Does online therapy work?
One of the biggest concerns about online therapy is that therapists don't have an opportunity to observe the patient—something that is usually integral to an assessment and diagnosis. The tone of voice, body language, and overall demeanor provide insight into an individual's well-being.
A major component of effective therapy involves the relationship between the therapist and the patient. As online therapy is impersonal (often, it's completely anonymous), many people have raised concerns about whether digital communication can provide skills, tools, and healing power to individuals staring at a screen.
Despite the concerns, research consistently shows that online treatment can be very effective for many mental health issues. Here are the results of a few studies:
A 2014 study published in the Journal of Affective Disorders found that online treatment was just as effective as face-to-face treatment for depression.
A 2018 study published in the Journal of Psychological Disorders found that online cognitive behavioral therapy is, "effective, acceptable, and practical health care." The study found the online cognitive behavioral therapy was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.
A 2014 study published in Behaviour Research and Therapy found that online cognitive behavioral therapy was effective in treating anxiety disorders. Treatment was cost-effective and the positive improvements were sustained at the one-year follow-up.
The Potential Benefits of Online Treatment
Online therapy offers some benefits over traditional face-to-face treatment:
People in rural areas or those with transportation difficulties may have easier access.
Many online therapy sites allow users to sign up with "nicknames" which can entice people who are embarrassed about getting services under their real names.
Most online therapy services cost less than face-to-face treatment.
Scheduling is more convenient for many people.
Studies show online therapy requires 7.8 times less of a therapist's time than face-to-face treatment—meaning therapists can often treat more people online than they can in-person.
Clients don't have to worry about seeing people they know in the waiting room.
It can be easier for some people to reveal private information when they're sharing it online.
Individuals with anxiety, especially social anxiety, are more likely to reach out to an online therapist.
The Potential Drawbacks
Online therapy isn't for everyone. Here are some potential risks and drawbacks:
Online therapy isn't meant for people with certain problems or conditions (such as suicidal intent or psychosis).
Without being able to interact face-to-face, therapists miss out on body language and other cues that can help them arrive at an appropriate diagnosis.
Technological issues can become a barrier. Dropped calls, frozen videos, and trouble accessing chats aren't conducive to treatment.
Some people who advertise themselves as online therapists might not be licensed mental health treatment providers.
Sites that aren't reputable may not keep client information safe.
It can be difficult to form a therapeutic alliance with someone when meetings aren't face-to-face.
It can be difficult for therapists to intervene in the event of a crisis.
How to Find an Online Therapist
If you are interested in online therapy, there are many options to choose from. Think about what type of services you want most—phone therapy, video chats, live chats, audio messaging, or text messaging.
You may find a local therapist who offers online services, or you might find you prefer a large organization that offers a substantial directory of therapists to choose from.
But do your homework and shop around for the service and price plan that best suits your needs.
Find the full article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
COVID 19 & Teletherapy
Seeing a therapist used to imply being in the same room with them, but not any longer. Teleconferencing has made it possible to see a mental health professional from a distance.
With recent requirements for social distancing, many therapists and clients have had to either pause their work or make other arrangements, including meeting by video conference.
I've been providing teletherapy services for a few years now. Here are some common questions and issues that come up when thinking about making the transition.
Will My Therapist Agree to Online Sessions?
Some therapists (myself included) are enthusiastic about using teletherapy, some won't use it at all, and a large number of therapists approach it with some reservations. I've been surprised how many therapists are now moving to it with the COVID-19 outbreak and resulting social distancing. Most therapists generally seem to find that it's a very beneficial approach.
Even among therapists I know who were skeptical about online sessions in the past, the majority have opened to the idea. They seem to recognize it as a good option to avoid an untimely break in the therapy relationship, and to provide continuity of care.
Will It Be Weird?
If you're generally comfortable with communicating through a screen (e.g., Skype, FaceTime), you'll probably be comfortable moving to online therapy. If you can't stand this form of communication, you'll likely have a harder time with it. Of the dozens of clients I've treated through teletherapy, most seem to find the transition to be smoother than they expected. Therapy tends to be intense, and quickly enough you're likely to forget about the medium and focus on the work.
