Is consulting a shrink online as effective as face-to-face?
Even before the Covid-19 pandemic, online consultations were on the rise. Having become a must since the beginning of the health crisis, are video-conference psychotherapies as effective as face-to-face?
If the Covid-19 pandemic popularized them, online therapies abound on the Web, especially since 2017 and the emergence of online psychology platforms. Nevertheless, without the cocoon of the shrink’s office and sitting in his living room, are we as well taken care of as in person?
A relevant method to treat depression and anxiety disorders
Online therapies, as studies conducted over the past ten years have shown, work particularly well in the treatment of depression and anxiety disorders treated with CBT (behavioral and cognitive therapies). Other disorders, however, cannot be treated by videoconferencing. Psychoanalysis, for example, is much too codified (the therapist’s couch is an essential part of the therapy, payment is necessarily in cash…) to be experienced online. EMDR, which treats post-traumatic syndromes and relies on touch, cannot be done remotely either. Finally, this type of consultation is not recommended for patients with suicidal thoughts or delusions.
A good internet connection
This is the prerequisite for any online consultation. Speech and eye contact (non-verbal and paraverbal) are crucial in the therapeutic process. In order for the psychotherapy work and the exchanges between the therapist and the patient to be fluid, it is essential not to be cut off, nor to have the image blocked or to be disconnected from the consultation.
No compromise on the quality of care
The therapist, in video, uses exactly the same method as in person. The therapist wants to use the free association of ideas method? He will bounce around or leave « blanks » in the same way as if you were face to face. Does he want to help you « unlearn », through role-playing, the psychological mechanisms that systematically generate the same behaviors? He will give you the same exercises, with the same relevance, and may even use virtual reality.
Better results?
Online therapy can sometimes produce better results than in the office. This was shown in a study by Wagner & colleagues (2014): online therapy was more effective than face-to-face therapy in people with severe depression (53% improvement online vs. 50 in face-to-face). The screen and the distance can indeed provoke a disinhibiting effect1, which allows the patient to go further in this therapy by daring to address or deepen certain subjects that he would have kept silent face to face.
Although it has many advantages (end of medical deserts, remedy to confinement), online therapy is a matter of personalities. Some patients may not be happy with it.
Suler, J. The Online Disinhibition Effect. CyberPsychology & Behavior, 2004
http://drleannawolfe.com/Suler-TheOnlineDisinhibitionEffect-2004.pdf