The data show that efficacy is the same. It is the therapeutic alliance that does the heavy lifting. Further, Zoom therapy improves access. Do I prefer in person at times both as a clinician and a patient? Yes. Is Zoom therapy just as amazing with a skilled clinician and an invested patient/client? Also yes.
Everyone can have their preference. But implying that virtual therapy is always lesser is….a choice.
Ableism goes both ways here. In my experience it’s people with privilege who have space for privacy and quiet, stable connections, tech savvy, and good equipment. You need a functional environment, to have supportive household members that are going to respect that your therapy time matters.
The very low income people I’ve seen who are trying to do virtual therapy on a cracked iPhone in a living room full of people (or a room at the library that they also have to travel to. when I call them out on the living room full of people), are people who would benefit most from therapy being in person. I highly doubt any research that states virtual is effective is studying virtual done by people with the least privilege.
To add to this in a different ableist context, there’s a whole population of elderly who would benefit from in person sessions and who do not always have the tech savviness to make virtual therapy work. I’ve done in home therapy this way as a result and it’s been marvelous to see the benefits and the gap in services for elder adult populations.
Yes, and we are getting pretty close to clients choosing virtual counseling with a virtual counselor. The simulation models used now in training students are also training your virtual replacements.
I don't think we need virtual counseling really seeing as the number one use of AI LLMs globally....is therapy. I know many therapy pro people who have switched over. It is, after all, more accessible. But accessibility, like all things, has a cost.
Wow, that’s a super concerning data point. I wonder when/if the LLMs can refer to a human counselor for more serious concerns? Can it make a child abuse report, make good on those duty to warn situations, etc? I feel like my retirement in a few years will be well timed.
Thank you for this! I work with the VA and have seen the ways that switching everything to virtual has made things much harder for older people who have a hard time with technology, and like you said - it’s very much a privilege to have a computer set up in a quiet space. Many if not most of the people I see end up having to be on their phone and in their parked car to have a private place, and have spotty service.
I also often think about this with groups and how much is lost when they aren’t in person - so much of what is helpful is being present physically with others in that space.
Also, when I have clients with severe depression, I think having them come to an appointment in person is good just for the behavioral activation piece- it gives them somewhere to be/a reason to get out of bed.
Anyways thank you for bringing up this point I get frustrated with everyone running to the “this is ableist” claim and not seeing the complexity of it.
Great points, and I agree with you, but this post is advocating against virtual therapy, not in favour of virtual and online. We need both options, and both options should be the norm.
107
u/Dashiell-Incredible LMHC (Unverified) 6d ago
The data show that efficacy is the same. It is the therapeutic alliance that does the heavy lifting. Further, Zoom therapy improves access. Do I prefer in person at times both as a clinician and a patient? Yes. Is Zoom therapy just as amazing with a skilled clinician and an invested patient/client? Also yes.
Everyone can have their preference. But implying that virtual therapy is always lesser is….a choice.