Telehealth vs in-person therapy

“Stay committed to your decisions, but stay flexible in your approach.”

Tony Robbins

On March 17, 2020, The HHS Office for Civil Rights announced that it would waive potential HIPPA penalties for good faith use of telehealth during the nationwide public health emergency due to COVID-19.  My newest client at the time had recently been discharged from a Rehabilitation Hospital and was considered medically fragile. All of my other clients were house-calls and continued with precautions like masks and social distance.  I did not feel comfortable meeting with my new client in person due to her poor health, so I offered to FaceTime her.  I’ll admit, at the time I was hesitant I’d be able to connect with her in the same way I would if we were in the same room. I knew I wouldn’t be able to view her full body language, lean in, or offer a tissue if she needed one. I expected our first session to be awkward, but I  knew it would have to be this way if I was to help her safely. 

Today, that first session feels like a lifetime ago.  I’ve learned so much since transitioning from an in-person provider to a telehealth provider. Here are some considerations if you are trying to decide between telehealth and in-person therapy.

  •  Telehealth is best for busy people. 
    • Sometimes the only break you have is a lunch break- and if it’s an hour long you can definitely squeeze in a therapy session.  I’ve met with clients in their offices, in their cars, and while they’re getting their steps in.  If you can speak privately on your phone, you can meet with a therapist. 
  • Phone only sessions are always an option.
    • I will never meet with a client via video while they are driving.  As long as they feel safe chatting while driving and they are able to utilize a hands free device, having sessions over the phone is a great option.  Phone sessions are also a good choice for people who don’t have access to high speed internet or who use a landline because of a lack of good cell reception.
  • Young children may lose interest in a telehealth session.
    • Play therapy is the best way for a therapist to connect with a young child, and this can be very difficult to do in a video session.  Consider opting for an in-person session for young kids.  
  • For family sessions- it depends. 
    • Most of my couple and family telehealth sessions involve the family sitting together in the same space, with me being on the computer or tablet in front of them.  I’ve also met with couples where one partner is away at work or on a business trip, and the other is home, but through three-way video chat, it’s like we’re practically all together.  A phone only session with more than two people, or trying to fit three people sitting together on a phone screen for video can be tricky.  My advice is to consider your needs and if in-person/in-home therapy is an option, to consider it.  

What is your favorite way to meet with your therapist?  Share your experiences or suggestions in the comments below.  

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