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Friday, January 15, 2021

Telehealth counseling: A silver lining to COVID-19

Scrabble tiles spell out “mental health.” // Photo by Kevin 
Simmons, Mayberry Health and Home

By Sadie Fick

There’s been a lot of supposed upsides to this pandemic.

Can’t go out with friends? Now you have time to scrub the shower or, more realistically, watch “Tiger King.” (Downside: You now understand why the United Kingdom has a Minister of Loneliness.)

No in-person classes? Sleep as late as you want. (Downside: The lack of routine makes getting anything done a Herculean task.)

In the midst of these flimsy positives, one silver lining to hold onto has been the expansion of telemental counseling or telehealth, where patients connect with counselors through technology instead of in person.

“[The pandemic] has shown many clinicians that [telehealth] is very possible and can be quite effective,” clinical psychologist Aarti Khullar said. “Nothing in the world is ideal, but if it’s more care, and it’s working for people, then [it’s] great.”

Khullar is the co-founder of The Shrink Space, a blog on counseling topics and free resource for college students looking for therapists, including over 2,000 in Washington.

Third-year Western student Reed Starks transitioned from in-person to telemental counseling at the beginning of the pandemic.

“[Telehealth] is much more comfortable,” Starks said. “I’m just at home in my office chair.”  

With everything that happened this summer, Starks said he’s grateful his therapist offered telehealth.

“I feel like I’ve gotten more out of therapy via telehealth in the last six months than I did in the years before that,” Starks said via Reddit.

People may feel more comfortable in their own space, which can help them communicate more about intimate topics, Khullar said.

“There’s no doubt that it’s been very helpful to see someone in their own home environment,” Khullar said. “That’s more data for a clinician and it provides that in vivo experience in a way that you can’t replicate [in a clinic].”

However, not everyone’s living situation is good for sharing, especially with the stress the pandemic has put on relationships, Khullar said. 

Even if privacy isn’t a concern, being in the same physical space can make discussing things difficult

Starks said he had difficulties finding a private space while staying at a family friend’s house

“That worked out, but I can see especially for students who live with roommates or their parents or whatever, that can be really problematic,” Starks said.

Another downside to telemental counseling is that some nonverbal elements of communication are lost.

“There’s so much nonverbal language that happens from the waist down, or subtle movements that you might make with your hands, or facial gestures that you may not be able to pick up [virtually],” Khullar said.

Mentally filling in the blanks where nonverbal cues would normally be makes virtual communication tiring, Khullar said.

If a little more mental effort is a downside to telemental counseling, then better access is a definite upside.

Also, insurance has been covering telemental counseling during the pandemic and advocates are pushing for insurance to continue doing so afterward, said Khullar.

Using telehealth, people can also keep working with a therapist they have a relationship with, even after moving, as long as the therapist is licensed in the state where the patient is living.

While clinical telemental counseling is only available to students in Washington, Western’s Counseling Center helps out-of-state students find local resources, said Counseling Center Director Sarah Godoy. 

The Counseling Center also offers workshops open to students outside Washington.

“What’s exciting is because [telemental] is now more normalized, it gives the client and the therapist more ability to discuss what’s best for that relationship,” Khullar said.

Starks said he would continue using telehealth services even when face-to-face counseling is available again because it’s more convenient.

“Telehealth [at Western] isn’t going away, nor should it,” Godoy said in an email. “For those students who could experience improved access to care, telehealth is here to stay.”

The pandemic has had so many “positives” with dark undersides, but mental health reverses the pattern.

Don’t have to go to work? Now you’re stressed about money and hoping for any reason to escape the depression cave your dorm has become. (Upside: Telemental counseling is here to help. Now, and after the pandemic.)

“I think that one of the tremendous barriers to access for students, and for all folks, was getting to a therapist’s office, fitting it into a tight schedule that we kind of all live by,”  Khullar said.  “Telehealth has drastically improved that.”

Telehealth also increases access for people with mobility issues or limited access to transportation.

Before the pandemic, telemental counseling was most commonly used to provide services to patients in rural areas without a local mental health provider.

Now, nearly anyone can access counseling as long as they have access to the internet and can afford it.

Some therapists charge less for virtual services, further increasing access.

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