Virtual Counseling Trends: When It Works, and When In-Person Prevails

Patient smiling and using a laptop

During the height of the COVID-19 pandemic, many therapists stopped seeing patients in their offices and virtual counseling or online therapy became more widely available. But telemedicine and its use by licensed therapists, mental health professionals, and licensed clinical social workers (LCSW) to deliver therapy and counseling has been in use for decades. 

Despite the fact that many specialists have returned to offering in-person services, more money is being invested in virtual counseling technology than ever before. Many patients enjoy the ease and flexibility of telemedicine, and they want you to offer them the same therapeutic experience they would have in person. These are important factors to consider if you are interested in scaling your practice by offering more telehealth and digital services.

Let’s start by defining key terms related to telehealth and examining the role of virtual counseling in addressing mental health disparities. Then we can explore the best way to provide virtual therapy services, and why in-person therapy or counseling services may be preferable in some circumstances. 

What Is Telehealth?

While the word "telehealth" has become more recognized over the last decade as an alternative or addition to in-person treatments, the definition is far from straightforward. When looking through peer-reviewed studies, books, and literature from leading organizations, it's common to come across dozens of terminologies defining identical telehealth procedures, as well as a variety of associated definitions differing in complexity and focus.

In the broadest sense, telehealth is described as the use of telecommunications and digital communication technologies to offer and facilitate health and health-related services such as medical treatment, provider and patient education, health information services, and self-care.

How Is Telehealth Used in Behavioral Health?

On the surface, the differences may appear as a matter of word choice or terminology. The American Counseling Association (ACA) considers telebehavioral health, or distance counseling, to be the use of digital platforms to provide secure and encrypted audio or video chat for the purposes of communicating with clients in real-time. They do not include asynchronous (not in real-time) texts, calls, chats, or emails to and from counselors and their clients.

The American Psychological Association (APA) states that telepsychotherapy is any situation in which counseling sessions are not held in person because of mobility issues, or remoteness whether out of preference or circumstance. The APA further differentiates services like psychotherapy which are delivered by telephone, audio- or videoconference whether in real-time or asynchronous can be known collectively as telepsychotherapy, e-therapy, or distance therapy.

Despite differences in terminology and definitions, several overlapping principles of telehealth emerge to guide understanding and practice. First, telehealth is an umbrella term encompassing numerous fields of health care services. Under this umbrella are specialty areas like telepsychology and specific psychological approaches like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

Secondly, there is a distinction between real-time or synchronous communication modes and asynchronous methods. Real-time modes include live, back-and-forth communication techniques that allow for a flow of dialogue between a specialist and a patient. This approach requires technology such as a phone, videoconferencing, or a live messaging app. Asynchronous modalities, often known as "store-and-forward," provide delayed communication. These modes store data and send it at a later time. Technology to deliver asynchronous telehealth can include messaging applications and email. 

The Role of Virtual Counseling in Addressing Mental Health Disparities

Virtual counseling: patient having a video call using a laptop

Mental health is one of the largest contributors to disability globally, persisting as a challenge for a large portion of the U.S. population. Common psychological diagnoses include anxiety, mood, obsessive-compulsive, substance use, personality, behavior, and neurodevelopmental and eating disorders. 

In terms of mental health, racial, ethnic, gender, and poly-social disparities are well known. Virtual counseling is emerging as a means of bridging access gaps to mental health services. Online counseling and therapy sessions enable someone who might not have been able to seek help otherwise to receive the professional services they need. 

While it was originally thought logistically unfeasible, tech innovation is resulting in cheaper, smaller, more powerful, and more easily accessible technology for everyday usage. One of the most significant technological advancements that contributed to the utility of online therapy was the widespread availability of the internet. In North America, the availability and usage of high-speed internet increased by 1355% between 2000 and 2020; there are more people who have an internet connection than those who don’t. Thus, access to options beyond the physical realm is growing more with passing every day.

Knowing When to Bring Patients In

In order to achieve positive clinical outcomes, the provider-patient relationship, also known as the therapeutic alliance, is essential. To provide the best online therapy, you must facilitate a clinical relationship in a virtual setting. In order to do so, you must remain hyper-aware of non-verbal cues that might be less obvious on video — much less over a phone call. 

