If you've felt any of these emotions recently, you're certainly not alone. Mental Health America saw a 19 percent increase in screening for clinical anxiety—and that was in March, at the start of the pandemic. This, coupled with more time at home, has led to more people wanting to seek out virtual therapy.
But finding a virtual therapist can be just as overwhelming as finding one to meet with IRL. In fact, given the awkwardness video calls can bring, it can be even more intimidating. To help make navigating it a little easier, clinical counselor Rachel O'Neill, PhD, who works with online therapy company Talkspace, shares her tips on how to start virtual therapy. She gives her intel on how to find a therapist you click with, what to expect in your first session, and tips for making it as beneficial as possible.
Finding a therapist who gets you
Finding a therapist is the first and, for many, most difficult hurdle. Beyond ensuring that you're finding a therapist who is licensed in their state and has a credible degree (LSW, LCSW, and CSW for social workers; PhD, MD, or PsyD for psychologists and psychiatrists), it's important to find someone who you think you can trust. "The therapy method is not as important as being able to trust your therapist and someone you feel comfortable opening up to," says Dr. O'Neill. "If you don't feel like you can truly be open with them, the type of method they use won't matter."
Dr. O'Neill says that companies who specialize in virtual therapy typically have dozens of therapists at their disposal, and they can match you with someone based on what you tell them you want. "For example, if you want a person of color or someone of a specific gender, you can share that so it's kept in mind with the therapist options they present to you," she says. Usually you can indicate those preferences through an online signup form or in an introductory call. There are also services specifically designed to connect patients with therapists of similar backgrounds, such as Ayana and Therapy for Black Girls. Many therapists are also transitioning to seeing clients virtually too, so be sure to utilize other resources such as the National Queer and Trans Therapists of Color Network, the Association of LGBTQ+ Psychiatrists, Inclusive Therapists, and Melanin and Mental Health to help narrow your search.
As with in-person therapy, Dr. O'Neill says it's also important to consider a practitioner's training in specific mental health disorders or issues that are most relevant to you. Need some help with depression? A relationship therapist might not be the best bet.
One of the perks of virtual therapy is that Dr. O'Neill says you can even seek out therapists who align with what you're looking for but aren't located near where you live. "This is a great opportunity to connect with a therapist who may live outside your city and you otherwise wouldn't be able to connect with," she says. If you find someone you like but their website doesn't mention virtual therapy, call or email them directly for more information—chances are they have started seeing clients virtually, even if it isn't yet reflected on their site.
Choosing between digital therapy options
There's also the type of virtual therapy to consider. Video calls, phone calls, and texting are all options and Dr. O'Neill says they all have different pros and cons.
"With texting, the pros are that you can do it without worrying about your partner or kids hearing you; you can literally be next to your partner on the couch and texting with your therapist," says Dr. O'Neill. "Another benefit is the immediacy of the moment. You can text your therapist right in the moments you need help most." She adds that texting provides a written log of the therapist's advice, so you can go back and reread them whenever you need to. However, texts are easy to ignore, which can lead to a slow, stagnant conversation unless you really put in the work. It might also be tougher to feel connected and engaged with your therapist if you can't see them face-to-face.
Dr. O'Neill says that with video and phone calls, you're getting more of a back-and-forth dialogue many crave, and video is the most similar to IRL, which many may prefer. "One con for video therapy, however, is that some people end of focusing on what they look like, so for those people, I recommend turning off the video or looking away from the computer so you don't see yourself," she says.
Dr. O'Neill says because of the difficulty for many people to see a therapist IRL right now, many insurance companies have started covering teletherapy—even if they didn't before the pandemic. This is still something that of course varies between insurance providers and by state, so it's something you'll want to check with them about, as well as the therapist themselves. Many digital therapy companies are cheaper than in-person therapy; Talkspace charges $65 per week for unlimited text, talk, and video therapy, BetterHelp charges $60-$80 per week, and newcomer Frame charges $75 to $200 per session, depending on the practitioner. However, a traditional provider pivoting to teletherapy might charge similar prices as they would in-person. Be sure to ask in those cases if they offer sliding scale pricing models, and see if you can negotiate your rate.
What to expect from a session
When it comes to that first session, Dr. O'Neill says they can be as surface level or as deep as you want to get; it will likely vary from person-to-person. Someone who is having trouble coping with life due to crushing anxiety may have more immediacy than someone who wants to eventually get to the root issues of a resurfacing relationship problem.
"The first session is still a time to get to know each other," Dr. O'Neill says. Typically, she says a therapist will typically ask what prompted you to seek therapy. Then, they will likely ask what you hope to accomplish during each session, and over time. If you feel completely awkward talking about these things (after all, it is deeply personal), she says that's totally fine. "Embrace the awkwardness, as therapy-ish as that sounds. It's part of the process," she says. "When you're doing something outside your comfort zone, that means you're moving and growing. Taking the step to schedule a virtual therapy appointment is huge!"
She also encourages telling your new therapist what makes you feel most encouraged to open up. Maybe it is turning off your video, if you're doing a video call. Or maybe it's leaving voice memos for each other instead of texting, if you choose a virtual therapist who specializes in texting. "My biggest advice is to be as open and honest as possible, so finding ways to feel comfortable doing that is important," Dr. O'Neill says.
How to get the most out of your virtual therapy sessions
Being able to do your therapy sessions from home is a double-edged sword. It's certainly more convenient, but unless you live alone, you also run the risk of those you live with eavesdropping on your convo. (And let's be real, you def want to be able to talk about your partner, roommate, or kids to your therapist.) "Some of my clients call me from their car parked in the driveway because that's a place where they can be alone," Dr. O'Neill says. "Others find a secluded space outside." She's even said some of her clients call her from the bathroom because it's the only place in their home where they can truly be alone. Whatever your living situation is, there are ways to make virtual therapy work.
Dr. O'Neill says you should also be open with your therapist if something isn't working for you. "A therapist may be an expert in their field, but they aren't an expert in your life," she says. "It's completely okay to tell your therapist if something doesn't feel right for you or you don't think it will work for you and it's good to set that tone early on." For example, if you feel judged or like your communication style doesn't mesh with your therapist's and it's preventing you from being truly open, it likely isn't the best fit.
And after a few sessions if you really aren't feeling your therapist, Dr. O'Neill says it's of course okay to find a new one. Even if it takes a few false starts, the benefits of opening up to a therapist you truly trust will be worth it in the end.
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