Over the last decade, the political and economic pressures made on mental health services have continued. The demand placed on services is on the rise whilst the resources available to meet this demand have been further constrained. This has forced services to redesign and rationalise their service, where some have adopted digital tools such as online therapy. This option presents itself as a way of dealing with the lack of resources and the increase in demand. It seems only natural that a manager would turn to such opportunities. However, is it really just as natural for psychologists to do so?
As clinicians we are taught to first and foremost care for our patients. Medical staff, for example, undergoes the Hippocrates Oath as a ritual before starting to practice. In doing so they promise to abide by a set of principles such as ‘do no harm’ when treating their patients. In psychology we don’t have our own quirky tradition, but it doesn’t prevent psychologists from caring predominately about the quality of care they deliver to their patients. And this is when we need to ask the question whether it makes sense for psychologists to use online therapy as a digital tool to enhance they practice. Does it really work? How much evidence is there on this? Is it possible to achieve the same outcomes with less face-to-face time and reduced costs?
Does online therapy really work?
These questions have been central in the many studies carried out by various researchers and universities. For example, Fricke et al (2015) carried out a systematic review evaluating the existing evidence for the treatment of PTSD through online CBT. Their work provides reliable evidence that online therapy is an effective means of reducing the severity and frequency of PTSD symptoms.
Indeed, numerous studies have evaluated the evidence of online therapy for the treatment of mental health disorders. Overall, they have shown that online therapy is effective and maintains the same standards achieved through face-to-face treatment. See this video with Prof. Dr. Heleen Riper if you want to know more about evidence.
Online therapy isn't all about reducing costs
There are many different reasons as to why online therapy maintains the quality of treatment by providing the same outcomes:
- One argument is that patients receive a more intensive treatment. Indeed, as patients have to carry out sessions and exercises in between their face-to-face sessions, they are continuously activated. This means that patients are for example reminded by their app to practice that mindfulness exercise. The content of their online session is there 24/7, allowing them to revisit easily what they have learned. This means that working towards getting better is continuously on patients’ mind and not just one hour a week.
- Another argument concerns patients’ sense of empowerment. As patients have to work autonomously, they are made to draw from their internal motivation, their own resources. This allows them to feel empowered as they start to witness their progress. By working independently patients start to feel like they can do it and that they are responsible for the changes in their lives. This form of motivation contributes to longer lasting treatment effects.
Online therapy has been and is being used to reduce costs. But at the same time, this doesn’t mean that online therapy also reduces the quality of care. Overall, we can see that online therapy has been proven to work. If used correctly, online therapy will allow services to treat more patients whilst making more cost-effective gains.
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