The COVID-19 pandemic has shifted a lot of our in-person practices online: grocery shopping, office jobs, and entertainment to name a few. But as individuals reckon with the stress of an ongoing pandemic and one in five Americans struggle with mental illness, more and more people are beginning to ask if it’s reasonable to conduct therapy online as well.
Online therapy, or “teletherapy,” isn’t entirely new. Though crisis hotlines have been conducting rapid counseling services via phone and text for the last few decades, teletherapy was introduced as an accessible option to the United States and much of Europe when Talkspace and BetterHelp started in 2012 and 2013, respectively. Since then, individuals, couples, and even families have been able to reap the benefits of talk therapy from the comfort of their own homes — without having to drive to a psychologist’s office, find parking, and do the awkward which-chair-do-I-sit-in dance with their therapist. (Just me?) The introduction of such services has made it less intimidating for some to approach therapy, since they can chat with their provider in an environment they already know, and has made it possible for those in rural areas to find a therapist when they otherwise wouldn’t be able to for hundreds of miles.
For people like myself, teletherapy is a godsend. It’s nearly impossible for me to be late for an appointment since I don’t have to encounter traffic on the way there; I save time by cutting out a “commute”; and I don’t have to feel guilty for using all of my therapist’s off-brand Kleenex when I cry a little too hard. Teletherapy also expands my network of potential therapists, making it easier to choose one with whom I “vibe” and feel I truly benefit, since location (beyond the boundaries of my state) isn’t a factor. As someone who is consistently working to add to her “mental health toolbox” and battle depression, anxiety, and OCD, I see myself using teletherapy for a while.
But as those unfamiliar with teletherapy (and perhaps telehealth services in general) consider it as an option, whether until psychologists’ offices reopen or indefinitely, concerns regarding safety and security rightfully bubble to the surface. Not only is data security generally an issue across the Internet, but many of us in therapy discuss things we aren’t exactly comfortable disclosing to people beyond our therapist — especially without our consent. How can any of us be sure our information won’t end up in the wrong hands?
The reality is that we can’t be sure—but that teletherapy is unlikely to be riskier than any other medical or mental health service, regardless of whether such services are being conducted traditionally (AKA in person) or online. This is because many medical and mental health professionals have begun to store patient records electronically; as a result, your data is going to end up on a drive or in a cloud regardless of whether you visit a provider at their office or online.
In fact, providers have not only been storing their records online in recent years, but sharing them with patients that way, too. While patients have always had a right to their medical records, obtaining them has historically required patients to complete lengthy request forms, wait forever for a response, and even pay small fees. But thanks to the 21st Century Cures Act, medical practices are required as of April 2021 to provide patients with free virtual access to their records. Some organizations already did this, like One Medical and VillageMD, whose entire schticks are creating seamless patient experiences between national offices using a centralized app; others have had to adjust to providing these electronic health records (or EHR) to patients via digital platforms. Those who are concerned specifically about teletherapy privacy, however, may be pleased to know that talk therapy notes are one of very few exceptions to this rule.
There may be a few sensationalized (yet admittedly scary) instances of bad actors hacking teletherapy data for financial gain, but these may just as easily occurred had the victims attended therapy in person. (Even after scribbling down notes during a session, therapists are likely to input those notes into a computer for safekeeping and efficiency purposes.) But people are nervous about teletherapy’s overall security, making these instances great, highly-clickable news stories. A story about a brick-and-mortar medical office’s records being hacked wouldn’t be as juicy, since there’d be no “safer” alternatives.
Anything new is bound to feel scary, and therapy already has its barriers to entry: stigma, for example, surrounding mental health issues and seeing a “shrink,” as well as limited financial or geographical accessibility compared to basic health services. It’s understandable that those new to teletherapy or therapy in general would be apprehensive. But for those who are interested in pursuing therapy but wish to social distance or avoid a regular commute, teletherapy is an option with no more risks than a traditional office—which is to say, very few.