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Tessa Aten
Mrs. Crandall
AP English Language
29 March 2024
Telemental Health: A New Perspective on Therapy
Introduction
Although telemental health is not a new concept, it was brought to the forefront of the
therapy world during the COVID-19 pandemic, as increased feelings of anxiety and loneliness
plagued the world. People were trapped in their homes with little to no human interaction and
limited communication with even their closest friends and neighbors. However, one positive that
came out of the worldwide pandemic was the increase in the availability of telemental health
services. Telemental health is a way for mental health providers to offer counseling and therapy
services to people remotely, whether it be through an online video service or simply just through
a call. While in-person help is the age-old practice for people’s therapy needs, telemental health
is allowing therapy to reach new distances of helping those in need.
Some people believe telemental health is not nearly as effective as in-person therapy, and
that consequences may arise, mostly because people are not receiving in-person human
interaction. Many mental health professionals disagree on the consequences of virtual therapy as
opposed to in-person therapy, with some saying the virtual aspect takes away from the efficacy
of the therapy, no matter how experienced the therapist is. However, other professionals claim
the virtual nature of telemental health does not have many negative effects, instead it has positive
ones, such as giving people who live in remote areas access to effective digital therapy
(comparison).
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While yes, telemental health lacks an in-person component, is this all bad? (concession)
Some people, such as people with depression, may not want to leave their homes to make a drive
to the therapist's office, or even find it too challenging to get out of their beds to get ready.
Telemental health mitigates these challenges by allowing people to receive help from the comfort
of their homes. Patients and therapists alike are wondering if telemental health can change the
way therapy looks for some people. Therefore, I want to clarify the effectiveness of telemental
health, and determine if it is effective enough to use as an alternative to in-person therapy. If the
answer to this were discovered, therapy throughout the globe could be changed, with therapy
being able to reach far ends of the globe and many more people able to be helped. In order for
this change to occur, however, mental health professionals need to be convinced of its efficacy
and ability to help people in real time.
Literature Review
Recent Rise
Telemental health is a relatively recent phenomenon, stemming largely from the global
pandemic that affected lives throughout the world. Largely the main reason for telemental health
gaining increased popularity was the quarantine orders throughout the globe. Jessica Lawson, an
author for the Psychiatric Quarterly journal, explains how “providers responded [to the
COVID-19 pandemic] by rapidly shifting to remote delivery” of online mental health services
(Lawson 2). Furthermore, Courtney Evans, a counselor of education and supervision with a
Ph.D., writes about in-person therapy being “affected by the worldwide impacts” of the
pandemic and the restrictions that came with it (Evans 1). It is not widely disputed that due to the
isolation of the pandemic, telemental health and remote therapy “rapidly [grew]”, which led to
increased curiosity and questioning on the effectiveness of the new type of therapy (Lawson 2).
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In-Person Therapy
Before telemental health was ever introduced, in-person therapy stayed the norm for
thousands of years. Vanesha Mcgee, an author from the website psychology.org, describes
“traditional” therapy as “face-to face [...] interactions”, and describes a few pros as having
“nonverbal communication” and a “neutral location” (Mcgee). However, some believe that
telemental health could potentially compare to in-person therapy, such as Annaleis Giovanetti, a
Ph.D candidate at the University of Kansas, conducted a study finding that “video-based
psychotherapy is roughly comparable” with in-person therapy (Giovanetti 3). Mental health
professionals throughout the globe are disagreeing about the efficacy and comparability of
telemental health to in-person therapy.
