is not about replacing the traditional in-person experience. Rather it is about increasing accessibility for clients who may not be able to engage in person. Providing digital therapy is not about simply replicating the in-person experience in another medium. Successful digital therapy requires planning for the benefits and challenges of each medium.
As an example, let’s consider video counselling. There are numerous benefits to the client and therapist as location does not pose a challenge. The client and therapist can be in two different locations with hundreds (or thousands) of kilometers between them. This helps a therapist avoid the cost of renting an office and affords them some convenience. This also enables a client to access good quality therapeutic care that may not be available in their geographic location. The client may also feel more comfortable/safe in their own physical environment and may be more engaged in therapy as a result. While the benefits are undeniable, we also must be mindful of some of the challenges.
- What does the therapist’s regulatory college/association say about providing online therapy?
- Do the client and therapist have enough knowledge about the online platform which is being used?
- Do both the client and therapist have a private space in which they can engage in the therapeutic process?
None of these issues are meant to be deter a therapist from offering digital services. Rather, being aware of these issues, helps one plan accordingly. For example, many insurance companies who provide professional liability insurance now explicitly list digital services as something that is covered within the policy. Additionally, there are a number of secure digital platforms through which therapy can be conducted. elivering online services might require us as service providers to behave differently but this method of service delivery can be beneficial to clients and therapists.
Offering digital therapeutic services even after the pandemic restrictions are lifted, is going to be essential if we want to ensure that everyone who needs mental health services can access it. We are seeing an increase in academic and professional coursework that aims to equip therapists with the skills to effectively deliver digital services. Regulatory bodies and insurance companies are also recognizing the efficacy of digital services. It is now up to us as therapists to understand and explore whether incorporating digital services in our practises would be suitable for us and our clients.
*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA