Technology has expanded to such extent that many of us now
communicate and interact more through modes of technology than we do via traditional
means of person to person contact.
The Smartphone and the wide availability of the internet
allows us the freedom to not only talk over a phone line but also to video chat,
instant text message, email and even have group meetings and company trainings wherever we are and at any time.
These platforms allow people from across the globe to connect in real time and high
definition for such low costs it feels free of charge and in many ways without
limitations.
Is it any surprise then that we are seeing a shift in health
care toward online services?
In the UK there has been a huge push toward online mental
health care services. The IAPT (Improving Access to Psychological Therapies) is
one clear example of this, where therapeutic services are being offered both in
person as well as online to increase the number of patients that can be treated
especially for low intensity conditions such as mild depression/anxiety.
In my current role as stop smoking adviser I treat patients
face to face as well as through using phone clinics, text message and email
services. In this format I have seen first-hand the benefits online services
bring.
Many patients are unable to make a physical clinic
appointment due to disability/illness or working/childcare commitments but are
able to attend a telephone/text consultation. The other side of the coin is
this also works for therapists in the same way, who can work from home at their
convenience and can therefore offer more flexible clinic times perhaps outside
regular working hours. If you live somewhere remote, or are stationed abroad
and don’t speak the local language well enough – how else would you receive
therapy but through online services?
Clients have reported to me that they feel very comfortable in
their own home sat in their own armchair without the stress of traveling to an
appointment and the awkward waiting room experience. Those with social anxiety can
also readily be affected by such factors and prefer the experience of online
communications.
Many of my patients openly admit to being ‘secret smokers’, and
don’t like the thought of being caught out by being seen attending a smoking
cessation session and therefore find online interactions more private and less
intrusive. The anonymity of an online therapy may also produce more open interactions
as inhibitions can be reduced, thus leading to more accurate and successful outcomes.
I have also come across various individuals who are far more
able to express themselves using the written word, where they have time and
space to consider questions and responses, something that is not always
possible in conversation during a given weekly time slot. With a text/email
service information can be read and re-read an infinite number of times, for
the patient to reply at their convenience without pressure.
Online services also opens the patient to a world of options
and choices, including more affordable or even free services they would not be
able to receive through attending traditional therapy.
To summarise telephone/online therapy is convenient,
comfortable, unobtrusive and flexible while offering choice. It is economic also if you factor in the lack
of travel costs and the logistics of a therapist potentially seeing a higher
quantity of patients.
But do we lose any ingredients from traditional face to face
therapy? The University of Wolverhampton UK lists some of the disadvantages.
For crisis situations where a patient is in emergency need
of guidance then a physical presence is ideal, especially if a patient represents
a risk to themselves or others. Severe mental health problems that require hospital
staff and treatment also cannot be easily aided online. If a patient is already
isolated from face to face interactions a traditional therapist is also preferential.
Online security is another factor to consider, particularly
bearing in mind how often we read about identity fraud and online grooming etc.
If we walk into a hospital we can feel a trust and confidence toward the
professional we are speaking to; but is that the same in an online scenario? I
would always encourage checks to be made and reviews to be read of any therapeutic
service online or face to face. Make sure the service you are signing up to is
credible.
Some individuals prefer face to face therapy. They like non-verbal,
visual communication. Many, especially amongst the elder generation, do not
have smart phones or the confidence in the internet and feel more comfortable using
traditional means of therapy. A certain level of technological competency (and
literacy when using text) is required, unless you have someone with you who
might assist on your behalf.
As good as technology is, we still get bad reception at
times, lines that crackle or batteries that run flat; which obviously can be
frustrating and can lead to misunderstandings or even increase levels of stress
that would not happen face to face.
If I currently see a patient in my clinic whose first language
is not English I can use language line or visual cues to aid communication
which perhaps would not be so easy over the phone/online.
I work with therapists who are adamant that traditional face
to face therapies work better through the development of therapeutic rapport.
Although I see their point of view, I don’t believe face to face interactions
are the only way to build rapport and is more a case of personal preference.
After all, don’t people make friends all over the world through communicating solely through instant messaging?
If you are someone at ease with communicating through technology
and are open minded enough to try something new then I see no reason why you
cannot interact exactly as effectively online as face to face, and if there is
any negative difference in quality this is more than offset by all the
advantages listed in this article.
All things considered I feel that if used in the right way the
advantages of online therapy certainly outweigh the disadvantages. Looking to
the future I believe it is a trend we are going to see a lot more of, not only
in healthcare but in education, the work place and society in general. I am
optimistic this can have a positive effect on global mental health trends, as the
flexibility and convenience of modern techniques can enable a higher volume of
patients to be treated both efficiently and effectively, with therapist and patient
brought together without limitations.
