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Halley Farwood August 2, 2020 2:00PM (UTC)

If you are anxious, stressed, or depressed about the coronavirus pandemic, you're in good company. Many of us could use some professional counseling right now, but social isolation practices have made therapists' offices inaccessible just about everywhere. The solution? Teletherapy.

 

Teletherapy (or "telemental health") is therapy conducted through video conferencing. Right now, it may be the safest way to receive counseling.  Typically, you won't need to purchase any special equipment or software; if your computer or phone has a front-facing camera and a microphone, you have everything you need.

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But talking to a therapist in front of a screen may seem weird, especially for those of us who are used to in-person healthcare. As a clinical psychologist, part of my work lately has been helping assuage concerns and answer questions about teletherapy, and letting people know what to expect. I've assembled a list of common questions I hear from patients about the process.

Is teletherapy as good as face-to-face therapy?

Overall, the science says yes. In several studies comparing teletherapy and face-to-face therapy, clients' symptoms improved equally with both types of treatment for a variety of problems. These may include depression, trauma, and panic attacks.

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Clients sometimes wonder whether they'll be able to bond with a new therapist through video chat. Fortunately, research indicates that ­the so-called working alliance – the strength of the emotional bond and working relationship between therapist and client – is equally strong in teletherapy and face-to-face therapy.

Will my insurance cover it?

Possibly. Some insurance companies covered teletherapy before the pandemic and others are adding coverage in response to it. To find out if you're covered, check your benefits booklet and look for a section labeled "telehealth." If you need help, call the customer service or member services number on the back of your health insurance card.

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How do I find a therapist if I do have insurance coverage?

I recommend Psychology Today, a search tool that can filter therapists by clinical specialty, therapy modality, insurance network participation, and availability for online sessions. This site will suggest therapists near your zip code, but for teletherapy, you will likely be able to see anyone licensed in your state. Feel free to expand your search beyond your zip code.

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Personal referrals to therapists can also come from friends, neighbors, colleagues, or your primary care doctor. Avoid seeing your best friend or family member's therapist, however. Therapists will typically decline to work with new clients who are close with their existing or recent clients.

You can also use the provider search tools on your health insurance company's website or call the company's member services number and ask for their assistance.

How do I find a therapist if I don't have insurance coverage?

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If you don't have health insurance, or if your plan does not cover teletherapy, you can pay out of pocket. If money is tight, you can often find private practitioners who offer lower prices based on client need; look for terms like "reduced fee," "sliding scale," or "scholarship sessions" on their websites.

Open Path Psychotherapy Collective lets you search online for therapists offering sessions between $30 and $60, after paying a one-time $60 membership fee. They ask that clients only use their service if they are either uninsured or unable to afford their in-network mental health benefits.

Some community resources also provide inexpensive or free counseling to those with financial limitations. To learn about options in your area, call 2-1-1 or visit 211.org. The National Alliance on Mental Illness also offers a huge list of resources for free and low-cost services, including online/teleconference support groups, crisis lines, and warmlines (for non-emergency support).

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What if I don't have a private space to talk?

For those who live with family members or roommates, social distancing has made privacy scarce. You can collaborate with others in your household, or get creative with your living space, to reserve a time and place for therapy. If you don't have a room to yourself, you can use a walk-in closet, a basement, or even a parked car. To create sound insulation in any space, do what therapists do: place a white noise source outside the door. You can use a fan or any device with a free white noise app. Person Centered Tech offers additional advice about preparing your space for teletherapy.

What are the downsides?

Technology glitches can interrupt sessions occasionally, especially if you don't have a strong internet connection. It can also be harder for therapists and clients to see each other's body language and facial expressions.

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Teletherapy isn't a good fit for every problem or every person. Clients who are uncomfortable and unfamiliar with video conferencing technology may find the experience less valuable. And many (though not all) therapists also advise against telehealth for more severe mental health conditions, like psychosis.

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Humans are social animals, so it's natural that social distancing will take a toll on us.

But remember that distancing need only be physical, not mental. Your support network, friends and therapists alike, are still there for you — in many cases, just a few clicks away.


Halley Farwood

Dr. Halley Farwood is a clinical psychologist in private practice in Portland, Oregon. She specializes in treating depression and anxiety. 

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New Zealand reports first virus cases in 102 days: "We had all hoped not to find ourselves in this position again"

New Zealand Prime Minister Jacinda Ardern said Tuesday that authorities have found four cases of the coronavirus in one Auckland household from an unknown source. They mark the first reported cases of local transmission in the country in 102 days.

Ardern said Auckland, the nation's largest city, will be moved to Alert Level 3 from midday Wednesday through midnight Friday, meaning that people will be asked to stay at home, while bars and many other businesses will be closed.

"These three days will give us time to assess the situation, gather information, make sure we have widespread contact tracing so we can find out more about how this case arose and make decisions about how to respond to it once we have further information," Ardern said at a hastily called news conference late Tuesday.

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"I know that this information will be very difficult to receive," Ardern said. "We had all hoped not to find ourselves in this position again. But we had also prepared for it. And as a team, we have also been here before."

She said that traveling into Auckland will be banned unless people live there and are traveling home.

She said the rest of the country will be raised to Level 2 through Friday, meaning that mass gatherings will be limited to 100 attendees and people would need to socially distance themselves from each other.

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Director-General of Health Ashley Bloomfield said the infections were confirmed after a person in their 50s went to their doctor on Monday with symptoms and was swabbed twice, testing positive both times. Six other people in the person's household were then tested, with three more positive results.

"Importantly, the person has no history of overseas travel," Bloomfield said, adding that the source of the infections remains unknown.

Before the new cases were reported, Bloomfield had warned the country to not become complacent amid the pandemic. 

 "We have seen overseas how quickly the virus can re-emerge and spread in places where it was previously under control, and we need to be prepared to quickly stamp out any future cases in New Zealand," Bloomfield said.

Until Tuesday, the only known cases of the virus in New Zealand were 22 travelers who had recently returned from abroad and were being held in quarantine at the border.

The country has been praised globally for its virus response.

New Zealand initially got rid of the virus by imposing a strict lockdown in late March when only about 100 people had tested positive for the disease. That stopped its spread.

The New Zealand border is closed to nearly all travelers, with some exceptions, according to the country's immigration site.

Life had returned to normal for many people in the South Pacific nation of 5 million, as they attended rugby games at packed stadiums and sat down in bars and restaurants without fear of getting infected. But some had warned that the country had become complacent.

New Zealanders have never routinely worn masks, but authorities have been urging people to buy them just in case.

The outbreak comes less than six weeks before New Zealanders are due to go to the polls in a general election.

Danielle Garrand contributed to this report.

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