While millions are impacted by mental health issues each year, figures continue to show that a large proportion of US adults don’t receive any treatment.[1] In 2018, fewer than 50% of adults underwent therapy or medical assistance for issues such as stress, anxiety, or depression.

These discouraging figures can be attributed to a range of factors – from fear of stigma and geographic distance, to lack of insurance, funding, or psychoeducation. Video therapy is one blended care approach that practitioners and mental healthcare providers are increasingly leveraging to help combat mental illness and enhance well-being.

Here, we’ll discuss what video therapy involves, it’s pros and cons, and we’ll consider how you can use it as a patient or practitioner to seek or deliver treatment and improve mental health.

What is Video Therapy?

Video therapy, also called video-based therapy, is an internet-based form of blended mental health care. Using video conferencing technology, practitioners deliver therapeutic treatments and psychological interventions in real-time to patients, allowing them to offer mental health care despite geographical distance.[2][3]

An adaptive approach to telemental health, video therapy can play an important role in psychiatric and psychological treatment for issues – including, but not limited to mood, personality, and substance abuse disorders[4][5][3]

An adaptive approach to telemental health, video therapy can play an important role in psychiatric and psychological treatments.

Is Video Therapy Effective?

On the whole, video therapy stands up well in tests of efficacy when compared to in-person treatments. For example:

  • A longitudinal study of almost 100,000 psychiatric, US veteran patients has shown that compared to in-person therapy, video therapy was linked to an overall lower need for hospitalization.[3]
  • Video conferencing, used as part of a larger teletherapy study, has also shown comparable patient adherence and satisfaction outcomes to face-to-face (F2F) therapy for depression.[6] Video therapy also resulted in similar improvements to depression symptoms as measured by the Beck Depression Inventory and Hamilton Depression Rating Scale.
  • Patients undergoing synchronous video therapy have also shown significant mental health improvements during virtual clinic trials, for a range of issues including anxiety, mood, cognitive, and substance abuse disorders after 3–6 months of follow-up.[7]
  • Encompassing a broad range of convenience and cost advantages over F2F mental health treatments, video therapy is also a highly practical way for practitioners to reach and help clients who may not otherwise seek help.
  • American Psychological Association reports also demonstrate higher levels of patient satisfaction and a reduced number of no-shows when patients used online video therapy versus in-person visit, suggesting video therapy may not only encourage engagement, but it may also hold significant practical benefits for treatment providers.[8]

A growing number of state and national authorities are also currently implementing or trialling video therapy clinics and services, further evidence of its growing acceptance as a viable blended health treatment for wider audiences.

Some good examples include the Finnish government’s Mental Health Hub and the UK National Health Service’s Back on Track initiative.[9][10][11]

Is it for Everyone?

Practitioners have been using video therapy platforms both as standalone ways to reach clients, and as one means to deliver treatment alongside F2F therapies. But is it suitable for everyone?

The short answer is no – it’s not a universally effective way to address mental health issues. Just as many individuals struggle with barriers like perceived stigma or cost when it comes to face-to-face therapy, video therapy may be inappropriate for certain groups.

Examples include[12]:

  • ‘High-risk’ patients, including those with serious psychiatric disorders, suicidal ideation thought disorders, or severe psychotic disorders.
  • Individuals who don’t feel comfortable using video technology or dealing with technical complications such as installing new software or fixing poor connections.
  • Anyone who doesn’t feel they will be able to establish a productive, trusting therapeutic relationship without private face-to-face contact. Therapeutic alliances and thus results depend heavily on a user’s confidence that they can communicate effectively – minus the usual non-verbal cues.

Related: What is Applied Behavior Analysis? 5 Apps To Try

Pros and Cons of Video-Based Therapy

Let’s summarize some of the benefits and drawbacks of video therapy that we’ve looked at, as well as a few more advantages and disadvantages for patients and practitioners.

