impact

The Impact
of Technology on Therapy

Written by Eugene W. Fields

Technology has allowed people to connect faster and more efficiently than ever before. In terms of the relationship between therapist and patient, technological developments have allowed therapists to reach patients in distant locations, such as prisons, military bases and rural communities. The trend for patients to explore distance therapy opposed to a traditional setting is becoming more popular.

The idea and practice of distance therapy is not new. Sigmund Freud maintained written correspondence with clients and the advent of the telephone led to audio therapy sessions – a practice still commonly used.

Darren Adamson, Ph.D., L.M.F.T., an associate professor at NCU’s School of Marriage and Family and the program director of the Master of Arts in Marriage and Family Therapy program, said virtual therapy should be looked at as an additional way for patients to receive therapy, rather than an alternative to traditional in-office therapy.

“We are simply talking about the method of delivery, not the preparation of the therapist or the evidence-based approach taken with clients,” Adamson said. “Those must remain consistent between the two delivery methods. In fact, research has demonstrated that outcomes are very similar between in office and virtual therapy for many of the most common issues clients bring to therapy.”

In a technologically dependent world, Adamson said some patients actually prefer virtual therapy over traditional in-office sessions.

Therapists can see clients from anywhere in the world, so how does a state regulate the preparation of a therapist that is not licensed in the state where the client lives?

Darren Adamson, Ph.D., LMFT

“It can assist … those who have difficulty leaving the safety of their homes (for example), those with anxiety disorders,” he said. “A very distinct advantage is that virtual therapy is more acceptable to those who prefer virtual communication.”

In some states, virtual therapy is being approved as well as virtual supervision. Adamson said part of the challenge for virtual therapy to become accepted nationwide is regulation – as well as dealing with popular virtual communication programs like Skype or FaceTime possibly violating HIPAA privacy violations.

“Therapists can see clients from anywhere in the world, so how does a state regulate the preparation of a therapist that is not licensed in the state where the client lives? With the client as the consumer, can the state dictate where they receive therapy?” he said.

Another challenge Adamson said that must be addresses is how a therapist who is licensed to practice therapy in a particular state can see clients that live in another state, which may have different regulations.

“Even if regulations are the same, will state regulatory bodies surrender their right and obligation to ‘protect the public’ living in their state to a regulatory body in another state?” he said.

Virtual therapy has many benefits, including not requiring a therapist and patient to be in the same physical space, as well as saving costs of office space or overhead. However, Adamson said virtual therapy is not for every patient.

“It can be done with anyone who … has a mild to moderate emotional disturbance, mental disorder or relationship issue,” Adamson said. “It will not work effectively with all mental disorders, particularly psychotic or personality disorders.”

Opponents of virtual therapy point to the lack of non-verbal cues that can be missed. The non-verbal cues include facial expressions, dilated pupils or sighing. Opponents also charge that the therapeutic environment might be more difficult to maintain because of the out-of-office environment, as well as an inability to control patients who act out during therapy sessions. According to a 2006 article in the Journal of Mental Health Counseling, online clients were satisfied with their treatment online in general, but not as satisfied as clients who underwent traditional, in-person counseling.

Our task as a profession is to research methods of providing effective virtual therapy, not with the goal of replacing but of supplementing what has traditionally been offered in an office.

Darren Adamson, Ph.D., LMFT

Still, Adamson said the benefits of distance therapy outweigh the challenges.

“There are an increasing number of reasons that many people who need services cannot access them in the traditional in office manner,” he said. “Our task as a profession is to research methods of providing effective virtual therapy, not with the goal of replacing but of supplementing what has traditionally been offered in an office.”

As more states approve the practice, students that graduate from NCU’s Marriage and Therapy program will enter a world in which seeing clients virtually is becoming recognized as effective therapy.

“The experience of completing training in a virtual world gives NCU students the cyber-savvy that is required to understand and manage the nuances of language – verbal and non-verbal – that exist in the virtual world,” Adamson said. “Additionally, NCU students develop the ability to effectively use technology to assist in serving clients – they are not intimidated by technology because they have used it to complete complex academic tasks and to communicate with faculty and fellow students.”