Deborah Belcourt had been seeing her psychotherapist in person for about 15 years. All that changed when the COVID-19 pandemic shut down, well, everything, and her sessions moved to Zoom, a video conferencing app. “Honestly, I found no change,” says Belcourt, a communications consultant in Toronto. “I would even venture to say that I would prefer to continue it this way because it’s easier.” Even before the pandemic, many people accessed mental health care digitally; Talkspace, for example, claims to have 1.5 million users. Here’s what to consider if you’re thinking of switching to online therapy.
What is online therapy?
Online therapy is a blanket term for mental health services delivered digitally, from texting to phone calls to video chat. It makes treatment accessible to people in remote areas, with mobility issues or who—like many of us—are practising social distancing.
Dr. Jane Dalton, the Clinical Director of Roncesvalles Psychology Clinic in Toronto, also points to online therapy as an option for those whose symptoms make in-person sessions difficult. “Sometimes with agoraphobia or a panic disorder or severe depression or certain types of OCD, [clients] might find it difficult to leave the home due to their symptoms,” she says.
Can my regular therapist switch to online sessions?
Professionals who practise in person are not obligated to deliver services electronically, especially if they don’t feel they can fulfill the responsibilities expected of them, such as a completely secure delivery platform, informed consent and competent use of technology. It’s an individual choice for practitioners. It’s also crucial to note that online therapy isn’t suitable for crisis situations.
How does online therapy compare to in-person therapy?
Though the research surrounding online therapy is just in its infancy, clients and practitioners have been thrust into experimenting with it because of the pandemic. Dalton, for example, switched to seeing clients by video at the start of the pandemic. The biggest change? “Most of my clients are not as open [as they are in person],” she says. Despite this, Dalton and her colleagues have found ways to engage. To get the conversation rolling, one therapist asks people to talk about their pets before starting a session. Others have found ways to share activities and be interactive through the screen-sharing function on Zoom.
I don’t have a ton of privacy at home. Can I still make online therapy work?
“The room for therapy creates a little bubble for the client to be in,” says Dalton. “Whereas when you’re in your own home […] you just don’t have that same separation from your life.”
Shivani Persad, a Canadian model, has found this to be true. “When you’re at home you think a million things at once and when you go to their office, it sort of helps me clear my mind more and just differentiate the difference between where I do work and where I do therapy,” she says. “It was a bit harder for me to dive into my feelings [online].”
If it’s difficult to find a space for a session, Abby Rozen, the clinical director and co-owner of the Healing Collective in Toronto, suggests heading outside or even to your car. If going outside isn’t possible, she suggests wearing headphones and turning on some background noise—one of her clients leaves the TV on during her sessions to provide some privacy. “If none of that is possible, you can ask your therapist to do a session via text message, although it won’t be the same,” she says. “Ultimately your therapist is there to provide support in any way that works for you, so creative suggestions will always be welcome.”
How much does it cost?
There are a few publicly funded services that provide virtual mental health care for free or at a subsidized cost. In general, most online providers also often charge less than in-person therapy. Inkblot, for example, costs $75 per hour, about half the national average. But these services do require Internet access and a stable Wi-Fi connection.
Overall, though, Rozen says that “this shift means that therapy can be accessible to a wider group of people. I think being able to offer therapy to people in rural areas, where support may be challenging, and overall, creating more normalized video teletherapy access to mental health supports will be one good thing to come from this challenging time.”
Where to start?
Here are three Canadian programs that offer online therapy—some of which may be covered under employee health benefits.
Inkblot: A video-therapy service that matches clients with certified specialists who provide personalized care for a range of mental health needs.
Maple: An Ontario-based services that allows clients to access a mental health professional through text, phone, or video. Doctors on Maple can also prescribe medication.
Beacon: After an assessment, Beacon gives clients cognitive behavioural therapy-based programs and offers secure messaging with a therapist—and it’s free for Ontario residents.
This article was originally published in 2020; updated in 2021.