Populations
One of the main benefits of telemental health is easy accessibility for certain populations,
such as certain age groups and people with certain disorders. Examining certain age groups,
Donald Hilty, a professor in the Department of Psychology and Behavioral Sciences at the
University of California, describes why tele-therapy could be “better” than in-person therapy,
because children and teens are already more accustomed to the digital world than older people
(Hilty 11). Next, Cory Chen, a professor of Psychology at Long Island University, with a Ph.D
from the University of North Carolina at Chapel Hill, suggests telemental health is an “effective
[...]treatment [...] for [...] depression [and] anxiety”, as outcomes of these telemental health
treatments are comparable to the outcomes of in-person treatments for the same disorders (Chen
1). Furthermore, Yudy Muñeton‐Castaño, an adjunct professor at William James College with a
Ph.D in clinical social work, expresses that for people with specific circumstances, such as
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parents with a housebound child, telemental health can result in “lowered anxiety, depression,
and fatigue scores” for exhausted, enervated (alliteration) parents whose children require
around-the-clock care (Muñeton‐Castaño 6). Conversely, Jill Åhs, an author published in
BioMed Central, a well-known peer-review medical journal, believes telemental health
“diminishe[s] [the] ability to observe emotions of patients”, therefore concluding that telemental
health does not provide the necessary tools of understanding the full picture of the
symptoms/emotions a patient may be exhibiting (Åhs 4).
Distance Implications
While there is no doubt telemental health can help therapists to reach farther distances,
some people conclude, while this is true, it may not be all that beneficial for therapy
(juxtaposition). Vanesha Mcgee, mentioned in the previous paragraph, establishes that in-person
therapy can give the client a “neutral location” where they can meet with their counselor
(Mcgee). Additionally, Mysore Narasimha Vranda, an employee of the National Institute of
Mental Health and Neuroscience in Bengaluru, India, when writing about victims of intimate
partner violence, communicates that telemental health patients could potentially have “limited
control over [their] environment”, which creates a potential obstacle to remote care (Vranda 2).
However, Marti Reimer-Reiss, an author from the Journal of Rehabilitation, a journal published
by the National Rehabilitation Association, concludes that clients and patients who live in remote
areas pose a “challenge” to providing in-person therapy, as counselors who wish to meet with
these people need to commit to “time-consuming travel” (Reimer-Reiss 1), which establishes
that telemental health can aid in this issue by reaching people over extensive distances. Each of
these authors present differing opinions on the concept of the effect that being in the same
location, versus not being in the same location, has on the quality of therapy services.
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Furthermore, in another article by Reimer Reiss, he further elaborates on issues regarding people
inhabiting places far from cities or towns, as their “locations [...] do not allow” for them to
receive in-person therapy (Reiss 1).
Technology and the Digital Divide
The world revolves around technology, leaving many feeling like there is not a single
thing left in their lives that remains undigitized (Hyperbole). However, some people are caught
in a “digital divide”, or an inability to obtain technology or understand it. Laura Orsolini, an
M.D. from the Marche Polytechnic Institute in Italy, conducted a post-hoc analysis (an analysis
occurring after datas has been collected) analyzing the role of digital mental health tools for
youth. She found that most of the individuals in the study stated “digital [...] interventions are
overall more effective” than in-person treatments, specifically for youth (Orsolini 10). The
participants found that the technology was an effective means of communication for their therapy
sessions. Later in the article, Orsolini continues to express the “low-cost” of digital mental health
interventions as well as the “easy-to-use” nature of the devices (Orsolini 11). Furthermore,
Mysore Narasimha Vranda, an employee of the National Institute of Mental Health and
Neuroscience in Bengaluru, India concludes: “the digital divide [...] is gradually declining”,
therefore more people can gain access to telemental health services smoothly (Vranda 4). On the
contrary, some believe the digital divide does have the ability to impede telemental health. John
Schieszer, a medical journalist and podcast speaker, believes telemental health can be
“challenging for many older adults and minority groups”, as online mental health services
require a certain amount of digital literacy that some people do not possess (Schieszer 1). He
establishes furthermore, some people who may be able to understand digital devices may not
even have access to a device of their own to conduct a telemental health session (Schieszer 1).
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Therefore, some professionals believe telemental health has the potential to be a saving grace
(metaphor), while others look upon the impending difficulties associated with it.