For Patients

Pros

Cons

Physical accessibility – Video technology requires no travel and can be conveniently done at home. It’s easier for those in remote locations or with impaired mobility.[13]Privacy concerns – Video therapy is best conducted in a quiet, private space to avoid compromising the confidentiality of discussions. Not all clients may have access to such environments.
Psychological accessibility – As a potentially home-based alternative to F2F, patients can avoid perceived social stigma that they may associate with in-person therapy.[14] They may be more likely to seek out treatment than not, or even engage with it more.[15][8][16]Digital security – Video technology usage brings with it concerns about data storage, such as the security of conversations and session notes. HIPAA-compliant software can offer some peace of mind, however data breaches remain a legitimate drawback.[17]
Greater choice of treatments – Online, users have more flexibility when searching for specific treatments or specialists.[18] For example iCBT, Applied Behavior Analysis, Acceptance and Commitment Therapy, and other specific frameworks.Unsuitable for high-risk cases – As noted, severe psychiatric conditions often warrant close supervision and may involve additional medical support. Not all teleproviders can prescribe medication, nor can they act immediately in high-risk scenarios such as threats of suicidality.[13]
Lower financial costs – Reduced travel requirements, plus the ability to ‘shop around’ and compare providers can lower the financial investment of mental health treatments.[17]Requires digital competence – While younger generations may be confident using and trouble-shooting video conferencing technology, a certain level of skill is required for video therapy to work smoothly and effectively.[12]

For Practitioners

Many of the benefits and drawbacks that patients encounter apply to practitioners, but if you’re interested in trying out video therapy as a professional, consider the following additional pros and cons.

Pros

Cons

Greater client reach – Digital technology allows therapists and practitioners to reach a larger audience, both with outreach efforts and when delivering treatmentsMore competition – The near-ubiquity of video therapy providers means more price competition for practitioners; it may be difficult to charge the same rates per session as for in-person therapy.
Location independence – With video therapy platforms available on all kinds of mobile devices, therapists can practice anytime, anywhere there is reliable internet and a private physical setting.Therapeutic alliance – Some patients simply aren’t cut out for online therapy, and will have difficulty establishing close rapport or trust with practitioners in the absence of non-verbal communication, olfactory cues, and more.[19]
Fewer overheads – The previous point has an additional advantage; video therapy has less of the costs that are associated with a brick-and-mortar office. E.g. rent and utilities.
Flexible working hours – It’s possible for practitioners to conduct appointments in the evening or on the road, depending on their internet connection.

6 Video Therapy Platforms to Try

For those looking to find online video therapy options, there are a number of apps available.

Below, some of the most widely-used mental health software tools, which offer a whole host of versatile features for both users, and practitioners of all sizes.

Platform

Details

Babylon Health Video TherapyBritish telehealth provider Babylon also has a US service. Best known for its medical and general practitioner treatments, which work through video chat, it also offers consultations with behavioral health specialists.

NHS support is a possibility for some of Babylon’s services, and it is compatible with most fitness software and trackers.

Therapists and specialists are all fully-qualified practitioners.

NameBabylon Health
Price£49+ consultations, £149 annually
Good ForBehavioral Health and Medical Treatments
Websitehttps://www.babylonhealth.com/

Platform

Details

Doctor on Demand Video TherapyDoctor on Demand is a US-based platform that connects patients with licensed, board-certified medical professionals, psychologists, and psychiatrists.

Available across the nation, it offers 24/7 care and can be covered by insurance.

The web platform, available also as an iOS and Android mobile app, offers a free mental health assessment plus a range of psychological treatments such as talk therapy and medication management to support the mental well-being of users.

NameDoctor on Demand
Price$75 for 15 min medical consultations, $129 for 25 min psychological consultations, $299+ for initial 45 min psychiatric consultations
Good ForPsychiatric, Psychological, and Medical Treatments
Websitehttps://www.doctorondemand.com/

Platform

Details

Amwell Video TherapyHIPAA-compliant Amwell is an APA-approved telehealth service that provides psychotherapeutic, psychiatric, and medical treatments for both insured and uninsured patients.

