Online Therapy DC

Does online therapy work?

The short answer is that yes, online therapy is as effective as in-person therapy for most people, with most therapeutic concerns, most of the time. For example, a 2018 meta-analysis (essentially, a type of study where researchers summarize findings across multiple studies) of 64 clinical trials found that online therapy was as effective as in-person therapy for anxiety and depressive disorders. Two clinical trials in 2014 found similar results for anxiety disorders and depressive disorders considered separately. These are just a few examples of peer-reviewed research to have supported the use of online therapy for the treatment of certain concerns, and additional research is ongoing as more mental health providers turn to online therapy to continue meeting their clients’ needs during the pandemic.

Online therapy may not be appropriate for everyone or to meet every need, however, and for this reason should be considered thoughtfully before beginning.

Is online therapy appropriate for me?

For many, the choice to engage in therapy online comes down to personal preference; understandably, some simply don’t like the idea of meeting with a therapist online. However, there are some reasons online therapy may not be an appropriate fit for you or your loved one, particularly if:

• You have serious thoughts of suicide or self-harm
• You have serious thoughts of harming others
• You are at risk for a significant mental health crisis
• You have untreated symptoms of psychosis
• Your needs require a form of therapy most appropriately delivered in-person when possible (e.g., EMDR)

If you experience any of the above circumstances and have the option to meet with a therapist in-person, it would likely be in your best interest to do so.

What are some of the benefits to online therapy?

There are a number of benefits to online therapy, many of which I have reviewed in greater detail in my blog. Here are a few worth considering:

• Online therapy is often more convenient, particularly as it reduces barriers to regular attendance like a commute
• Online therapy is more accessible for individuals in areas that have few mental health providers, who have mobility issues that make attending in-person more challenging, or for whom life is too busy to make meeting in-person during daytime hours a possibility
• Online therapy is more comfortable for some, particularly those who may feel anxious meeting with a therapist in-person or who may struggle to “open up” when face-to-face
• Online therapy increases opportunities to share things like cherished objects, photos, and expressive arts that exist in your home
• Online therapy may add some privacy for those concerned about seeing familiar faces in a therapist’s waiting room or lobby

What are some of the disadvantages to online therapy?

As with the many benefits to online therapy, I have detailed a number of drawbacks to online therapy on my blog. Those include the following:

• Online therapy may introduce frustrating technological hiccups, like being disconnected from a session due to poor connectivity, that distract from the therapeutic process
• Online therapy may limit a therapist’s ability to see and interpret your body language
• Online therapy may make it harder to manage potential interruptions or distractions that exist in your home
• Online therapy may make it more difficult for a therapist to effectively meet your needs and plan for your safety when you are in an emotional crisis or suicidal
• Online therapy may introduce certain data privacy concerns, for example by making your sessions vulnerable to hacking

What are some ways to ensure my privacy when meeting with a therapist online?

There are a few things you and your online therapist can do to safeguard your privacy when meeting online:

• You should ensure your online therapist is using HIPAA-compliant software for meeting with you online. This software would feature end-to-end encryption and other data privacy measures that help to safeguard it against attack
• You should only meet with your online therapist via a private Wi-Fi network. Public Wi-Fi networks, like those hosted by a hotel or shared by an apartment building, may be more vulnerable to attack
• You may wish to ask whether your online therapist has a waiting room or other feature activated on their video hosting platform that would allow them to prevent others from accessing your appointment
• You should only communicate with your online therapist electronically via personal accounts, particularly if your employer has access to your accounts or if you work in an agency subject to FOIA requests
• You should see if your online therapist can communicate information regarding your appointments and other personal health information via secure messaging platforms, like Simple Practice, or using email encryption browser extensions like Virtru
• You should never include your meeting information in publicly available calendars or platforms that may be vulnerable to hacking
• You should only meet with your online therapist from a private space, like a bedroom or secure office space
• You should use headphones when meeting with your therapist online
• When possible, you should lock any doors and face your computer away from doorways, in the event that someone might walk in while meeting with your therapist online
• If you share your space with others (e.g., roommates or a partner), you may want to ask that they leave the space, introduce a sound barrier (like a TV), or put in noise canceling headphones when you are meeting with your online therapist
• If you are still concerned about maintaining privacy while meeting, you should discuss these concerns and strategies for mitigating any privacy risks with your online therapist

Is online therapy covered by my insurance?

Though I am an out-of-network provider and do not work with any insurance companies directly, many of my clients seek reimbursement for the cost of online therapy through their out-of-network insurance benefits. These benefits often require specific stipulations to be met in order to receive coverage, some of which may include specific policies regarding telehealth. With the beginning of the coronavirus pandemic, many insurers implemented new policies or created waivers to existing ones to allow clients to begin or continue working with their therapists online. Many of these still exist and may even become permanent policies, but ultimately the specifics will vary by insurance plan. You should reach out to your insurance provider to seek additional information regarding their coverage for online video teletherapy and ask whether there are any restrictions or limitations that differentiate this coverage from that for in-person therapy.

Which therapists can I work with online?

I imagine that many therapists, though eager to meet in-person when possible, will continue to offer some blend of online and in-person therapy as appropriate to the clients they work with. Most therapists are communicating whether they are meeting with clients online in their web materials, so if you find a therapist you like, you may wish to review these or simply give them a call or send them an email to request additional information regarding their online therapy availability.

It is important to note that all therapists are restricted to working with certain clients by local licensing laws. Meeting with clients across state lines is interstate commerce that is therefore limited by state law. Most therapists are only able to work with clients who are physically located in the state that they are licensed in, even when meeting online; for example, a therapist licensed in DC can only work with clients who are physically located in DC at the time of their appointment. There are some exceptions to this, particularly for psychologists who are licensed in multiple states or who are registered with an interstate program called PSYPACT.

Fortunately, I am both licensed in DC and with PSYPACT, an interstate license that allows me to work virtually with clients in the following states: Alabama, Arkansas, Arizona, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Indiana, Illinois, Kansas, Kentucky, Maryland, Maine, Michigan, Minnesota, Missouri, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, Nevada, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington State, Wisconsin, West Virginia, and Wyoming. If you are located in any of these states, we would be able to meet online while meeting together. Similarly, I am able to continue working with clients who are generally located in DC but who wish to continue meeting while traveling, visiting family, or during a short-term relocation to the previously listed states.