Argument
In-person therapy has long been the norm, with its offerings of face-to-face human
interaction and proximity. Many people believe the human interaction offered in a room in a
therapist’s office cannot be replaced with a virtual therapy session on a screen. However,
following the COVID-19 pandemic, telemental health arose as an effective alternative to in-person
therapy, offering a different perspective on the way therapy is conducted. Telemental health offers
a way for therapists to reach audiences who may not have the capacity to obtain in-person therapy,
and it also allows a more convenient and efficient way to ensure that mental health professionals
maximize their time. Therefore, telemental health is an effective alternative to in-person therapy in
numerous instances, such as depression, and its benefits can reach farther distances and
underserved populations, as well as enabling clinicians to provide a more targeted and effective
therapy.
The primary reason why telemental health took the spotlight during and post COVID-19 is
because it allowed people to continue to interact regardless of quarantine or isolation restrictions.
Through the use of technology, therapists and clients were able to stay increasingly connected
regardless of the distance between them. Furthermore, even before the COVID-19 pandemic,
people living in remote locations often had difficulties getting to therapy or getting on a consistent
therapy schedule. To this point, for some people, especially those with a history of depression, a
consistent therapy schedule is crucial to maintaining mental stability, which is possible through
telemental health regardless of location challenges. Marti Reimer Reiss, a journalist from the
Journal of Rehabilitation establishes that telemental health provides a way for people, especially
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people in “rural” areas to receive help, as it is often time-consuming for clients living in these
areas to consistently keep up with therapy (Reimer-Reiss 2). On another note, individuals who live
in remote locations may not be able to work into a fixed schedule for group therapy if needed,
such as sexual offender groups which are often divided into groups for different offenses. Amanda
Aten, a mental health clinician with a Master’s Degree in clinical psychology and social work,
who has practiced both in-person therapy and telemental health, states telemental health enables
people to be put in more effective groups based on their “characteristics”, which suit them and
provide them the best treatment (Aten). Without telemental health, it would be significantly more
difficult for specific people to all meet in the same place at the same time.
While telemental health provides ease of service to clients, it also allows for less time and
money spent by mental health professionals, leading to a more
convenient option for most clinicians. My mother is a mental health
clinician who owns her own business in Louisiana. However, when
we moved to Georgia, she was required to continue to travel back
and forth to Louisiana to continue her counseling groups, much to
the detriment of both of us. Not only was it inconvenient traveling
back and forth to Louisiana every month, she was also spending an
excessive amount of money on monthly travel costs. Consequently,
she made the switch to telemental health, enabling her to continue
owning her own business and running her therapy groups, but from
the comfort of her own home. She further states she can work with
her clients “wherever she is”, meaning she is no longer required to
travel to a specific meeting location, allowing her to work with
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clients in her home or even a hotel room (anecdote) (Aten). The overall convenience of telemental
health adds to the appeal of the service, however, further evidence of its efficacy should be
discussed.
Telemental health has been studied in recent years, with researchers finding that it benefits
people who may be incapable or unwilling to leave their homes, whether it be for mental reasons
or personal preferences. For example, people with depression may find it difficult to even make it
out the door for their therapy. Individuals who battle depression are among some of the people
who need therapy most, and it has been found that telemental health is a proven effective
alternative to in-person therapy for people struggling with it (Chen 1). Further, Amanda Aten
confirms people with social anxiety often “prefer” telemental health counseling, as they are not
required to be in a large group or even sit in the waiting room of a therapist’s office (Aten).
Others, however, may simply just prefer to stay in the privacy of their home rather than go to an
office, mainly for fear of the negative stigma of therapy. While the stigma should be squashed, it is
not disputed that a myriad of negative connotations could arise from going to therapy. Therefore,
people who are in need of effective therapy need not worry about a negative stigma following
them when they attend therapy from the comfort of their own homes.
