Therapy starts in the morning, once a week for Sarah Cornwell’s 15-year-old son. He leaves his bedroom to open a Chromebook laptop in a nook in the corner of the kitchen and living room. Cornwell puts earbuds in to give her son some privacy as he starts his session.
Cornwell’s son is one of a growing number of Oregonians now regularly participating in therapy sessions held exclusively online.
The COVID-19 pandemic has spurred countless changes in how Americans communicate, from the workplace to personal get-togethers, and therapists have similarly embraced technology to stay connected to clients from afar. Telehealth has offered a unique and easy tool for patients to get an appointment that is flexible with their schedule.
Some patients are grateful they no longer must incur travel costs while others feel more comfortable discussing personal matters from inside their own homes. Some still prefer the value of talking in-person with their counselor, but experts say teletherapy has proven to give similar positive results in patient care and expect it is here to stay.
For Cornwell, teletherapy led her son to a happier and healthier life.
Cornwell’s son has impaired processing and impaired working memory, so it takes him longer to process information than others. He’s been in traditional in-person therapy since age 7, and he’s developed natural coping strategies to remember and to combat the stress he feels.
Online therapy has proven to be more accessible. Now there’s no more dreaded 35-minute commute to therapy from his home in Creswell, near Eugene. No time spent acclimating to the therapist’s office each visit. And his therapy dog, Dotty, an 18-month-old Great Pyrenees and Anatolian Shepherd mix, gets to curl up nearby while they enjoy the comforts of home.
“Despite the world being very stressful right now, he still has his dog with him, right next to him at the computer and he’s very comfortable,” Cornwell said.
There’s no definitive count of the number of Oregonians participating in teletherapy but the need is clear for easier access to care. People often seek therapy to overcome personal experiences or deal with loss. Counseling and other forms of therapy offer a greater self-awareness and coping mechanisms. Patients remain in therapy for a few short sessions to their entire life, depending on what they are hoping to achieve.
A national Centers for Disease Control and Prevention report surveyed adults in June 2020 and showed 31% of respondents reported symptoms of anxiety or depression and 26% reported stress-related symptoms in the past 30 days.
In Oregon, a 2019 report from Mental Health America showed the state had the highest prevalence of mental illness in adults nationwide, at 22%, or about 714,000 people. The report tallied a wide range of diagnosable mental, behavior or emotional disorders, including mild anxiety and depression up to severe mental illness, and excluded development and substance-use disorders.
Licensed psychologist Brad Larsen Sanchez said the pandemic has made his practice, Portland Mental Health and Wellness, shift how counselors work with their clients. When the pandemic began, the practice made the shift to 100% telehealth services.
“Demand skyrocketed throughout the pandemic,” Larsen Sanchez said.
Larsen Sanchez said many of the providers may have lost the in-person elements of therapy and counseling, such as watching body language or where a person might sit in the session, but the benefits outweighed the costs.
In Cornwell’s case, the lack of group sessions has been the only drawback she has noticed for her son. He has been working on remembering facial expressions, which are often easier to do with other people, so he can improve his ability to understand non-verbal communication.
“He can’t really practice that if it’s just one therapist there,” Cornwell said. “But that doesn’t detract from the positive outcomes that he’s had.”
Larsen Sanchez said he’s found that patients are more likely to be vulnerable during their sessions at home than in a traditional office setting. The idea of being inside a safe, familiar environment was a significant benefit for patients during the pandemic.
“Psychotherapy is so much more than just talking and listening,” Larsen Sanchez said. “By necessity, we attend to the experience of the whole person.”
He believes that virtual therapy will continue — even after the pandemic fades away.
In fact, most insurance companies have added telehealth to their policies. America’s Health Insurance Plans, a trade group, noted that many companies adapted to the pandemic, adding telehealth as a cost covered under their plans. Telehealth encompasses any visit with a licensed doctor, including therapists.
Oregon H.B. 2508 was signed into law on June 1, stating telemedicine would be reimbursed at the same rates as in-person visits.
Sydney Ey, professor of psychiatry at Oregon Health & Science University, said the pandemic brought heightened attention to mental health. This last year proved to be a very stressful one.
“The problem is COVID is so unique in that it’s not a one-time thing,” Ey said. “It’s been ongoing, and it’s not just COVID.”
Ey said the past year has brought large-scale issues to the table for many patients, including the loss of loved ones due to COVID-19, but also global issues like climate change or political instability worldwide.
“People take in multiple hits and one of the things about stress is that you can eventually break anybody if we pile enough stress on them,” Ey said.
And the research to keep it around, according to Ey, is there. People are doing just as well with telehealth appointments as they would with in-person appointments. The National Council for Mental Wellbeing reports youth patients showing more benefits, such as discussing more depth and emotion in their conversations.
Noting wellness apps like Calm and Headspace, Ey said that many of her patients have turned to the ease of getting help from technology, rather than having to go in-person to a licensed psychologist.
If a patient “lives in a rural community that doesn’t have as many therapists ... they now have access to mental health professionals across the state,” Ey said. “I think telehealth could end up being incredibly helpful and address a huge problem that exists worldwide — access to more mental health treatment.”
For Cornwell and her son, teletherapy will continue to become a part of their daily routine, and it won’t be going away anytime soon.
Her son looks forward to therapy now, and Cornwell has noticed less meltdowns and no stress hives from the effect of leaving for in-person therapy. He has more time to work on drawing, playing games and focusing on his schoolwork.
“Just having that consistency, and that routine and availability of a therapist to help him through things — the positives just really outweigh the negatives,” Cornwell said.
You can reach Alexandra Skores at [email protected]; 503-221-8073; @AlexandraSkores.
