Teletherapy: Is it for you?

In a world where connections transcend physical boundaries, a new form of healing is reshaping the landscape of mental health therapy. Through virtual windows to the human mind, we witness the triumphs, challenges and poignant moments that unfold when healing transcends time and space.  

Step into a realm where healing knows no borders: the world of teletherapy. 

Tele-psychotherapy provides emotional help across distances using telecommunication. Such services may involve live or real-time interactions when the client and therapist are present online at the same time for a session.  

The service could also be asynchronous: the help seeker and the therapist do not interact at the same time or place, but over email or text, for example. 

Time is not a constraint 

Yudhajit Roychowdhury, a Kolkata-based therapist who also avails mental health services for himself, explains how people from small towns often have to take time off from work to travel to the city for a one-hour session. This is because their places lack mental health infrastructure and professional services.  

Teletherapy addresses this issue by reducing the need to travel and accessing therapists online from across the country. 

One can seek online therapy at a convenient time, says Purvi Balasaria, an online psychotherapist based in Kolkata. Therapists and clients can schedule sessions late in the night or early in the morning, and reach each other across geographical or time zones worldwide. Which means that people who have unconventional jobs, routines or constraints can use these services at a time of their choosing.    

For Pooja Saraf (name changed), who is studying MA in psychology, accessing online therapy has meant being consistent with therapy. She can meet her course deadlines without missing therapy sessions. “I can choose my preferred location, and it is time-effective.” There is also relief and comfort in online therapy, she says.  

A win-win cost option  

Roychowdhury counts some additional costs of a physical therapy session, for example, the amount of money spent on travel to and from the therapist’s office.  

Online therapy reduces travel cost for the seeker and office building rental for the therapist. Aayushi Palan, a Mumbai-based psychotherapist, says this makes it possible for the therapist to charge the client on a sliding scale basis.  

Additionally, teletherapy can be sought and given in different flexible modes, such as text, email, audio-visual (video call) and audio-only options. 

Serene Sarah George, a Bangaluru-based psychologist and co-founder of Reflective Conversations, says she has worked extensively through a text-based format. Considering that most therapy sessions are weekly, she says many clients cannot afford too many real-time sessions, which tend to be costly.  

George stresses the advantage of text-based therapy during transitional periods when clients need a secure environment. She explains that counselling by text or email may have its limitations, but it is an option for the seeker to reach the mental health practitioner between two `visual sessions’. 

Emphasising that even limited support is preferable to no support at all, George says text-based therapy may particularly benefit individuals who are comfortable expressing themselves through writing, as she found it in her own experience. 

Cultural familiarity counts 

Cultural sensitivity contributes to a therapeutic relationship, and teletherapy has allowed Indian practitioners to work with Indians abroad, says Aayushi Palan, the founder of ‘Uncircle It’. She has clients from seven countries, including Indians who are studying abroad.  

Adding to Palan’s point, Balasaria explains, “Teletherapy ensures that [the help seeker’s] cultural background and belief systems are understood, making the therapeutic process easy and accommodating for clients.”George says individuals requiring a wheelchair can use teletherapy from the comfort of their homes. Therapists working at unconventional hours also feel safe in their homes. For Balasaria, this has enabled receiving oversight and support from experienced therapists from other cities and countries and learning from experts.  

Limitations  

With all its advantages, teletherapy has its limitations. Offline or direct physical sessions provided him with a greater sense of presence and safety than online sessions, according to Roychowdhury, who has been undergoing therapy since 2017.  

George points out that teletherapy, especially in text and audio-based formats, lacks visual and non-verbal cues that are important in any therapeutic relationship.  

Roychowdhury believes that offline sessions are helpful to individuals who feel stuck and unsafe in their situations.  

Experts also note that some clients may find online work restrictive. Palan mentions the challenges of working with teenagers online: including tasks and props is difficult online, and rapport can be affected.  

Then there are basic issues such as finding a stable internet connection with a reliable power supply, particularly in rural areas.  

Balasaria says older adults need the help of their children or others to use their smartphones. 

Living in a shared space may affect privacy and confidentiality which are necessary in therapy. 

How to make the decision 

Therapists Roychowdhury, Balasaria, Palan and George pool in a few questions clients could ponder when deciding between teletherapy and in-person sessions: 

1. Can you set aside the time and finances needed for commuting to therapy, keeping in mind factors like traffic, travel time and transportation expenses? 
2. Which therapy session times are convenient, and which type of therapist (online or in-person) can accommodate your preferred schedule?
3. Do you have access to a secure and private space where you can engage in therapy without being overheard or distracted?
4. Will you be at ease experiencing emotional release, such as crying or shouting, in your immediate surroundings?

And finally…   

While teletherapy has revolutionised mental health support, it does have its limitations. In some instances, therapists may recommend in-person therapy, consultation, or assessment if they believe individuals would benefit from a physical presence.