On the contrary, telemental health is not without its flaws. While it does offer ease of
service for both clients and clinicians, technology is not always perfect (juxtaposition). Technical
difficulties are inevitable, as the world learned during the wake of the COVID-19 pandemic, when
nearly everything went completely virtual. The chance of technical problems poses issues when it
comes to telemental health, as problems with internet connection, user ignorance, and access to
technology are limiting factors in worldwide use of the service. As stated by John Schieszer, a
medical journalist and podcast speaker, many older adults can potentially have difficulties
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working with technology that is most likely foreign to them. Additionally, the digital divide is ever
present in the world around us, with those living in poverty or third world countries being virtually
unable to obtain or afford technology that would allow them to connect with a counselor for a
therapy session. However, considering the digital divide and limitations of technology on
telemental health, I do not believe that technical difficulties render telemental health ineffective in
any way. Rather, telemental health can thrive in areas where technology is common and accessible
as an effective alternative to in-person therapy, while in areas which may not have access to
technology, in-person therapy may still be the right decision.
Conclusion
It is not a debate that much of human interaction relies on face-to-face contact. But while
this reigns true, I have heard about countless times where people received life-giving help from
their therapist right through their screen. I have first hand experience hearing stories of how
people overcame mental illnesses and addictions through monthly zoom calls, leading me to trust
heavily in the efficacy of these measures (anecdote). While this is true, many should and still will
continue to see their therapist in person, as it works best for them (concession). However, human
preference is not a basis for the claim that telemental health is “not as effective” as in-person
therapy. Telemental health itself can give people with disorders such as social anxiety and
depression a new way to connect with a therapist to receive the help that they need to thrive.
Digital therapy is a bridge (analogy) between people who feel distant and isolated, to helpful
therapists, enabling them to feel connected and reachable. Telemental health itself is still
up-and-coming, and needs to be supported and trusted by the community, so that all people,
regardless of circumstances have the opportunity to receive help. The negative in-person therapy
stigma is a cruel one, and can sometimes leave people unwilling to go get help when they know
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they need it, so while we can’t eradicate the stigma completely, let’s give people a chance and an
option to feel comfortable in their therapy experience. Thankfully, there has been an increase in
awareness of the importance and significance of mental health for people as a whole, so let’s
continue to provide mental health services to people everywhere, and make therapy available to
all.
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Works Cited
Aten, Amanda Personal Interview 13 March 2024
Åhs, Jill W., et al. "Encountering Suffering in Digital Care: A Qualitative Study of Providers'
Experiences in Telemental Health Care." BMC Health Services Research, vol. 23, no. 1,
May 2023, pp. 1-8. Academic Search Complete,
https://doi.org/10.1186/s12913-023-09367-x.
Chen, Cory K., et al. "When Distance Brings Us Closer: Leveraging Tele-psychotherapy to Build
Deeper Connection." Counseling Psychology Quarterly, vol. 34, no. 3/4, Dec. 2021, pp.
1. Academic Search Complete, https://doi.org/10.1080/09515070.2020.1779031.
Accessed 2 Feb. 2024.
Evans, Courtney T. "Adlerian Play Therapy and Telemental Health Counseling during
COVID-19: Practical Considerations and Examples." Journal of Individual Psychology,
vol. 78, no. 2, summer 2022, pp. 1. Academic Search Complete,
https://doi.org/10.1353/jip.2022.0024.
Giovanetti, Annaleis K. "Teletherapy Versus In-Person Psychotherapy for Depression: A
Meta-Analysis of Randomized Controlled Trials." PubMed, 10 Jan. 2022,
pubmed.ncbi.nlm.nih.gov/35007437/. Accessed 8 Feb. 2024.
Hilty, Donald M. "The Effectiveness of Telemental Health: A 2013 Review." PubMed Central,
June 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3662387/. Accessed 7 Feb. 2024.
Lawson, Jessica L., et al. "The Good, the Bad, the Uncertain: Diverse Provider Experiences with
Telemental Health during COVID-19." Psychiatric Quarterly, vol. 93, no. 3, Sept. 2022,
pp. 2. Academic Search Complete, https://doi.org/10.1007/s11126-022-09990-7.
Accessed 2 Feb. 2024.
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Muñeton‐Castaño, Yudy F., et al. "Tele‐mental health intervention for caregivers of children on
home ventilation: A randomized control trial." Child: Care, Health & Development, vol.
