I haven’t seen my therapist IRL for almost three years and I know I’m not the only one taking my sessions from the couch. A small silver lining to months of stay-at-home orders was moving traditionally in-person activities to online spaces. Book clubs, market weekends and courses all began inhabiting the digital world, and while some things just can’t be replicated on a screen, your therapy session is not one.
In fact, remote psychotherapy made getting help more convenient and more accessible at a time when Covid was causing increased emotional suffering and placing unprecedented demands on mental health services. While it might have felt weird to begin with, tele-therapy has so far outlasted the pandemic, with many people choosing to continue their digital sessions for myriad reasons, including accessibility, convenience, childcare and transport costs.
Even before the pandemic, one of the biggest problems people faced when trying to access mental health services was lengthy waiting lists. According to Dr Mike Millard, director of the Clinical Research Unit for Anxiety and Depression at St Vincent’s Hospital in Sydney, the average person suffers with mental health symptoms for eight years before seeking help. Worse still, when those people do seek help, says Dr Mike, only 50 per cent actually receive help.
“Within that 50 per cent, only one in three patients get therapy that is scientifically proven to work. So that’s a pretty sobering starting point for us,” he says. “But the biggest problem with psychological treatment is still that people can’t access it.”
Dr Mike and his team have partnered with the University of New South Wales (UNSW) to create This Way Up, a range of online treatment programs that attempt to make mental health help more accessible. The programs are based around Cognitive Behavioural Therapy (CBT) and are designed to be prescribed by GPs (or other health professionals) to their patients.
“Our programs are an illustrated story, evolving over six modules. It starts by introducing two characters who have symptoms of whatever you’re experiencing. So, if it’s anxiety and depression, they’ll have anxiety and depression. And then it follows what they do for their recovery,” says Dr Mike. As well as being accessible straight away, the online program introduces people who might not be familiar with therapy to the basics.
“The programs provide people with an understanding of what they’re experiencing, and the skills and techniques they can use to help,” says Dr Mike. “This Way Up is focused on the here and now, something you can do even if it’s while waiting to get into traditional services.”
Dr Mike says that, in terms of online CBT, Australia is leading the way. “CBT is a strongly evidence-based intervention and perhaps more evidence-based than a lot of other interventions we have,” he says. “Being online makes it an even more empowering tool.”
Dr Mike says that although some GPs are reluctant to try something new, it’s easy to add onto the traditional referral process.
“I tell them to do what they would normally do — refer someone to a psychologist,” he says. “And when they can’t get in, give them this program. It will help.”
Online therapy was a lifesaver for me both during the pandemic and after. Recently, I had a couple of rough weeks and struggled to get an appointment with my psychologist. I knew I needed help when I started sleeping in for a couple of extra hours and completely skipping my usual routine. I searched for “therapy” in the apps section and found Bloom. The app blurb sold me: Finding freedom through daily mental health challenges.
I chose a female therapist, Shernita, and for the next half an hour I did a CBT session with her pre-recorded videos, following her soothing voice through a series of exercises and typing my responses. I reached for the app that night when I started to overthink. The therapy became a soothing place for me and taught me how to challenge some of my difficult thought patterns. I still use the app today, even when I’m feeling good, to keep me in the right headspace.
Dr Lillian Nejad, clinical psychologist and author, has moved her clinical practice to almost exclusively online. Dr Lillian has developed online courses and resources for the well-known mindfulness app Insight Timer and is the founder of Skills for Life,
a website that provides online mental health content and courses to assist people with anxiety. In October last year, Dr Lillian launched Contain Your Brain, an app designed to combat worry.
“One issue that is a feature of many mental health problems is worry. So my co-founder and I created a simple app to help people manage their worries more effectively,” says Dr Lillian. Contain Your Brain uses the concept of ‘worry time,’ which is a strategy used by therapists to help their clients spend less time worrying. “The idea of ‘worry time’ is to help people contain their worry to a particular time and place, rather than spending their whole day worrying and, therefore, struggling to focus on more important things,” says Dr Lillian. “You pick a time of day, a place, and then you spend that time processing your worries in an effective and productive way. Research shows that this practice can help you to contain your worrying to 30 minutes or less, so you can spend more time living.”
Since moving her clients to remote therapy, Dr Lillian has been able to transform her practice. “Times have changed. As a mental health professional, I can assist so many more people than I did before. For instance, in live streaming,
I have had up to 500 people attending a one-hour webinar on a particular strategy or skill that I was presenting. It is also global — Australia, the US, the UK, France — all over the place,” she says. “I have also found that most of my clients prefer online therapy. Of course, some clients still prefer in-person sessions and there is value in seeing people face-to-face.”
For me, online therapy has made getting help so much easier. Right now, I’m about to click the link my therapist sent over email and have my session from home, in my pyjamas. No driving time, no parking, and I can work right up to the time I’m ready to log on (I might need to talk with her about work-life balance at some point).
Rebecca Whitehead is a freelance journalist and content writer living in Melbourne.
