Survive, Transform, Soar! – Issue #4

Remote Therapy: Overcoming Roadblocks

Article by: Amanda Kippert in SurviveTransformSoar.com | Friday, March 31, 2017

Professional therapy can be an invaluable boost to the healing process after a toxic relationship, making it quicker and helping you get to the roots of why you stayed so long, which will help you avoid doing it again. Especially if you have PTSD (as about 50% of toxic relationship survivors do), the guideline is “the sooner, the better” because it will generally get worse over time if not treated.

Yet, there can be many roadblocks to therapy for abuse survivors. Cost is often a factor, especially right after leaving the relationship. It’s not always easy to find a therapist you feel comfortable with who is also nearby and has hours that fit your schedule. Former partners can become agoraphobic, making it too hard to take that step out the door. For anyone who has never done therapy before, it can be intimidating to begin a process you don’t understand with someone you haven’t met.

Remote Therapy

These are all hurdles that can be lowered, at least somewhat, by remote therapy. In today’s age of online-everything, something called telemedicine is starting to become more popular; at its core, it’s health care via your computer or smart phone. Several websites offer online therapy options with certified therapists who can help you begin processing the trauma you’ve endured.

There are a bevy of new online therapy options popping up all the time. Be careful; advocates caution that therapy from someone who isn’t experienced or knowledgeable in domestic abuse has the potential to do more harm than good. Survivors should make sure the therapist they choose has previous experience and expertise in treating survivors of abuse.

To help me understand the viability of remote therapy as an option, I tried two online therapy sites – Breakthrough.com and Talkspace.com – so I could give you an overview of what to expect.

Breakthrough.com

A Little Background: Launched in 2009 and acquired by MDLive in 2014, they have more than 1,000 therapists in their network with thousands of individuals logging on for therapy each year, says Amy Siders, vice president of behavioral health products at the company.

Many of their therapists specialize in treating trauma and abuse. Therapists also offer family therapy if there are children who need counseling. MDLive makes sure all therapists are fully credentialed before they’re allowed to join.

HIPPA confidentiality rules apply the same virtually as they do for in-person appointments. – “We have an extremely high bar when it comes to protecting health information,” says Siders – so survivors need not worry about personal information going further than the therapist (although therapists are mandated reporters and would need to report if they suspect child abuse is occurring).

Siders says not having to travel to attend therapy is one of the main draws for telemedicine of this sort. “Especially if you’re being tracked or watched, this makes it easier to get the help you need.”

How It Works: The concept is simple: Answer a few questions online about your needs, scroll through a catalog of therapists licensed in your state (therapists can only see patients in states they’re licensed in, though they may not actually be living in your state), choose one, message them and set up an appointment. Your therapy session is live, like FaceTime or Skype, and can be done via your computer or through their app.

Cost: You pay per session, and each therapist sets his or her own price, ranging from $50 to more than $200 per hour. You can choose self-pay or submit your insurance information for payment.

Unique Features: In 2017, Breakthrough.com will begin “e-prescribing” capabilities with psychiatrists, where patients can be prescribed prescription drugs, when needed, and get help with medication management.

My Experience: I created an account as a survivor would if she was wary of sharing her personal information; I used a made-up name, address and phone number. The process was easy and pretty quick.

Then, I chose “domestic violence” as the specialty of the therapist I wanted to talk to, and you can choose more than one specialty, such as anxiety, depression or PTSD. I was given 12 options of therapists with a photo and bio to accompany each. It felt a little like online dating.

I chose a woman with a friendly face and 20 years of experience who charged $70 an hour. I requested an appointment for the following afternoon.

Breakthrough then asks you to download VSee, a program much like Skype. I tested the system to make sure everything worked. Admittedly, I’m not what you’d call computer-savvy, but I was able to accomplish all the steps very quickly without any complications. I also downloaded Breakthrough’s app on my phone, from which I could easily message my therapist for an appointment time.

Note: I did need to give my real name and address when it came time to enter my billing information for my upcoming appointment.

The next day, my therapist and I connected through the VSee program on my computer. She was in her home office and I was on my couch. She instantly made me feel comfortable.

I won’t review how effective or not our session was, as it will obviously vary per therapist and patient, but I can say that I’ve seen a therapist in person before and this felt very much the same. Having that face-to-face connection was great and in an hour we were able to chat it up quite a bit.

She left it to me to schedule another appointment and never did I feel any pressure to do so. I chose not to since this was just for testing purposes and I wasn’t contacted by her or Breakthrough.com again with any pressure-y sales pitches.

Talkspace.com

A Little Background: Talkspace, an NYC startup that launched four years ago, has a goal to help make mental health support more accessible and affordable. Shannon McFarlin, LMFT, is the site’s director of clinical experience and a licensed marriage and family therapist. She says she sees many patients – both men and women – who are survivors of physical, verbal and/or emotional abuse.

McFarlin says the online aspect of Talkspace is good from a safety aspect. “Some of [her patients] live in rural communities and the therapists there might be someone they know,” she says. Techcrunch reported the company has secured an additional $15 million to roll out new features and services, including group therapy.

How It Works: This service matches you with a licensed therapist that you pay a monthly subscription rate to talk to. They also have more than 1,000 therapists in their network and report that some 300,000 individuals have used their service.

Most of the therapy is done through instant messaging via their website or through a smart phone app, an aspect McFarlin says is helpful for all clients who may be in a dangerous situation. “They can write every day. I worry when someone is in the position of being potentially harmed, so with this, I am able to monitor their situation more closely.”

Cost: Three different subscription options are available that range from $128 to $276 per month. Each offers unlimited messaging therapy, but the higher priced packages offer more video sessions each month. Talkspace does not accept insurance.

Unique Features: Talkspace markets several demographic-specific therapy options, like a business therapy plan “to create a happier, healthier and more productive workplace,” as well as therapy for veterans and the LGBT community.

My Experience: I signed up for an account under a pseudonym, though I did give my real information for billing. They also offer an anonymity option where one would only need to give their ZIP code. I filled out a short questionnaire that she messaged me and then she told me it would take several hours to a day to find a therapist for me.

Unlike Breakthrough.com, there was nothing additional to download on my computer and I ended up messaging with my therapist through the phone app anyway. It worked just like texting does, which was great for its ease of use, but once I got hooked up with my therapist, I felt somewhat disconnected receiving advice this way.

Our communication was sporadic and disjointed; I would message her in the morning and she would type back a sentence in the afternoon. While she seemed truly concerned with whatever issues I wanted to talk about, not having the instant back-and-forth routine traditional with talk therapy left me wondering what exactly I was supposed to tell her. I soon got busy with other things and forgot to keep texting her, and since she didn’t follow up, our short-lived relationship fizzled out.

The Bottom Line

Only you can decide what type of therapy – if any therapy at all – will be most beneficial during your healing process. Some people might like not having to make eye contact with their therapist or will find it more convenient (or safe) to text their therapist sporadically rather than sit down for an hour with them. Others may know they need that direct, face-to-face interaction in order to feel comfortable opening up. For some, the cost of therapy may not be a possibility at all right now.

If that’s the case, consider asking a domestic violence advocate in your area about support groups for survivors. You may find that just sharing your story with others who’ve experienced something similar is better than no therapy at all.