That said, expect some differences with teletherapy. It's different when you're not in the same room with someone, and you're experiencing them in two spatial dimensions instead of three. It can also be harder to pick up on body language through a video. And while most of my clients seemed to be comfortable with making the switch, a few were not, or found the transition to be quite challenging. Occasional tech issues come up (like a delay in the audio and video), but typically can be handled with a little patience and humor.
Is It Effective?
Research suggests that therapy by video conference can be very effective, which has also been my clinical experience. It depends on you and your therapist, of course, but in general you should expect it to be helpful if you were finding in-person therapy helpful.
Personally, some of the most powerful clinical experiences I've witnessed have occurred through teletherapy. In my own practice, I've seen it work for people dealing with things like depression, anxiety, obsessive-compulsive disorder, insomnia, relationship issues, grief, and trauma.
Will Insurance Reimburse Me?
A growing number of insurance providers seem to be willing to cover online therapy sessions. They'll probably require the standard things for reimbursement: your identifying information, the provider's license and so forth, a diagnostic code, and a session (CPT) code. Check with your insurance provider before starting your sessions if you'll depend on reimbursement to cover the sessions.
How Does It Work?
You and your therapist will agree on a platform to use (or in some cases may decide to forego video and simply speak by phone). Some rely on Skype or FaceTime, although those options are not HIPAA compliant. More secure platforms include VSee, Zoom, and Doxy, among others. There may be a fee for your therapist to use the technology depending on the service, but it should be free for you (aside from your therapist's session fee, of course).
How Should I Prepare for My Sessions?
Some important and finer points about the logistics of teletherapy:
Do a test of the software beforehand for your own peace of mind and to be sure it will work, and verify that you have your therapist's contact information (e.g., VSee username).
Find a place in your home where you'll have as much privacy as possible. This could be a challenge if kids are out of school or other family members are always home (or work from home).
Along those lines, I recommend ear buds for privacy and also better sound quality. That way your therapist's voice won't feed back into your microphone and out their speakers.
Make sure you're sitting somewhere you'll be comfortable for the length of your session.
Have your screen on a stable surface, since excessive movement can create a feeling of seasickness for your therapist. If they're new to teletherapy and their screen is bouncing around, ask them to do the same.
A finer point: try to have the top of your head near the top of your video screen, rather than in the bottom half of the screen. That way when they're looking at your face they'll be looking more or less into their camera (assuming it's at the top of their computer), so it will feel like they're looking at you.
Be sure to close email and turn off notifications that could be distracting and dilute the experience for you. You'll want to have your full attention focused on your session.
Also close programs that could slow down your computer's processing ability and interfere with the quality of the video.
You may also need to work out payment arrangements with your therapist if you generally pay in person. Some therapists will keep a credit card on file for you; others will ask that you mail a check. Find out what they prefer.
Are There Other Advantages to Online Therapy?
One plus of online therapy you'll notice right away is that there's no travel time involved, so your sessions will probably take up much less of your day. With that in mind, you may want to build in some transition time into and out of therapy, since travel time often provides a buffer before and after your session. It might be challenging, for example, to return directly to childcare after an emotional session. Even a 10-minute break to process and digest the session can make a big difference.
You'll also never have to cancel for weather (assuming you have electricity and Internet), and there are no concerns about whether you could pass along a sickness to your therapist (or vice versa) if you're well enough to meet but possibly contagious. It's also possible to see your therapist when you're traveling, just as I've been able to see clients when I've been on the road.
What If My Therapist Won't Do Online Sessions?
If your current therapist isn't open to doing teletherapy, you might consider speaking with a new therapist who does offer online sessions. Obviously it's not ideal to have to start over with someone new, especially if you've been seeing your therapist for a while. But it may be your only option if you're committed to continuing therapy with as little interruption as possible.
