On World Mental Health Day, we’re taking a look at how COVID allowed teletherapy to thrive, providing readily-available treatment for everyone online.
It used to be that it took an hour and a half train ride—and a small chunk of my sanity—to get to therapy each week. Now, my commute to treatment is non-existent. All I need to do is open up my MacBook and log into my therapist’s HIPAA (Health Insurance Portability and Accountability Act) compliant virtual office. It takes all of two minutes. Maybe three on bad WiFi days.
As a mental health advocate and writer who specializes in mental health and wellness, I am a firm believer in getting help when you need it. With the stress of a global pandemic and suspension of in-person services, teletherapy has been a total game changer for those seeking mental health assistance in the age of COVID-19, but don’t just take it from me.
How teletherapy works
Teletherapy refers to mental health services that are delivered through technology, like phone calls or video conferences. This modern day therapy enables licensed and certified therapists to work remotely with patients through online therapy sessions, and can often result in patients feeling more relaxed in their home setting.
Mental health advocate and mom blogger Lynneah Bennett began looking for online therapy options after the coronavirus pandemic began in 2020. Working all day while looking after her young twins, Bennett needed help: She was seeking support for her Bipolar 2 diagnosis, as well as increased anxiety and depression post-divorce. Although medication helped her get her bipolar disorder under control, she knew she still needed therapy to work on herself. One of her biggest worries was that she would never be a good enough mother to her twins due to her mental health—and therapy was one way she could ensure that she could show up as her best self.
She ended up turning to online therapy platform, BetterHelp, one of the largest companies in the teletherapy space.
“Working on my mental health was the best possible thing I could do for [my kids],” Bennett tells us over email. “Therapy and medication have been my saving graces.”
Like other online therapy platforms, BetterHelp connects people with licensed providers, such as psychiatrists, psychologists, and clinical social workers. According to its website, the organization has over 20,000 licensed mental health practitioners who have conducted over 147 million psychotherapy sessions.
Since the platform allows for text-based therapy as well as video sessions, Bennett was able to communicate around the clock if she was in need of additional support, and simply type if she wasn’t able to speak out loud. “Online therapy ended up opening many doors for me as a single work-from-home mom, thanks to its awesome flexibility,” Bennett tells us over email.
Mental health and motherhood blogger Lynneah Bennett uses Instagram to share encouraging posts about her own mental health journey.
Online therapy services during COVID-19
Telemedicine has been around for years. Telemedicine has been around for years. In the late 1950s it was used to conduct video consultations at hospitals, then later for NASA scientists monitoring the health of astronauts in outer space. Since then, it has been mainly used to treat patients in remote areas that have limited access to healthcare. But it wasn’t until COVID hit that telemedicine became somewhat mainstream. According to a recent study conducted by consulting firm McKinsey & Company, use of telehealth services was 38 times higher in July 2021 now than in February 2020.
This increase in demand is a reflection on the growth of reported mental health symptoms experienced during the pandemic. A 2020 study from the Jama Network medical journal found that depression rates tripled since the start of the pandemic: 27.8% of the people interviewed reported depression symptoms from March to April 2020, versus 8.5% in 2018. Similarly, a CDC survey of 5,412 people found that rates of anxiety disorder symptoms jumped from 8.1% pre-pandemic to 25.5% mid-pandemic, with nearly 11% of respondents saying they had seriously considered suicide.
Online therapy company Talkspace doubled usage from March 2019 to March 2020, according to CNBC. The app now has more than 1 million users. Meanwhile, U.K.-based digital mental health platform Ieso Digital Health reported an increase of 84% in referrals for its online cognitive behavioral therapy (CBT) services when lockdown was announced in March 2020, compared to 2019, pre-pandemic.
There’s no question about it: many people today can benefit from therapy, and because of teletherapy, more and more people are actually getting the help they need.
Mental health care accessibility for all people and groups
“The number of folks who I have seen [in therapy] that I wouldn’t be able to otherwise has been a dramatic shift,” says counseling psychologist and Oklahoma State University professor Madeline Brodt, Ph.D over email.
Besides single moms like Bennett, marginalized people, disabled people, and those who live in areas without access to mental providers, are benefitting from specialty care services online. Dr. Brodt calls this increased virtual accessibility “the silver lining of the pandemic,” and hopes it can be the new normal. “After the pandemic is over, I hope that providers continue to offer virtual services so that anyone who wishes can access services regardless of their health or ability status,” says Brodt.
The BIPOC community has long been an underserved group when it comes to mental health treatment. Research has shown that BIPOC are less likely to seek help when they’re experiencing mental health struggles, and if they do seek treatment, they’re likely to receive subpar care because of their insurance coverage (or lack thereof), racial discrimination, or because they live high poverty neighborhoods without access to health services.
