Specialists ramping up online therapy
Professionals finding themselves deluged with clients’ troubles
Gregory Hyde’s client told him she consistently found herself in bed, watching the news and crying about the most traumatic crisis of our lives.
“I find myself talking to people about finding opportunities and possibilities among all this uncertainty,” said Hyde, a licensed clinical psychologist from Merrillville, who’s been in private practice for 15 years. “Some people have used the entire session to talk about the coronavirus and related situational stressors. This is understandable and important but it is a departure from the reasons they are coming to therapy.”
Mental health professionals are
finding themselves deluged with clients’ emotional troubles heightened or triggered by this COVID-19 pandemic and its psychological turmoil — anxiety, fear, confusion, lack of control, panic disorder and posttraumatic stress disorder.
The mental health workers are using online “teletherapy” to treat and counsel their troubled clients, many of whom are stuck at home and isolated from family, friends and coworkers. Or these clients are unable to attend public meetings for substance abuse problems, alcoholism, support groups and other face-to-face reassurances.
“I found a platform that is HIPPA-compliant and I completed a seminar on tele-health counseling,” said Susan Breymeyer, a licensed mental health counselor in Lake County. “I wanted to do this before making the decision to switch to tele-health for the duration of this pandemic. It was a good thing because soon thereafter the stay-athome order went into effect.”
Social distancing and self-quarantine mandates are forcing vulnerable populations of people to deal with their disorders or illnesses within their own home. Their internet access is now their conduit to connective wellness and virtual treatments.
“My practice is completely altered,” said Jim Lampe, a private practice psychotherapist licensed in both Indiana and Illinois. “Each week more clients have realized they need to have their sessions online as they feel the threat of leaving home, and the need for physical distance, while recognizing how essential psychotherapy is in their mental health.”
“Sessions often not only focus on the here and now anxieties based on the threat of the virus, but also the triggered emotional experiences related to past traumatic experiences in their life,” Lampe said. “An example is seen in patients who lived through the
AIDS epidemic. Memories, fears and associations to threat-to-life are triggered from the past and felt in relation to the current threat and necessary behaviors to feel safe.”
A majority of clients are noticeably more emotive or candid with their psychologist, though it isn’t yet clear if it’s due to the online tele-therapy (versus faceto-face appointments) or if it’s heightened anxiety about this public health emergency. Either way, anxiety is surging in our society, a national expert told me.
“Everybody’s anxiety and fear has increased, not only those people with preexisting mental health vulnerabilities. And I mean everyone,” said Dr. Ken Duckworth, chief medical officer of the National Alliance on Mental Illness, based in Virginia.
It’s as if a smoke detector is going off in our brains, detecting this existential inferno of self-preservation feelings.
“We are deeply, deeply wired to think this way,” Duckworth said.
To help counter this reaction within already vulnerable people, most mental health professionals are now conducting their work and treating clients virtually through online technology.
“The biggest change we are seeing in the industry is the liberalization of teletherapy and tele-psychiatry,” Duckworth said.
He characterized teletherapy as a side road that is now a major highway in the mental health industry.
“It’s the only highway we’re now allowed to use in many jurisdictions,” Duckworth said.
This road had existed for more than 10 years, but not many mental health workers had to venture down it. Today, every type of vehicle for treatment is ramping onto this highway and navigating through traffic.
“Just three weeks ago, everything changed on a dime,” he said.
I asked him how dramatically tele-therapy will alter the clinical dynamic of the industry, its current clients and expected waves of new clients.
“We don’t know yet,” Duckworth said.
At Hyde’s new teletherapy practice, an introductory pop-up box on his Doxy.me webpage informs clients: “Please check in below to let Dr. Hyde know you are here.”
“I had never done any type of tele-psychology before. I still don’t even know what to call it. Sometimes I say tele-health, or tele-psychology, or telemedicine or online therapy,” said Hyde, who stopped seeing clients in his office on March 16.
“It has been an adjustment for me as a therapist.
Talking to people online still seems strange. I am still trying to figure out when to look at the client on the screen and when to look directly at the camera,” he said.
Lampe, a psychodynamic-oriented psychotherapist, said tele-therapy technology is not perfect, with occasional online screen freezes. He likens this new interaction with clients to viewing a neighborhood via Google maps versus actually driving through the neighborhood.
“It hits the senses differently,” he said. “I am still assessing the efficacy of these online sessions.”
Breymeyer said the telehealth option has been going well for her, so far.
“Most of my clients have adapted quite well. They have been very appreciative to have this option available. Some have expressed feeling more comfortable as they are in their own environment. Though there have been some challenges, especially with individuals who are not as technically savvy.”
Hyde said finding privacy has been a problem for some clients.
“Some people live in small homes, which have become more crowded because people are staying home. A few people have sat in their cars for sessions,” he said. “One client who seemed especially guarded during a session expressed concern that someone might hear what he was saying.”
Duckworth said this ramped-up type of virtual treatment will transform the industry and how clients receive needed therapy throughout this pandemic and beyond.
“I believe these changes will outlast the virus,” he said.
An upcoming column will provide coping strategies, online resources, and more insights from Duckworth and these local mental health specialists.
jdavich@post-trib.com
“Everybody’s anxiety and fear has increased, not only those people with preexisting mental health vulnerabilities. And I mean everyone.”
— Dr. Ken Duckworth, chief medical officer of the National Alliance on Mental Illness, based in Virginia