In-Person Therapy Is Still the Best

Technology is bringing rapid changes to the field of psychotherapy. A number of recent stories have discussed the possibilities and limitations of so-called teletherapy, or therapy that is performed remotely. Most New York psychotherapists have at least a passing familiarity with this notion; many patients use their phones to “call in” to appointments if traffic renders an in-person visit impossible. And because so many patients now sport smartphones and webcams, the notion of “Skype therapy” comes up often.

Someday it seems inevitable that the pace of progress will make these remote sessions commonplace, and essentially indistinguishable from their real-world counterparts. But for the moment, teletherapy bumps up against a difficult set of practicalities, not least that most video-chat software remains poorly secured, and unable to offer the same protective privacy as a closed office.

And then there is the legal issue, which remains the principal obstacle for many of us in the field of analytic therapy:

The legality of Skype therapy is a gray area because most state laws require the professional to hold a license in the state where the client resides. . . . Some therapists call themselves “life coaches” when they work across state lines; others simply ignore the law. The arrival of distance therapy and telemedicine is rapidly rendering state-by-state licensure impractical. As usual, the law lags far behind technical innovation.

We’ll get there, of course. And it is heartening to see that the tremendous value of talk therapy continues to find its way into national conversations about health and technology. But for the time being, the easiest way to find a therapist in New York remains the old-fashioned way: let your fingers do the walking, and then follow them to your doctor’s doorstep.

A Hunger for Analytic Therapy in More Places

The benefits of talk therapy have long been known, but innovation continues to touch the world of psychotherapy. Concepts such as mindfulness and specialties such as LGBT therapy are constantly adding ferment to the field, for instance, and the advent of the Internet has added many new topics worthy of study. Recently much of the “talk” in therapeutic innovation has centered around the possibility of Web-based psychotherapy. The idea involves a version of Skype, where patient and therapist meet somewhere in cyberspace and conduct a conversation over an encrypted video connection. As a recent article in Wired described one website peddling such technology, “Patient and practitioner connect via TalkSession’s video platform—no couch required.”

Is Teletherapy Real?

There are some inherent advantages to this approach, including improved accessibility for remote patients, enhanced convenience for both patients and therapists, and freedom from the sigma of mental health appointments in communities where such prejudices remain.

Yet sites such as TalkSession cannot readily substitute for the real thing -- yet. There is a shared experience that takes place in the room which cannot easily be duplicated. (Witness the confusion that arises when your partner on Skype begin reacting to things you can’t see.) And of course there remains a formidable series of regulatory hurdles to surpass, including a byzantine national licensing system that makes out-of-state therapy a legal minefield.

Still, there is no question that teletherapy will arrive someday. What this news demonstrates most clearly to us is that vital specialties such as depression therapy, anxiety therapy and relationship therapy are still needed throughout the country. If you’d like to find a therapist here in New York City, please contact the Psychoanalytic Psychotherapy Study Center today.