If you don't want to start with a new person, consider other resources during the hiatus from seeing your therapist (and work with them on the plan, if possible). For example, there may be books, brief online courses, or other resources that will help you to continue the work. Your therapist might be open to having brief phone check-ins during this time.
Seek out additional support from loved ones, as well, and be sure to take care of your basic needs like sleep, nutrition, and movement to keep your body and mind healthy. You might find journaling to be helpful during this time, as it's been shown to be an effective way to process thoughts and emotions.
Keep in mind that there could be unexpected benefits to taking a therapy vacation. While it may not be ideal, an unplanned break from therapy can lead to surprising growth, as the work you've done settles in and takes hold.
The Bottom Line
If you're considering teletherapy, talk it over with your therapist and see if it's worth giving a try. You don't have to know in advance if it's the right decision for you—you can always plan to do a limited number of sessions to see how it goes. If it works well, it could be a convenient and time-saving way to continue the important work of therapy.
Find the fill article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
Dear Diary...
Writing down your feelings is a powerful tool for relationships because by doing it, you get to know the number-one most important person in your life: yourself. The quality of any romantic relationship is going to be directly correlated to your own self-worth. You are the person you really need to get to know, and journaling is a great ally in that process.
Writing can help you tune in to your inner voice and appreciate who you are—in other words, your journal shouldn’t just be a dumping ground for frustrations about your partner. (Although that can definitely be helpful in some situations, like if you need to have a talk with them and want to organize your thoughts.) Rather, you can also look at it as a place to dig deep into who you are and what you want.
Here are a few journal prompts that can help take a person’s relationships to the next level, whether single or attached.
Journal Prompts for Single People
The perfect day visualization: A big roadblock people come up against when dating is that they don’t really know what they want. And if you’re not clear on your endgame, you risk wasting time and energy on people who ultimately aren’t going to be the best fit for you.
To find that clarity, try this two-part journaling exercise. First, take a little time to dream about what [your ideal] partnership looks like and feels like. These prompts can help get you started, but feel free to be creative here:
Journal out a whole day spent with this person. What does it feel like when you wake up together? Where do you go? What do you do? Really dig in and get specific.
Keep coming back to how it feels physically and emotionally. Are you energized? Does it give you a sense of safety? Are you having fun?
Next, use the intel gleaned from your perfect-day visualization to make a list of qualities you want to prioritize in a partner. What are the nonnegotiables for you?
The post-date debrief: One of the ickier aspects of dating-app culture is that it can make a person feel like they’re on a job interview, and it’s easy to put too much focus on the performance aspect. We’ve all fallen down the rabbit hole of self-doubt. But this is the absolute wrong approach. We’re often so preoccupied with being chosen that it’s easy to forget that you are picking your partner, as well.
You can use your journal to flip the script. Don’t just get caught up in the ‘shiny object’ aspects of their persona or appearance, ask yourself about the qualities they exhibited and if those are in alignment with what’s most important to you. Here are some things she suggests you journal about after a date:
How did your evening make you feel?
What did you enjoy about spending time with this person (or not)?
Did they make you feel good or kick up insecurities?
It’s not about judging your date. It’s about being connected with yourself through the dating process and assessing whether you two humans are a good fit for one another. You might be surprised to realize that person you were hoping to impress isn’t actually that impressive themselves!
Journal Prompts if You’re in a Relationship
The stress-buster: Stress is a major relationship buzzkill—if you’re obsessing over your to-do list or a conflict with someone at work, it’s hard to be present with your partner. Compounding this is the fact that self-care can often take a backseat when you’re coupled up. It erodes the foundation of the relationship long-term, because you both need to be taking care of yourselves in order to have the energy and clarity to take care of each other.
Here’s how you can use your journal to calm your mind and clear mental space for your S.O.
At night in bed, jot down a list of everything you want to get out of your head. This might help you sleep better—and wake up knowing exactly what priorities you need to tackle the next day. (That way, you’re not thinking about them during quality time with your bedmate.)
