In Mind Series: Telehealth and Us
The COVID-19 pandemic has led to rapid changes in the way we access mental health care. All around the world we are transforming the way we communicate, and six months down the track we’re now using telehealth more than ever. We offer some reflections on what we have learned so far at Minds Online from providing telehealth services to our clients. We share some useful tips for making the most of telehealth appointments, so that you can make telehealth your go-to resource to help you stay mentally healthy on the go.
The COVID-19 pandemic has brought with it sweeping changes to online communication, with improved online infrastructure, increased funding for telehealth and greater user confidence in telehealth as a viable platform for accessing quality health care.
As consumers and providers alike have embraced telehealth platforms they have struck a chord with researchers who have been advocating for the benefits of telehealth in the therapy space in recent years. As technology has improved we no longer have the issues of slow dial-up connection speeds and poor camera resolution. This allows us to connect with eachother online more authentically, in real time.
A birdseye view of the literature suggests that telehealth by videocall is just as effective as face-to-face therapy in reducing client symptoms and distress. As confidence in this modality grows, client satisfaction ratings are also in favour of telehealth. Clients like this modality because it is accessible, affordable, convenient, they have greater choice of practitioner and it reduces travel time. Indeed, telehealth retention rates are high across the health professions, with people more likely to keep appointments and access telehealth services on the go.
Traditionally the difference between face-to-face and telehealth in mental health care has been more apparent when therapists and clients have been asked to rate the quality of the therapeutic alliance. This is important for us as Psychologists, because the relationship between client and therapist is a pivotal factor in predicting response to treatment, often accounting for more variance than the specific kind of therapy or techniques applied to treat a particular mental health condition. Psychologists have traditionally voiced concerns about how the intimacy and safety of the therapy space might translate to what feels like a less personal rapport when interacting online. For many therapists, this has understandably led to a reluctance to adopt telehealth practices, in favour of in-person therapy.
What’s interesting though, is that therapists have typically rated the therapy relationship in these studies less favourably than their clients do, suggesting that we as psychologists are likely to take a more conservative approach to this question, and perhaps hold greater responsibility and ownership for the quality of the therapy alliance.
So, what have we learned so far…? As more people have reached out to our telehealth psychology services at Minds Online during the pandemic, we have worked hard to promote safety in therapy for our clients and ourselves. Twelve months down the road of our telehealth private practice journey, and we have been heartened when families come together to support engagement with technology for their more senior or more junior loved ones. We have also seen a shift in how we share ownership of creating the therapy space with our clients. We have learned to communicate more openly with our clients to co-create a safe space for therapy, taking into account ways to promote confidentiality, safety, comfort, boundaries and reliability between us. This has brought specific challenges which we have had to address, but with the same considerations, training and guiding principles that we would bring to face-to-face sessions.
Telehealth has brought some tender moments too. Many of our colleagues have commented on their appreciation for being welcomed into their clients’ homes and being introduced to pets and children. They have voiced their surprise at how the natural fit of telehealth into the ‘everyday’ of life appears to enable their clients to speak from the heart when they feel comfortable and safe in their own private space. At Minds Online we have noticed a levelling of the playing field that comes from us as clinicians working from home ourselves, rather than clients entering into our professional office space. There is an authentic human connection that comes from being seen both as person and professional and somehow the paradox of telehealth brings an opportunity for these authentic moments to be shared and for conversations to unfold in a meaningful and therapeutic way.
We have learned some useful tips to help our clients make the most of our telehealth appointments. If you are preparing to attend a telehealth appointment, it is helpful to take some time to set up your therapy space. Look for a private space where you can speak freely in a room on your own, with a door that you can shut so that people won’t walk in, and if possible, to arrange appointments at a time when you won’t be needed or disturbed. You might want to use earbuds or headphones to assist with privacy and sound too. We encourage our clients to make the therapy space comfortable, perhaps with water or tea, to have a cushion and tissues handy – finding a balance between comfort while also feeling alert and attentive. Sometimes our clients leave their home to go to a private space in nature, such as the beach or their garden, where they can think and be mindful.
If possible, it helps to take a few minutes prior to your appointment to settle in before you dial in, so that you’re not too rushed and can make the shift to a more reflective headspace. This will help you make the most out of your appointment. Having time to enjoy something positive for yourself after your appointment can also help make the transition back to the day’s routine, after the work you’ve put into your session.
Take time to become familiar with the telehealth platform and technology you will use, and consider a larger screen where possible, such as a laptop or desktop, to make it easier to speak face to face online in therapy. It helps to charge your device or plug it into power and turn messaging off also. Lastly, it’s helpful to have some materials, such as paper and pens handy so that you can write down things that stand out or come up for you that you want to follow up on between sessions.
If you would like to know more about telehealth psychology services, or would like to book an appointment with us, contact Clinical Psychologists Laura Keane and Jackie Cesareo at [email protected]