On the Couch Online: Does Tele-Therapy Work?

Reply Sat 1 Nov, 2008 07:15 pm
On the Couch Online: Does Tele-Therapy Work?

It's called telemental health " the burgeoning field of online and remotely delivered mental-health services " and while many people say they benefit from it, some experts remain unconvinced of its long-term merit. Certainly, more and more doctors and patients are taking advantage of the convenience and, in most cases, the lower cost of Web- or phone-based sessions. Organizations such as the Veterans Administration have employed e-mail and online video conferences to connect doctors with patients in isolated areas, primarily to answer questions or refill prescriptions. But live video is also being used to counsel patients with post-traumatic stress disorder, agoraphobia and eating disorders; so far, the few scientific studies on this new service show that patients and doctors are satisfied with the quality of care, and that the patients do no worse than those attending in-person sessions.

While remote services may break down physical barriers, say some skeptics, they may erect emotional ones to the detriment of the care provided. "All day long, I pay attention to the disconnect between people's words and what they are really feeling," says Dr. Eric Plakun, chair of the American Psychiatric Association committee on Psychotherapy by Psychiatrists. "Tuning in to nonverbal communication is an essential part of the psychotherapy process, and even with a video interface, that seems to be a pretty complicated burden to put on a limited means of communication." Even silences during a therapy session, notes Plakun, have meaning; understanding it often increases patients' self-awareness, helping them to achieve mental and emotional well-being.
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Reply Sat 1 Nov, 2008 07:38 pm
@Robert Gentel,
I think only really good outcome research is going to tell.

I know people who began such practices, and have since ceased them.

It's a damn good thing here, with our remote communities, to do crisis assessments via tele-link for things like whether someone needs to be hospitalized and, over time to do remote diagnosis for serious mental illness, since mental health professionals are only getting anywhere near some communities every eight or nine weeks.

Both clients and professionals say they find it better than nothing, but that it still sucks.

I know Monash University did a research program on running online anxiety diagnosis and treatment recently. I note that this has ceased...but I have not seen the research ourcomes yet. They will be interesting, as anxiety really responds a lot to cognitive/behavioural input, and ought to be a good candidate for online methods for those with mild to moderate symptoms.

I can't imagine working that way a lot of the time...but I certainly do a lot of between session phone contact with remote clients, and do a lot of supporting other professionals with their clients in that way.

I know there was a lot of talk at some stage about setting up sophisticated online robot programs to work with people...and I saw some reports that some people preferred that to actually seeing someone.

I haven't seen research on that.

Actually, that sort of group stuff ( I just read the article) is likely to be pretty damn helpful...especially for folk disinclined or unable to do it live.

It kinda happens here.

I'm worried about someone who needs to talk about bloody "syndromes" ("wife-abandonment syndrome" yet!) in order to talk about perfectly reasonable grief, though.

Syndrome inventors fill me with syndrome-inventor dread syndrome.

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Reply Sat 1 Nov, 2008 08:39 pm
Robert Gentel wrote:
On the Couch Online: Does Tele-Therapy Work?

I believe this website is a form of tele-therapy for some of its customers. It seems to work for them -- they seem happy enough to return.
Robert Gentel
Reply Sat 1 Nov, 2008 08:42 pm
That's why it was interesting to me, I don't think this website's a good substitute for in-person therapy but I imagine that most of the people who use it for therapeutic value aren't substituting it for in-person therapy. So I guess I'm in the better than nothing camp.
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