Telehealth and Psychotherapy: Can this be our new normal?

Initially, I was quite hesitant to see clients via Telehealth. 

I believed that face-to-face therapy was essential to therapeutic growth and success. After all, the client-therapist relationship is fundamental to change in therapy, and I wasn’t convinced that any meaningful change could happen beyond the confines of a therapy room. I mean, with the intimacy and sense of connection that face-to-face interactions bring, how could virtual therapy translate to any meaningful outcomes?

When I began to use Telehealth, I didn’t see the big deal. If anything, there were some hassles that Telehealth sessions brought that I wasn’t prepared for. The times where internet connection would drop out mid-sentence or when clients were unable to get privacy at home. But after solving some of these minor issues, I started to see how beneficial Telehealth could be.

Over time, I noticed little to no difference in seeing clients online versus face-to-face. I was still able to form secure relationships with my clients and was pleased to see how much clients benefited from this new approach. Surely, this was just a stroke of good luck I thought? While it is clear that Telehealth has now become a matter of convenience, what did science have to say about this? Was Telehealth as efficient as it was convenient?

In a 2019 literature review by Lamb and colleagues showed that interventions delivered through telephone, video, and online modalities demonstrated good efficacy in treating anxiety and depression in general, and when presenting comorbid with other disorders.

More recently, in a 2022 study by Greenwood and colleagues, which compared Telehealth to face-to-face delivery of psychotherapy for less common mental health conditions and physical conditions, found no significant differences in the outcomes of these two approaches. They even found that this outcome was maintained at follow-up. These findings were supported by another 2022 study by Giovanetti and colleagues (2022), who concluded that video-based tele-therapy may be a feasible and effective alternative to in-person service for reducing depressive symptoms.

Outside of these therapeutic benefits, I also discovered many other benefits in using this approach. For example:

• Sessions were more likely to commence on time;
• Clients were less worried about having to travel or find a park;
• Clients did not have to miss work in order to attend;
• Payments became so much easier.

While I was blown away by these benefits, I still wasn’t convinced that Telehealth was equally as effective in building a strong relationship with my clients. However, a 2023 review by Seuling and colleagues revealed no statistically significant difference in the therapeutic alliance between face-to-face versus Telehealth methods. So, it seems safe to conclude that Telehealth sessions are quite effective, both in fostering client-therapist connections, as well as treatment outcomes.

If you’re having doubts about trying Telehealth, I completely understand. It’s not easy. It took me a while to be convinced of its value. Indeed, there still are times where I miss face-to-face sessions, and the sense of intimacy and connectedness it can bring. However, based on my own experiences in the last two years, and knowing the research, the benefits of Telehealth sessions are just too hard to ignore.

So, if you travel a lot, live remotely, can’t take time off work, or don’t have the means to see a therapist in person, I’d say give Telehealth a go. It’s an effective and convenient alternative.