In the morning, do a free-write for at least four minutes and see what comes up on the page. Think of it like a juice cleanse for your brain.
The self-love party: Let’s be honest: One of the perks of being in a relationship is having someone constantly tell you how great they think you are. But if you’re solely looking to your partner to validate you, you’re likely heading down a sketchy path. We aren’t going to get all our needs met by a significant other. That’s unreasonable and unrealistic.
If you find that your moods peak and dip based on the amount of attention you’re getting from your plus-one, try giving yourself the gratuitous praise you’re seeking. Make a list of the things that you appreciate about yourself, and not a short list! Go for at least 50: traits, body parts, habits, you name it. Like how you set the dining room table? Include it. Think you have lovely feet, claim it. Love how you are a good friend to x person? Celebrate it. It’ll take the pressure off your partner to be the president of your fan club—but, more importantly, it can help you fall a little deeper in love with you.
Read the full article on Well+Good.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Cultivating true happiness? Here's how!
Many people find themselves struggling against external ideas about what should make them happy. What’s the one thing you’re pining for in your life that would make you happier, if only it would happen? A new job? Romance? More Instagram followers? There’s always something, that’s for sure.
There are so many conceptions out there that you have to have something by a certain age, you have to have everything in place. Research shows external factors have the power to make us happier in the moment, but cultivating a deep sense of happiness is a much different project that spans far beyond any promotion or number of likes.
Here are a few things, proven through research, to help you cultivate true happiness.
Get more sleep Getting enough sleep is so important for our overall well-being, on so many levels! The vast majority of us need somewhere between seven and eight hours of sleep a night.
In addition, more than a decade ago, Harvard Women’s Health Watch reported chronic lack of sleep can weaken the immune system, make maintaining a healthy weight more difficult, contribute to high blood pressure, and interfere with learning and memory. It’s hard to believe something free has so many amazing benefits—or that we’re not all getting enough of it every night.
Exercise Exercise, like sleep, is a quick ticket to happiness, with even more immediate effects on mood. A recent study by the Black Dog Institute in Australia found even just one to two hours a week of exercise, defined as an activity that raises the heart rate and gets you warm and slightly out of breath, has a whole host of physical and mental benefits.
Spend time outdoors This may make you tweak your exercise routine to do double duty. While that candlelit spin experience is sure to boost your endorphins, a lower intensity jog or even a brisk walk outside gets you closer to something researchers are finding makes humans very happy: nature.
Find meaning Here’s where things get a little trickier. Getting enough sleep, exercising, and spending time outdoors are all pretty much guaranteed to quickly improve your mood. They’re also simple to plan and execute. But what about your internal monologue and your overall satisfaction with your life and what it all means?
A growing body of research is differentiating between two different types of happiness: hedonic and eudaimonic. Hedonic well-being is instant-gratification stuff like getting a present, collecting a record number of likes on your latest Instagram masterpiece, or going out on Friday night. Eudaimonic well-being stems from an overall sense of building a meaningful life. The two can dovetail—maybe you’re headed out on Friday night with an old and dear friend, for instance. The relationship is eudaimonic, while the activity itself may be hedonic.
We all find meaning in different places: work, relationships, family, and volunteering. This kind of happiness can also be described as a sense of purpose—and cultivating these elements in your life can take years and a good amount of self-knowledge.
Maintain relationships The Harvard Study of Adult Development is the longest running longitudinal study on happiness, and its main takeaways all have to do with relationships. The qualities that showed up time and time again in the happiest lives? Spending time with others regularly; long-term relationships; investing in the future by having children or establishing strong mentor-like bonds with younger people; and having social support systems. (There’s that eudaimonic well-being again!) Maybe call a friend you’ve been meaning to catch up with and look into some volunteer opportunities, like spending time at a nursing home.
Listen to yourself This one may require some self-examination and soul searching to figure out. I regularly work with clients to help them find clarity in terms of what they actually want to do with their lives versus external pressures telling them what they “should” be doing. I also advocate for self-compassion. Many patients who come to see me are very hard on themselves.
