Does It Work?
First of all, as I have said in other articles: therapy is all about the fit. It doesn’t matter if the therapist is in person, on video, or the phone; if the therapist-patient relationship is not a good fit, therapy will most likely be unsuccessful. Finding the right therapist is much more important than where or when therapy will take place – depending on the situation.
Assuming the fit, however, research shows that video therapy works with specific populations. PTSD has been the most widely researched diagnosis to be helped by video therapy. Video therapy has also been shown to be nearly equally effective as in-person therapy in treating depression, anxiety, and some eating disorders. For a thorough review of the research, check out this literature review chapter written by Wangelin et al. (2016).
What are the Benefits?
Video therapy provides many benefits for a patient, most of which have to do with flexibility. The most obvious advantage is that you do not need to travel to the therapist’s office. This can help people who live in rural areas and would have to otherwise drive for hours to get to the nearest therapist. It can also benefit someone who has a hectic schedule in a major city and cannot afford the additional travel time it would take to get to a therapist.
Another flexibility that video therapy can offer is that of the flexibility of time. Therapists may only be in their office on certain days; however, they do not need to be in their office for a video therapy session (assuming they can find a private room at home). This opens up other potential times for you, as the patient, to be able to schedule a session. Some therapists may even have some flexibility in price for a video session; however, that is up to the individual therapist and something you should discuss with him or her.
What are the Drawbacks?
Research shows that video therapy is effective; however, there may be some personal considerations to make before starting video therapy. Most patients who do not want to do video therapy say that they prefer going to the therapist’s office. Just like you go to the gym to work out and go to the kitchen to eat, there is a comfort level with knowing that you are going to the office where you work on your mental health.
Additionally, some patients do not feel comfortable talking about certain things in their home. Imagine you are complaining about your roommate and he or she walks into the apartment at that same time. If you do not have a private space where you feel comfortable speaking openly, that can be restrictive.
One final thing to consider is whether or not your internet and computer are strong enough to support a video therapy platform. It can be very frustrating to come up with a great revelation only to have the video cut out at that specific moment.
Is Video Therapy Legal/Ethical?
Laws regarding video therapy are very new and not well defined and can vary from state to state. One common rule of thumb is that the therapist you see should be licensed in the state where you reside. For example, if you live in New York, your therapist needs to be licensed in New York – even if they are in a different state.
Another important ethical consideration is ensuring the protection of your private health informant (PHI). According to the Health Insurance Portability and Accountability Act (HIPAA), information about your name, address, etc. are all protected information. Therapists should use a program that is compliant with HIPAA and does not collect PHI. Applications such as FaceTime, Skype, and Google Hangout are not meant for use for therapy and therefore are not HIPAA compliant.
One final concern with regards to video therapy to treat depression is suicide. If you are having active thoughts of suicide, it is always important to call 911 or go to the nearest emergency room. If you have some passive thoughts of suicide or a history of suicidal thoughts, it may be good to establish a safety plan with your therapist in case you begin to have more serious thoughts.