One person aiming to change this is Eric Coly, Founder and CEO of Ayana Therapy, which specializes in mental healthcare for marginalized and intersectional communities. Launched in Los Angeles in 2020, Ayana Therapy now has 400 therapists and is aiming to reach 700 by the end of the year. At $60 USD per session, Ayana Therapy costs much less than the average out-of-pocket therapy visit for someone without insurance, which is often a huge barrier to treatment.
Eric Coly, founder of online mental health platform Ayana Therapy.
While various online therapy platforms use questionnaires to match you with a therapist, Coly wanted Ayana’s matchmaking process to be more suited toward BIPOC. His goal was to help people find a therapist who mirrors them in some way, so their struggles will be better understood. (Fun fact: “ayana” means “mirror” in Bengali).
“We have an advanced algorithm that we call ‘culturally intelligent,’” Coly says over Zoom. “It gives us a chance to really narrow down and further identify who you are for you to be better seen and better heard.”
Like many of today’s modern businesses, Ayana uses social media like Instagram, to grow its audience and raise awareness about mental health. The company also uses Linktree to make it easy for followers to get matched with a therapist or even purchase gift cards to Ayana.
Benefits of online therapy from home
Author Gabriela Herstik has also reaped the benefits of teletherapy since the pandemic. Over FaceTime, she tells us that she loves the fact that she doesn’t have to deal with the traffic or parking. “The convenience of not having to be stressed before therapy to get there on time is great. I feel like it allows me to go into therapy more level headed,” says Herstik. As a self-care enthusiast, Herstik says she considers tending to her mental health as part of her spiritual practice.
But convenience is far from the only benefit for Herstik, who says having therapy at home allows her to be more vulnerable. “I’m able to talk about things that are difficult that I’m working through in my own space, which allows me to feel more comfortable and safe,” she says. “I can lie on my bed and hold my stuffed animal and make myself tea, and I can have the freedom and comfort of being in an environment that already cultivates a sense of peace and introspection.”
Although some therapists were wary of online therapy at first, many have taken the plunge and don’t plan on turning back. BIPOC and LGBTQ+ affirming therapist Teresa Thompson, LCSW says she was skeptical of online therapy pre-pandemic, refusing to give it a try with her own therapist because she didn’t think it would be a substitute for the “real” thing. “My actual experience has dispelled all my preconceived notions,” Thompson tells us over email. “I have found that two people can be present with each other and connect deeply, even in a virtual space. Therapeutic connection is the foundation of effective therapy. If that connection is there, online therapy can be as effective as in person.”
She also notes unexpected benefits from a therapist’s POV. “I often have a closer view of clients’ faces on video than I would have sitting together in a room, making it easier to perceive subtle shifts in emotional reactions, and the physical spaces clients choose to call in from sometimes provide me with helpful information,” says Thompson.
“I have found that two people can be present with each other and connect deeply, even in a virtual space."
Does teletherapy actually work?
If you’re a skeptic wondering if teletherapy actually works, the answer is yes. Even before teletherapy became mainstream, it was still very much a thing. A 2019 systematic review of 24 studies found that video and phone therapy were effective at helping to treat depression and anxiety.
Dr. Brodt recognizes teletherapy’s benefits, as well. “Clients have let me into their lives in a way that we couldn’t do when in person,” she says. “I also have a developing hunch that for some clients, online therapy can allow for treatment to go deeper than it would in person because they feel less vulnerable when discussing challenging issues over technology.”
Take me as a case study. For the first several months of quarantine, my anxiety disorder (that I’ve had since I was 12) was worse than it had been in years. Almost every single night I had a panic attack. My somatic OCD surrounding my shortness of breath was so bad; I was always convinced that I was going to die, and I was losing my mind. I found a therapist who specializes in CBT for anxiety, who was practicing virtually due to COVID. Although I wasn’t there in person with her, the therapy was not at all hindered. Every exercise we did together to challenge my irrational thoughts—particularly surrounding my breathing—worked perfectly fine over video. Plus, there was no added anxiety surrounding taking the train to commute to therapy.
Within the first few months of weekly (and sometimes twice weekly) CBT sessions, I was noticing major changes. The progress I’d made within a few months surrounding my breathing anxiety had surpassed the progress I’d made over the past year, and it was all done virtually.
Ultimately, it’s a personal choice whether someone wants to “attend” virtual therapy, or any therapy at all. But there’s no doubt that therapy can be life changing if you put in the work, and thanks to teletherapy, life-changing services are more accessible than ever.
Author Ashley Laderer is a mental health advocate on social media.