A recent study published in the Journal of Experimental Psychology found that when we repress emotions we don’t perceive as correct—say, ambivalence over motherhood, or being angry when we think we should be happy—we end up less happy than if we would simply express our inconvenient emotions. Cultivating respect for your inner voice—whether it’s a fleeting weird emotion that you need to just sit with, or a change in career paths to something more meaningful to you—is a lot harder than going to bed earlier. But it may be the ultimate key to deep happiness.
Spend money on experiences not things Whenever you go shopping, whether it’s in person or simply hitting the “place your order” button on Amazon, it’s not uncommon to feel an instant thrill and get excited about your new purchase. It happens to all of us. Unfortunately, that happiness doesn’t last. Past research published in the Journal of Positive Psychology found the only way spending money is going to make you happy is if it’s on life-benefiting experiences—not more material objects that are only going to add clutter to your life.
When you save up for a trip rather than spending your entire paycheck on new workout clothes, you’ll be able to go on an adventure that will leave you with memories to last a lifetime. Ones that are so meaningful and profound you won’t even feel the need to share all of them on your Instagram Stories.
Unplug often Technology undoubtedly makes your life easier. You can buy your latte with a flash of your phone and tell Alexa to order your groceries. But with as many perks as it adds to your life, happiness isn’t always one of them. According to the World Happiness Report, activities related to smartphones and digital media, including the endless scrolling on your social media platforms, have been linked time and time again to decreased happiness. In fact, those who unplug often are typically happier overall. So, post your cute dog pics to Instagram, then take a break from the screen for the rest of the night and play with your pup without social media.
Grab a good book Speaking of unplugging, one of the best ways to do so is to grab a good book. In an online survey of 4,164 adults, researchers found regular readers not only had less feelings of stress and depression, but also felt happier about themselves and their lives overall. The best part is you only need 30 minutes a week to see improvements in your happiness levels, and there are so many options to choose from, whether you want to pick up one of the buzziest wellness reads of the year, hit up your local library, or download some free classics online.
Find the full article at Well+Good.
If you live in the Los Angeles/Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Growth Mindset
Our minds have such an ability to influence our lives. It's amazing how powerful our minds and our thoughts can be; how we look at the world shapes our own world.
"Growth mindset" (a term coined by Carol Dweck of Stanford University) is marked by a self-belief that your intelligence is malleable and never set in stone. As Ellen DeGeneres once said, "It's failure that gives you the proper perspective on success. When you take risks, you learn that there will be times when you succeed and there will be times when you fail. Both are equally important." Researchers have found that children who are encouraged to view failure as an opportunity for growth faired much better than children who had parents who reinforced the notion that failure is always 'bad.'
People with a growth mindset believe that intelligence is malleable, expandable, and never fixed. They also believe that you can learn and grow from mistakes or setbacks.
Failure and success are two sides of the same coin. Previous research has found that growth mindset also boosts resilience, positive emotions, and someone's ability to bounce back quickly from the agony of defeat. With practice, a growth mindset helps you let go of failure's disappointment and move on to new challenges.
On the flip side, those with a "fixed mindset"—who believe that their intelligence and abilities are less fluid—tend to beat themselves up and get stuck by dwelling on failures. A fixed mindset is also linked to a lack of self-compassion, in which failure can create a demotivating downward spiral of hopelessness and low self-esteem.
This is especially important for parents of younger children when teaching kids how to respond to setbacks in ways that are encouraging rather than discouraging. Nourishing a growth mindset can give youngsters a set of coping skills that could last a lifetime. I encourage teachers and parents to help children learn to pay more attention to their mistakes in a way that opens up growth mindset opportunities. Glossing over mistakes or shying away from a constructive dialogue about the importance of short-term failure as a pathway to long-term success can undermine someone's potential growth.
If you live in the Los Angeles/Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. Full article on Psychology Today.