48, no. 1, Jan. 2022, pp. 6. Academic Search Complete,
https://doi.org/10.1111/cch.12905. Accessed 6 Feb. 2024.
Orsolini, Laura, et al. "The Role of Digital Tools in Providing Youth Mental Health: Results from
an International Multi-center Study." International Review of Psychiatry, vol. 34, no. 7/8,
Nov. 2022, pp. 10-11. Academic Search Complete,
https://doi.org/10.1080/09540261.2022.2118521. Accessed 5 Feb. 2024.
Riemer-Reiss, Marti. "Vocational Rehabilitation Counseling at a Distance: Challenges, Strategies
and Ethics to Consider." Journal of Rehabilitation, vol. 66, no. 1, Jan. 2000, pp. 1.
Academic Search Complete,
widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=2&encode=0&proxy
=https%3A%2F%2Fproxy.openathens.net%2Flogin%3FentityID%3Dhttps%3A%2F%2F
idp.wa.galileo.usg.edu%2Fentity%26qurl%3D&find_1=search-ebscohost-com.us1.proxy.
openathens.net&replace_1=search.ebscohost.com&find_2=logon-ebsco-zone.us1.proxy.o
penathens.net&replace_2=logon.ebsco.zone&target=https%3a%2f%2fsearch.ebscohost.c
om%2flogin.aspx%3fdirect%3dtrue%26db%3da9h%26AN%3d2892777%26site%3deho
st-live%26scope%3dsite.
Riemer-Reiss, Marti L. "Utilizing Distance Technology for Mental Health Counseling. (cover
story)." Journal of Mental Health Counseling, vol. 22, no. 3, July 2000. EBSCOhost,
web-p-ebscohost-com.us1.proxy.openathens.net/ehost/detail/detail?vid=2&sid=c834ebdb
-e84e-44e5-93ee-30377b70a67f%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29w
ZT1zaXRl#db=a9h&AN=3535640. Accessed 25 Jan. 2024.
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Schieszer, John. "Digital Divide May Impede Telehealth." Renal & Urology News, vol. 21, no. 3,
summer 2022, p.1. Academic Search Complete,
widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=2&encode=0&proxy
=https%3A%2F%2Fproxy.openathens.net%2Flogin%3FentityID%3Dhttps%3A%2F%2F
idp.wa.galileo.usg.edu%2Fentity%26qurl%3D&find_1=search-ebscohost-com.us1.proxy.
openathens.net&replace_1=search.ebscohost.com&find_2=logon-ebsco-zone.us1.proxy.o
penathens.net&replace_2=logon.ebsco.zone&target=https%3a%2f%2fsearch.ebscohost.c
om%2flogin.aspx%3fdirect%3dtrue%26db%3da9h%26AN%3d160673993%26site%3de
host-live%26scope%3dsite.
Vigluicci, Vincent V. "Calculating Credibility: State V. Sharma and the Future of Polygraph
Admissibility in Ohio and beyond." Akron Law Review, vol. 42, no. 1, 1 Jan. 2009.
EBSCOhost,
web-p-ebscohost-com.us1.proxy.openathens.net/ehost/detail/detail?vid=9&sid=f25560e3-
acc2-436b-a5c5-d6ceb697d63f%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29w
ZT1zaXRl#AN=67613987&db=a9h. Accessed 25 Jan. 2024.
Virtual therapy vs. in-person therapy. (2022, August 16). Psychology.org | Psychology's
Comprehensive Online Resource.
https://www.psychology.org/resources/virtual-therapy-vs-in-person/
Vranda, Mysore Narasimha, and Vasanthra Radhakrishnan Cicil. "Tele-Consultation for the
Survivors of Intimate Partner Violence: Guidelines for Mental Health Professionals."
Indian Journal of Psychological Medicine, vol. 44, no. 4, July 2022, pp. 2-4. Academic
Search Complete, https://doi.org/10.1177/02537176221098772. Accessed 2 Feb. 2024.
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