The 6 benefits and limitations of remote video therapy
by Yuri Tomikawa
Remote video therapy sessions can be controversial - some question whether it's as effective as in-person therapy sessions.
The reality is that I’ve been doing remote video sessions with my therapist for two years, ever since I started Zencare. Having done both video and in-person sessions with my therapists and coaches, I put together the pros and cons of remote vs. in-person sessions.
Benefits of remote video therapy
1. You can see your therapist when you’re traveling.
For some clients, the ability to see therapists remotely can make or break the ability to continue therapy. When I was working as a consultant, I stayed at the client site Monday-Thursday working 8:30am-11pm, and worked in the office all day on Fridays. There was literally no time to go to therapy other than Friday evenings and the weekends, not only because of my long work hours, but also because I wasn’t even in my home city!
When I was on a multi-month project in Washington D.C., I met a therapist I liked, so I started seeing her, but when the project ended, we didn’t discuss the option of remote sessions. I now wish I did because it would have helped to have her in my corner as I navigated the next year of stressful consulting life.
When I first started Zencare, I spent half my time in New York with my boyfriend, and the other half in Providence to meet therapists and users. My therapist was in Manhattan, and I would go see her for in-person sessions, but also have remote sessions whenever I was out of town. Knowing I could see my therapist remotely during work travels gave me peace of mind, and allowed me to continue seeing a therapist I clicked with. (Note: therapists do have ethical limits around seeing patients remotely outside their state.)
2. You can schedule sessions more flexibly.
I’ve found that remote sessions offer more flexibility in terms of scheduling, both during and outside of traditional business hours. By eliminating the travel time to the therapist’s office, I’m able to take an hour break at 11am on a Tuesday, whereas I would feel uneasy physically leaving the office for two hours in the middle of the day (accounting for travel time and time to pull myself together and refocus on work afterwards).
I also find that therapists have greater flexibility when it comes to remote sessions: because the sessions can happen from the therapist’s home office, it’s been easier for them to fit me in during evenings and even on weekends.
3. Overall, it lowers the barriers to scheduling a session.
When I know that my therapist will be able to fit me in relatively last minute, I’m more likely to reach out about a semi-urgent issue that has come up, rather than waiting a few weeks for my next session. That’s a great feeling, and encourages me to at least ask.
Limitations of remote therapy
1. It doesn’t work as well for body-based therapy methods.
I see both a coach with whom I work on self-improvement, and an Internal Family Systems (IFS) therapist for deeper process work. With coaching and “maintenance” work, remote sessions have worked perfectly well. But when I had a scheduling conflict the other day and considered doing remote therapy with my IFS therapist, I realized I didn’t want to because it might not be the same experience as an in-person session. A significant part of my IFS session involves her watching my facial expressions change as I process past experiences, and I was concerned that wouldn’t work as well if our connection were spotty or our video were pixilated in any way.
Similarly, I know some therapists incorporate yoga postures and therapies that involve noticing physical changes like eye movement or breath patterns. For these therapies, in-person sessions may work best.
[Edit 2017/12/5: I've had a few remote sessions with my IFS therapist since I initially wrote this post, and they have worked out very well! Connection issues can still get in the way, but I've gained just as much from the sessions as being in person, and without the hassle of travel.]
2. It doesn’t have the same calming effect of physically stepping foot into a therapist’s safe space, and relies on the client to be responsible for their setting.
Whenever I entered my therapist’s beautiful, sunlit office with fresh air and a dash of aroma oil, I would instantly feel calm, relaxed, and at peace. My body knew, “I’m going to feel better here.” While it was a 45min subway commute to get to my therapist’s office, that feeling of physical comfort was well worth it. Following the session, I could take my time walking back to the subway to process what we covered, and I really enjoyed the peaceful moment that experience afforded.
That safe, special space is difficult to recreate when you’re on your own in your apartment, dorm, or office. While I always make sure to have my sessions in my quiet apartment when my boyfriend isn’t around for full privacy, and I leave enough buffer time before and after sessions to take a breath, it doesn’t feel as “special” as physically sitting in a therapist’s calming office. Many individuals simply don’t have the luxury of a fully private space either; their partner, roommate, or kids may always be home, and having a therapy session at work may not be an option.
3. It comes with the challenge of internet connection.
Finally, the biggest challenge with remote therapy is one that is least in your control: internet connection. I have high speed internet and sit right next to my router at home, but I still sometimes have to restart Skype or switch to Facebook Messenger or endure the session with a pixilated image of my therapist. Poor internet connection can be a source of great frustration and aren’t a great start to sessions, and it’s worse if your session gets cut off in the middle. While scheduling sessions so you can be in a space that 99% of the time offers great internet connection, it can simply be unpredictable and once you get cut off, there’s not much you can do about it.
There are clear benefits to remote therapy, and I’m excited to see more therapists offering this as an option! That said, if you can afford the luxury of time to go for an in-person session, know that it’s hard to beat the calming effect of physically sitting across from your therapist.
Yuri Tomikawa is the Founder & CEO of Zencare. She was selected MedTech Boston's 40 Under 40 Healthcare Innovators for her work in improving patient access to mental healthcare and has appeared as a keynote speaker on entrepreneurship, mental health, and female empowerment. She is a graduate of Brown University and former management consultant at McKinsey & Company.