6 Interesting Facts About Teletherapy And Online Therapy

Teletherapy—or receiving mental health care via phone or internet—is nothing new. Healthcare of various types has been provided remotely for years, and teletherapy specifically had already been steadily becoming more common pre-2020. However, the COVID-19 pandemic drastically increased its popularity within a short time frame. Faced with lockdowns and social distancing requirements, many mental health professionals and their clients turned to teletherapy as a viable alternative to in-person treatment. 

The future of teletherapy in treatment

Though the most acute phase of the pandemic seems to now have passed, teletherapy has remained popular. A study of nearly 13,000 mental health treatment facilities reveals that almost 40% offered virtual mental health care in 2019, but by 2022, that number had increased to nearly 90%. While teletherapy is likely here to stay, the breadth of its potential applications is still being explored. That said, research from the past few years especially indicates that teletherapy may continue to be an effective treatment option for many populations. Let’s examine some of this research to gain insight into both the opportunities and challenges of this care modality.

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Six key takeaways from recent teletherapy research

Teletherapy will likely continue to grow in popularity as it becomes increasingly recognized as a viable alternative to traditional care. Just as with in-person treatment, virtual therapy has both advantages to offer and opportunities for development. Below are six interesting facts about populations best served via teletherapy and insights into the future of this practice, all based on recent research.

1. Teletherapy may still struggle to reach those in poverty compared to in-person therapy

One of the greatest hopes of teletherapy proponents has always been that it will allow many more people than are able to seek in-person treatment to receive mental health care. That’s why there’s commonly a focus on teletherapy’s reduction of geographic barriers. For example, a teletherapist located in a well-served area could see clients from rural or underserved areas without any travel required. While this is true, other barriers can still disrupt the benefit of teletherapy. 

One of the main barriers to receiving therapy, both remotely and in person, is still cost. While teletherapy is sometimes cheaper than in-person therapy, any type of paid treatment remains out of reach for many living in poverty. Some insurers have shifted policies to allow for more straightforward billing for telehealth, but many people still find it challenging to pay for sessions. Medicaid services have expanded to fill some of the gaps, and the Centers for Disease Control and Prevention (CDC) reports that the United States' uninsured population dropped considerably during the pandemic. However, as of 2022, over 12% of adults in the United States had no health insurance, and paying out-of-pocket costs is not always feasible for everyone.

2. Older adults are some of the biggest users of telemedicine, but not teletherapy

Across all fields represented by telehealth services, nearly 37% of patients report using telemedicine in the last 12 months. Individuals aged 65 and over reported the greatest utilization of remote services; over 43% said they’ve received healthcare this way in the last year. The lowest utilization was seen by those aged 18 to 29, of whom only roughly 30% received telemedicine services in the last 12 months. 

3. Diversity in teletherapy is as significant a concern in online therapy as in-person therapy

Evidence suggests that psychotherapy is most effective when the language and culture of the practitioner and the client align. Because of this, it can sometimes be difficult for racial and ethnic minorities, immigrants, and those who speak English as a second language to receive therapeutic services that are comfortable and effective for them. Teletherapy has been touted as a way to reduce the impact of the mental health practitioner shortage, but evidence suggests it has done little so far to close the gap for marginalized populations.

Data from the American Psychological Association’s Center for Workforce Studies indicates that, in 2019, the psychologist workforce in the United States consisted of 83% white practitioners and 17% who were a racial or ethnic minority. Despite this significant disparity, evidence does also suggest that the field is becoming more inclusive over time. From 2000 to 2019, the number of racial or ethnic minority psychologists increased by 166%, likely indicating a positive trend toward increased diversity. 

4. Advances in teletherapy technology may offer additional options for evaluation and care

Teletherapy is already considered by researchers to be as effective as traditional therapy in many cases. However, emerging technological advancements may eventually make it consistently more effective than other methods. As one example, some therapists have begun to incorporate an increasingly common tool in traditional medicine: digital symptom tracking. This can be a powerful addition to online sessions, as research suggests that client symptoms reported digitally between provider visits may significantly increase treatment fidelity and improve outcomes. Digital symptom tracking can be integrated with many types of teletherapy platforms and may soon be a standard approach to helping people better manage mental health challenges.  

5. More therapists are getting on board with teletherapy’s potential

Provider pushback against teletherapy seems to have been more substantial before the COVID-19 pandemic, when lockdowns and social distancing policies forced many practitioners to reach their clients remotely. Prior to this burst in teletherapy utilization, much of the criticism of this format came from therapists themselves. Many worried that teletherapy would negatively affect client outcomes.

Following the peak of the pandemic, however, data has indicated a substantial shift in the attitudes of behavioral health practitioners regarding teletherapy—perhaps due in part to increased research findings supporting the efficacy of this format. While there are still barriers to overcome, a larger number of clinicians have become significantly more comfortable helping many of their clients address their mental health needs through virtual therapy compared to before the pandemic. Therapists will likely continue to see teletherapy as one of many new, valuable health resources as technology progresses. 

6. Teletherapy training is expanding

As teletherapy continues to increase in popularity, there is an ongoing need to ensure that practitioners can competently apply the technology. While the use of teletherapy was slowly on the rise before the pandemic, the eruption of COVID-19 around the world led to a massive spike. At the time, many therapists felt unprepared to use the technology appropriately due to a lack of standardized training.

Since then, many have found it necessary to obtain additional training on teletherapy’s best practices. The American Psychological Association also updated its Guidelines for the Practice of Telepsychology significantly during and since the peak of the pandemic, providing new guidance to psychologists. Numerous training and certification programs have also appeared, and many higher education institutions have incorporated teletherapy best practice principles into their curriculum. These changes were made to increase the confidence of therapists who practice remotely, to standardize the quality of services they provide, and to increase client confidence in this format as well. 

Exploring teletherapy for your own mental health needs

The rise of teletherapy has coincided with the rise of internet-based therapy services that operate independently from a physical practice, clinic, or health system. These services, which may be more affordable than teletherapy obtained through another source, offer an easy way to try this type of service yourself. 

Teletherapy or online therapy services for mental health support

Online therapy is conducted by licensed therapists with the same training and credentials as traditional therapists and who use the same evidence-based techniques as those applied during in-person sessions. Research suggests that many well-supported psychotherapeutic techniques, such as cognitive behavioral therapy, can be effectively leveraged remotely as well to help clients manage a variety of mental health concerns.