Telepsychology: Is it the future of treatment?

Technology has become an integral part of our daily world. We ask Alexa about the weather, tell Siri to place a phone call and use voice recognition software to write emails. How far a step is it, then, to reach out to a therapist via technology?

Telepsychology, or telehealth, the practice of providing psychological services over telecommunication equipment, is not exactly a new facet of the profession.

Since video conferencing equipment was first developed in the 1990s, there has been a slow, but steady, expansion of therapists who offer the option. Insurance coverage has been a bit slow to follow, as have laws covering inter-state practice.

Still, today nearly half of psychological practices offer an option for working remotely according to the Behavioral Health Workforce Research Center.

For the therapist, telepsychology can provide a way to expand one’s marketing reach and to maintain a better work-life balance. But, primarily, it is seen as a way to bring services to those who cannot or will not travel because of barriers of time, health, distance, or lack of transportation.

“At our core as psychologists, we want to help as many people as possible,” said Rick Barnett, Psy.D, LACD, a licensed psychologist and drug and alcohol counselor with a private practice in Stowe, Vt., “and there are people who cannot get to the office.”

Studies have shown that telehealth done right can have similar outcomes as in-person care. The Veterans Administration, long a leader in the area, has found that telehealth services reduced the number of days vets spend in acute care by 39% and has seen a 32% decrease in VA hospital admissions with those using it.

In fact, the Veterans Administration has begun a push to bring all health care providers into the telehealth loop.

“A lot of veterans live in rural areas and do not have ready access to services,” said Jennifer Doran, a staff psychologist at the VA Connecticut Healthcare System and assistant clinical professor at the Yale School of Medicine.

“The VA is trying to mandate that all providers can provide telehealth, that they have the equipment and know how to do it. I think the target date is by the end of 2020.”

Are we catching a glimpse of the future? Will therapy be done primarily through a computer interface?

“While I definitely see it growing,” said Carrissa Phipps, PhD, a licensed psychologist and owner of Small Victories Wellness Services in Middletown, Ct., “I don’t see it taking over or becoming the norm. For some client populations, it really works but, for others, in person will always be key.”

For Barnett and Phipps, each of whom has incorporated telehealth into their daily practice, and Doran, whose job with the VA consists primarily of therapy via remote access, technology has fit smoothly into their practices and may be the real face of the future.

Technology is simply another option for any client, said Phipps. In fact, many tend to use it more as an alternative when an on-going patient cannot be seen in the office or as a way to introduce new clients to the idea of therapy.

“I have one client I see only through telehealth but I have some who just have a lot going on, their schedules may shift,” said Phipps. “It’s another tool I can offer.”

Phipps and Barnett each see approximately two-three patients a week via technology. It’s not a large number, of course, and some may feel that adding telecommunications to their standing practice is not worth the effort.

“Psychologists tend to be very risk adverse,” said Barnett. “But I am of the attitude that, if you want to try it, appreciate the risk aversion but don’t let it prevent you. It may not seem crucial now but the way the field is going in 10-15 years, it may be beneficial to familiarize yourself with it.”

One hold-back for many therapists is the feeling that technology would hinder the therapeutic relationship, adding an emotional distance because of the physical one. Surprisingly, said Doran, it really does not feel that much different once you get past how to use the technology itself.

“I was skeptical before doing it,” said Doran. “I am a relational therapist. I wasn’t sure how it would affect my practice; is this good therapy? But these relationships feel just as close and intimate as in person. I assumed they wouldn’t, that they would feel lesser in some way, but they don’t.”

NOTE: For information on ethical and legal regulations with telehealth, the American Psychological Association has published guidelines on setting up a telepsychology practice. Find more information at:

https://www.apa.org/practice/guidelines/telepsychology