Amwell practitioners are licensed, board-certified and trained to treat issues such as anxiety, trauma, addiction, stress, and more.

As well as being the largest US-based telehealth company, Amwell claims its medical practitioners boast an average of 15 years of professional experience.

NameAmwell
Price$85+ per visit
Good ForPsychiatric, Psychological, and Medical Treatments
Websitehttps://business.amwell.com/

Platform

Details

TalkSpace Video TherapyTalkspace users can request up to one video therapy session weekly with a trained and credentialed therapist.

Users can access and find a private practitioner from more than 3000 therapists; among them all 50 states are covered.

As a patient, you can expect to receive between 1-2 responses daily from your therapist. It’s possible to supplement your live calls with asynchronous video or audio messages between sessions.

NameTalkSpace
Price$29+ weekly
Good ForOne-on-one Psychological Counseling
Websitehttps://www.talkspace.com/

Platform

Details

ReGain Video TherapyRegain offers private, professional counseling with licensed mental health and psychological specialists.

Focused primarily on couple’s counseling, Regain provides options such as live video calls with both partners and dedicated state-credentialed therapists.

Users can opt to remain anonymous, using only a nickname for sessions, and are free to request an unlimited number of counseling sessions.

NameReGain
Price$40+ weekly
Good ForCouples Counseling
Websitehttps://www.regain.us/

Platform

Details

BetterHelp Video TherapyBetterHelp offers private, live video therapy sessions with professional trained counselors.

It’s not limited to video therapy, either – users are assigned a private chat room in which they can leave messages for their counselor 24/7.

Therapists are trained to help patients with issues such as family counseling, couple’s counseling, panic, OCD, PTSD, and more.

NameBetterHelp
Price$40+ weekly
Good ForPsychiatric and Psychological treatments
Websitehttps://www.betterhelp.com/

Practical Advice for Therapists

As a practitioner, you’ll want to consider a few things before you start searching. For example:

  • What are your larger goals? Would you like to grow your business by reaching new markets? Will you need a platform that is easily scalable? A provider that can help you with marketing? Many platforms incorporate both video therapy and more generalized functions to help you run your business; client management, scheduling, and billing functions are just a few examples.
  • What part will online video play in your overall service delivery? Will you be using videoconferencing as a supplement to in-person therapies, perhaps between sessions? Or will you be using it as the main point of contact with clients? If online calls will play a large part in your therapy, quality and reliability will be particularly important.
  • Is the software HIPAA-compliant, to ensure patient confidentiality and privacy? Is there a secure place for me to record notes?
  • Is it cost-effective, given the size of your practice? Some providers offer discounts for new practitioners, while others provide enterprise benefits for larger mental health practices.
  • Is it easy for my client to use? Patient engagement, commitment, and the quality of your working relationship can all be impacted by how smooth your interactions are online. If you’re battling continuously with unreliable connections, poor customer service, or if your clients find a platform hard to use, it may be worth expanding your search.

More general considerations include the computer literacy of your patients or clients. As we’ve mentioned above, not all users are able to use videoconferencing software or a dedicated video therapy platform with the same degree of ease.

Before you commit long-term to a specific provider, why not check whether the platform you’re interested in offers free trials? This could save you a lot of hassle down the line!

Final Thoughts

Video therapy is often a highly viable, even preferable alternative to in-person mental health treatments. Where clients can’t physically travel, afford, or seek out face-to-face treatment, it’s a promising and frequently very effective way to complement or replace real-life sessions.

Importantly, research suggests that users on the whole are relatively content with their experiences – both practitioners and clients often report similar satisfaction levels with video as they do with in-person therapy. As steadily more platforms and features become widely available, this is one approach that holds plenty of promise for blended care practitioners and patients.

Are you experienced with helping others via video? Have you tried out any of the platforms above, either as a patient or as a therapist? Or, have we missed any great video therapy applications that you’d like to share with your fellow professionals? Leave us a comment and join the conversation below!