As we've established, online therapy services provided by professional counselors can be an effective, beneficial, and cost-effective way to deliver care. However, one of the most important questions to continue asking is, "When is in-person therapy better?"

Face-to-face therapy is a well-established format for a conventional manner of treatment, and many clients have a general concept of what to expect during the process. While internet treatment is becoming more popular among providers and consumers, it is critical not to overlook the numerous advantages of in-person counseling. 

It can be challenging to disclose unpleasant life tales with a counselor in any setting. As a qualified professional therapist, you have received extensive training in developing therapeutic alliances with your clients. These collaborations contribute to a better patient experience, heightened satisfaction, deeper engagement, and favorable outcomes. If you are like most therapists, you were trained for mostly in-person client interactions rather than online interactions such as video sessions. As a result, you may find it more difficult to connect with your clients online than in person.

It may be helpful to bring new patients into the office for the initial sessions, testing, and onboarding. Additionally, it’s useful to offer the flexibility of either face-to-face sessions or virtual counseling. ContinuumCloud's EHR solution and patient engagement app both offer telehealth features to support virtual counseling as well as facilitate in-person appointments with technology such as patient scheduling, automated appointment reminders, and touchless check-in and payments. 

ContinuumCloud’s Online Therapy Platform, Mobile App, and In-Person Tools

With ContinuumCloud’s EHR, the CaredFor patient engagement app, and related tools, you can facilitate both traditional therapy and teletherapy options to suit your clients best. Here are some of the most beneficial features. 

ContinuumCloud’s Comprehensive EHR Solution

Behavioral health and human services organizations can benefit from our comprehensive, cloud-based electronic health record system. No matter what type of therapy you provide, ContinuumCloud’s EHR solution can help you streamline workflows, improve patient outreach, and increase revenue by enabling better clinical documentation for health plans and health insurance providers and government payers like Medicare and Medicaid. 

  • EHR with mobile application: Deliver care easily and securely. Clinicians can access intuitive documentation and scheduling with or without Wi-Fi access. Having a clinical-facing app helps therapy providers prepare for upcoming sessions whether in-person or online.
  • Patient portal: Allow patients to reach you at any time from anywhere for better communication and outcomes. Our patient portal gives patients a secure central hub to access and collaborate in their care, including virtual therapy. Patients can leave messages, so communication doesn’t rely solely on therapist availability. 
  • Innovative telehealth and engagement solutions: With HIPAA-compliant live video calls, video chat, text messaging, and other tools, you can increase client engagement with your care team and give clients the opportunity to cooperate on their mental health care and wellness.
  • Real-time surveys and engagement manager: Deliver HIPAA-compliant surveys with data collection and reporting capabilities including real-time post-visit surveys, self-assessments, and more. Just as virtual counseling extends the continuum of care, so too do surveys and questionnaires. 
  • Real-time decision support: One of the most impactful features of our comprehensive EHR system for online therapists is the ability to access clinical decision support. Understand your options when it comes to relapse prevention, and admission criteria. Know ahead of time what documentation you need for health insurance company approval.

ContinuumCloud’s Patient Engagement Enables Virtual Counseling

Through ContinuumCloud’s patient-facing mobile app, you can encourage long-term engagement with the people you serve. The CaredFor app assists patients, alumni, and families in connecting to services like virtual counseling and group counseling, in order to minimize attrition and enhance outcomes by providing a friendly and safe online platform.

Collaborate With ContinuumCloud to Deliver Phenomenal Virtual Counseling

Virtual counseling: patient using headphones and smiling at the camera

Telehealth isn’t new to behavioral health, but it is new to many of our clients. Since the beginning of the pandemic, when in-person therapy was not an option, virtual counseling and other types of online care have gained popularity. In the years following, it has helped bridge gaps in health care, including mental health services for patients affected by disparities.

In spite of the breakthroughs online counseling services have made, it's still important to know when it's time for in-person therapy. Providing technology that supports both face-to-face and remote therapy is where ContinuumCloud fits in. To learn more about our customizable, cloud-based behavioral health technology, connect with us today

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