Long Distance Counseling

In our age of technology everyone – including mental health treatment providers – is trying to get the most out of the tools at hand. A new kind of mental health treatment, called long distance counseling, is emerging as a way to provide help for those who wouldn’t otherwise receive it.

Reaching Patients in Rural Areas

Telemedicine is relatively new, and few mental health providers use long distance counseling, although studies have found it to be just as effective as face-to-face counseling. Telemedicine uses secure Internet and phone connections to provide treatment to patients in remote areas. These patients may live in areas where there are no licensed therapists, or they may be unable to make the trip into a clinic. Providers who offer this type of therapy are able to reach many more patients in this way, at a fraction of the cost of setting up a physical office in these areas. Lynn Bufka, a psychologist and staff member of the American Psychological Association, said this kind of therapy, “may open access to those who might be reluctant to go to an office or to those who might be physically or psychologically unable to.” (1)

There are still many areas of the country where there is a shortage of providers, and statistics show that people living in rural areas are not immune to things like depression, anxiety, and stress. In fact, the Minnesota Department of Health reported in 2005 that rates of depression among rural women were as high as 40 percent, while only 13 to 20 percent of urban women were depressed. (2)

Blue Cross is currently building a telemedicine network that will reach these rural areas. “We saw the need when we surveyed rural sites. We asked, ‘What do you need, as far as specialists?’ Psychiatry was the No. 1 need that we found,” said Blue Cross spokeswoman Cindy Sanders. (3)

Disadvantages of Online Therapy

However, there are some disadvantages to long distance counseling. It can be difficult to assess someone’s facial expressions on a screen, which makes it hard to understand their mood and really connect with the patient. Teleconferencing is not appropriate when dealing with suicidal patients, because there is no way to keep the patient safe if necessary. Some doctors suggest that getting a depressed patient up and dressed and out the door to see their psychiatrist in an office is beneficial and doesn’t happen with long distance counseling. Finally, the idea of online therapy has not caught on enough for insurance companies to cover the services, therefore it can be costly to patients.

As we continue to develop more ways to connect with people in remote areas, this kind of innovative therapy will continue to grow and expand. “I think that it has virtually unlimited potential,” said Dr. Terry Rabinowitz, medical director of telemedicine at University of Vermont College of Medicine. “Not only can we help folks in underserved areas in the United States, but with little — comparatively speaking — investment, we can do consultations worldwide.” (3)


(1) The Therapist Will See You Now, via the Web

(2) Rural mental health in crisis

(3) Mental health treatment by video growing

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