The Pandemic Saw the Rise of Remote Mental Health Care. It May Be Here to Stay.

• Online therapy is expected to continue and grow as a form of mental health support.
• Concerns have been raised about losing the "human" connection over video calls and the associated difficulties with recognizing a patient's physical cues.
• However, other people argue that without of telehealth, many people would not have access to the mental support they need, or face delays in their treatment via traditional methods.

Running a small mental-health practice isn’t easy. In addition to working directly with patients, there are invoices to send out, privacy laws to comply with, credentials to maintain, offices to manage, and administrative staff to pay—not to mention marketing strategies to develop if you want to grow your practice based on more than word-of-mouth.

And now, with the rise of telehealth, there’s a whole new medium to consider.

Though plenty of patients will no doubt resume in-person sessions when it’s safe for them to do so, online therapy isn’t going anywhere. The question for mental-health practitioners is how ready they are to not just “make do” with Skype and Zoom sessions, and instead capitalize on the full potential of the technology.

Before 2020, if therapists were interested at all in telehealth, it was typically so that they could accommodate clients with mobility issues or tricky schedules, or to supplement their own practices by offering evening or weekend hours without needing to upend their commuting schedules. But the pandemic forced nearly everyone in the field to at least start experimenting with email, video calls, and online calendar apps.

Kristen Souza is a licensed mental health counselor who helps onboard therapists onto Choosing Therapy, a platform founded in January 2020 to manage the business end of mental-health practices. “Nearly every therapist I onboard these days views teletherapy as an essential part of their practice and an important part of increasing the accessibility of quality remote mental health care,” she says.

Many therapists first developing a remote practice run into the same kinds of problems faced by people in any field when they shift to remote work, she notes. “[T]here’s new software to learn, all communication is happening through email so emails are piling up, wrangling calendars and appointments [feels like] a full-time job, and it seems like everything you do is triggering an alert or pinging a reminder. It’s a lot and can be overwhelming,” she says.

But as therapists get more comfortable with their digital setups, they’re becoming more nuanced in their approach. “[T]here are a few clinical questions that arise more frequently now during onboarding than before the pandemic,” Souza says. “Those tend to focus on what modalities are particularly effective via telehealth, and how to set and maintain healthy professional boundaries in an online venue where the clients may have expectations of communication that’s more immediate, 24/7, and casual than it tends to be” than in typical healthcare settings.