Zooming In On Mental Health: Is Virtual Therapy Here to Stay?

“You’ve been doing therapy over zoom for the last year and half? Does that even work?”

I’ve been getting that question a lot lately. The answer? Well, yes and no. 

Before the corona pandemic our practice utilized telehealth therapy online on a very limited basis. It has allowed us to address urgent patient issues as well as expand the reach of our services beyond our Jerusalem and Beit Shemesh offices.

But in Israel, as well as around the world, telehealth became necessary. Virtual therapy has existed for over a decade but in the last year and a half has grown exponentially as the world becomes more virtual-friendly and globally connected and people have needed to adapt to the isolation and restrictions of lockdowns.  There are virtual therapy apps that were developed in response to the growing demand, furthering the popularity of virtual therapy. But for many traditionalists, it’s still an odd idea. 

Psychotherapy is an intense and intimate interpersonal experience. Accordingly, we hold onto the idea that engaging in this experience virtually is inherently not as good as doing it live. This despite the fact that current research has clearly shown that virtual therapy is just as effective as in-person therapy in most cases. It is interesting to note that clients who were originally opposed to the idea of “Zoom therapy” at the start of the pandemic but did it anyway, have found it to be just as helpful as having sessions in person. 

There are pros and cons to virtual therapy, but in order for it to be successful, it’s important to mention three critical requirements:

1. Maximum privacy. Therapy is an intensely personal and private experience, so absolute privacy is essential.  This is easily achieved In a therapist’s office.  Finding a space that is private enough not to be overheard is extremely important to ensure that you get the most out of your session. If a closed door and headset are not sufficient, consider buying a white noise machine to put near the door, or downloading a white noise app on your phone to prevent anyone from hearing your conversation.
2. A strong internet connection.  We are all familiar with slow connections that can make virtual conversations cumbersome and awkward. This is not good for therapy, where the therapist and client are highly attuned to the interaction. Having a strong connection that allows conversation to flow smoothly is important for virtual therapy to be successful. 
3. A good quality webcam.  Much of our communication is nonverbal. Though virtual therapy makes us unable to perceive body language in full, we can still see the vast majority of it through facial expressions and gestures. Being able to see one another clearly from the chest up greatly increases the effectiveness of our communication. 

Aside from these three critical components, it might also be helpful to take 10 to 15 minutes before a session to get settled, and another 10 to 15 minutes to transition out of the session and allow yourself to take in what was discussed. In-person meetings generally include travel time to and from the therapist’s office, which allows us to get settled and absorb information. With virtual sessions, the change from therapy sessions to our regular routine is more abrupt and taking time in this way can be helpful.

Advantages to Each

There are several major practical advantages to virtual therapy. You can join a session from anywhere without being tied down to a particular place and without having to commute. You can join a session during a break in your day or even when traveling. No commuting makes scheduling much more convenient and flexible. It also opens up options for accessibility to therapists who might be a better fit for you but are located farther away. For therapists, offering virtual sessions may allow certain slots to be available that might otherwise not be, and the lack of a commute may increase general quality of life, reducing burnout and preserving the therapist’s mental resources that are critical for providing good care. 

At the same time, many of us still prefer the tried and true face-to-face model. Humans are social beings, and for some the in-person nature of the therapeutic encounter can make the relationship feel more authentic. Beyond the question of whether or not the work is effective there may be a strong preference to meet in person because it feels safer, or more authentic. Or maybe because of zoom fatigue in general, or because it’s easier to get distracted sitting in front of a screen.

Like everything else, there is no one-size-fits-all way to do therapy. Virtual sessions may be good for some, while it may not be best for others.  If you are considering it, it is worth an honest shot. While it can be helpful to anyone, it may not be ideal for those who feel most at ease in physical proximity to their therapist, while it may be a godsend to people on tight schedules or who require more flexibility in scheduling.