References

  1. ^ NAMI. (2020). Mental Health By the Numbers. https://www.nami.org/learn-more/mental-health-by-the-numbers. Retrieved from https://www.nami.org/learn-more/mental-health-by-the-numbers
  2. ^ Day, S. X., & Schneider, P. L. (2002). Psychotherapy using distance technology: A comparison of face-to-face, video, and audio treatment. Journal of Counseling Psychology, 49(4), 499.
  3. ^ Godleski, L., Darkins, A., & Peters, J. (2012). Outcomes of 98,609 US Department of Veterans Affairs patients enrolled in telemental health services, 2006–2010. Psychiatric Services, 63(4), 383.
  4. ^ Carlbring, P., Ekselius, L., & Andersson, G. (2003). Treatment of panic disorder via the Internet: a randomized trial of CBT vs. applied relaxation. Journal of Behavior Therapy and Experimental Psychiatry, 34(2), 129.
  5. ^ Yellowlees, P. M., Odor, A., Parish, M. B., Iosif, A. M., Haught, K., & Hilty, D. (2010). A feasibility study of the use of asynchronous telepsychiatry for psychiatric consultations. Psychiatric Services, 61(8), 838.
  6. ^ Ruskin, P. E., Silver-Aylaian, M., Kling, M. A., Reed, S. A., Bradham, D. D., Hebel, J. R., & Hauser, P. (2004). Treatment outcomes in depression: comparison of remote treatment through telepsychiatry to in-person treatment. American Journal of Psychiatry, 161(8), 1471.
  7. ^ Neufeld, J. D., Yellowlees, P. M., Hilty, D. M., Cobb, H., & Bourgeois, J. A. (2007). The e-Mental Health Consultation Service: providing enhanced primary-care mental health services through telemedicine. Psychosomatics, 48(2), 135.
  8. ^ APA. (2011). Video Therapy in Action. Retrieved from https://www.apa.org/monitor/2011/06/video-therapy
  9. ^ Ohinmaa, A., Roine, R., Hailey, D., Kuusimäki, M. L., & Winblad, I. (2008). The use of videoconferencing for mental health services in Finland. Journal of Telemedicine and Telecare, 14(5), 266.
  10. ^ MentalHub.fi. (2020). Mental Health Hub. Retrieved from https://www.mielenterveystalo.fi/en/Pages/default.aspx
  11. ^ NHS. (2020). Back On Track. Retrieved from https://www.backontrack.nhs.uk/what-we-offer/online-therapy/
  12. ^ Suler, J.S. (2001). Assessing a person’s suitability for online therapy: The ISMHO Clinical Case Study Group. Cyberpsychology & Behavior, 4(6), 675.
  13. ^ Alvandi, M. (2017). Telemedicine and its role in revolutionizing healthcare delivery. The American Journal of Accountable Care, 5(1), e1.
  14. ^ Slavich, S. (2003). The status of online mental health services. Unpublished doctoral dissertation, Wichita State University. Wichita.
  15. ^ Al-Krenawi, A., Graham, J. R., & Fakher-Aldin, M. (2003). Telephone counseling: A comparison of Arab and Jewish Israeli usage. International Social Work, 46(4), 495.
  16. ^ Morneau Shepell. (2013). The effectiveness of video counselling for efap support: video counselling compares well to in-person counselling. Retrieved from: https://www.morneaushepell.com/sites/default/files/assets/pages/622-efap-tools-and-resources/effectiveness-video-counselling.pdf
  17. ^ Simpson, S. (2009). Psychotherapy via videoconferencing: A review. British Journal of Guidance & Counselling, 37(3), 271.
  18. ^ Alvandi, M. (2017). Telemedicine and its role in revolutionizing healthcare delivery. The American Journal of Accountable Care, 5(1), e1.
  19. ^ Manchanda, M. & McLaren, P. (1998). Cognitive behaviour therapy via interactive video. Journal of Telemedicine and Telecare, 4(1), 53.

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