In March 2020, our world was jolted to action by a global pandemic that presented dangers requiring quick action and adaptation. Many of us moved our offices to our homes, honed our tech skills and equipment and oriented our clients and ourselves to teletherapy. We all abruptly found ourselves dealing with the same threatening health crisis.
Together, we experienced a change in our routine environment that included a loss of physical connection to public spaces, passing strangers, colleagues and even family. Despite that, the rapid adjustment to online therapy seemed to happen quickly. It required finding that private space with a comfortable chair, figuring out how to deal with the long hours of sitting and managing the fatigue from the hyperfocus required in this new virtual medium. Two and one half years later people are surprised.
People wondered if the convenience we found in teletherapy will affect the return to traditional therapy.
Now we know it has profoundly changed the practice of therapy. A 2020 study (Bekes, et al. 2020), in which 190 therapists were interviewed found the major complaint to be technical problems not the quality of the therapy or therapeutic relationship. They witnessed over time that their opinions of online therapy became more positive. In another study (Shklarki, et al. 2021) reported 70 % of therapists felt remote therapy is more draining than traditional therapy but that they found it to be as effective as in-person. Hybrid therapy was found to be the choice of 62.7 percent of the study participants.
There are now many complex questions:
Whether to meet with clients in person again?
Should one maintain an office and save overhead?
Would a combination of in person and online (hybrid) suite my clients and I?
How do these options affect my lifestyle?
Will the clients return to the office?
How is our Society reaching this challenge?
Brynn Stember, Linda Buch-Hammonds, Tamara Kaiser, Leslie Blessing and Joy Allen are 100% doing remote therapy. Alison Hayward made the distinction that she sees supervisees 90% virtual and clients 100% in-person. I wonder how many of us have made that similar plan. Marie Ridgeway is 90% in person as she treats emergency personnel. Ann person is back to 100 teletherapy. Several of the above members have given up their space for a variety of reasons. Joy Allen reports she is 100 % mostly as she relocated and is still considering her future plans.
Some are starting to see a return to the office slowly and with ongoing questions. Kathleen Field is approaching 10 %. Since she treats children Barb Schnickels is 5% with those children in person and with adults is 95 percent on teletherapy. She has chosen remote therapy as she prefers the work life balance, probably a major reason therapists are choosing a hybrid model.
Clay Sankey, Rebekah Morse and Melissa Raetz are approaching about 20-25 % in person, as is Ann Trench, who is aiming for a 30-35 percent level. Colleen Gunning is adamant she will only see clients in- person only in the future. She has a new position working with people with diagnosed disabilities and will stick with her goal. This writer also is aiming for 25%. I hope I can talk my clients into it, but they remain very comfortable and couples definitely prefer the convenience of teletherapy. I miss that synergy and my office that I only see once a week.
The pros and cons, gains and losses of teletherapy can be debated endlessly. We will have to wait for the research that surely will come. But it would seem it has filled a need in this pandemic, increased the availability of therapy and captured the support of our community.
Bev Caruso
Bekes, V, Aafie-van doorn, K, Prout, T, Hoffman, L, (2020) Stretching the analytic Frame, analytic therapist’s experiences with remote therapy during COVID-19, Publication of the New York Psychoanalysis Society and Institute, April 2020.
Shkarlarski, L, Abrams, A, Bakst E., (2021) Will We Ever Again Conduct in-Person Psychothera Sessions? Factors Associated with the Decision to Provide in-Person Therapy, (2021) Journal of Contemporary Psychotherapy, 51: 265-272
