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THE PROS AND CONS OF ONLINE THERAPY

October 13, 2017 | By Kaitlynn Pelio

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Is your company experiencing productivity losses because of employee mental health issues? The answer is probably “yes.”

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In a study analyzing the financial impact of 25 chronic physical and mental health problems, researchers polled over 34,000 employees at 10 companies, tabulating the amount the companies spent on medical and pharmacy costs for employees, along with employees' self-reported absenteeism and lost productivity.

When researchers ranked the most costly health conditions, depression ranked first, and anxiety ranked fifth. (Obesity, arthritis, and back/neck pain were the ones in the middle.) The researchers concluded that the indirect costs of mental health disorders—particularly lost productivity—exceed companies' spending on direct costs, such as health insurance contributions and pharmacy expenses.

Mental health disorders often go unrecognized and untreated—damaging an individual's health and career, while at the same time reducing work productivity and adding to absenteeism--time taken off because of mental health symptoms. Professional treatment can lessen these symptoms for the employee and improve job performance.

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Still, many Americans aren’t getting the help they need.

  • 26.2% of U.S. population (59 million people) suffer from a diagnosable mental health or addiction disorder.
  • Less than 1/3 of those get professional help.

Why aren’t the people who need therapy getting it?

  • Concerns about cost.
  • Feeling that their problems aren’t serious enough.
  • The stigma of admitting to a mental health problem.
  • Doubts as to whether therapy works.
  • Men are more likely than women to say they don’t trust therapists and that they don’t want to be associated with the “types of people” who need therapy.
  • 52:% of adult Americans believe mental health therapy is difficult to get.

This strongly suggests that companies should invest in the mental health of workers — not only for the sake of the employees but to improve their own bottom line. You already offer therapy as part of the mental health benefits in your company’s health insurance. So the question is...

IS ONLINE THERAPY A VIABLE WORKPLACE OPTION?

In theory, yes. Currently, nearly 20% of of therapists offer online, telephone, email, or video conferencing services. According to John Grohol, a psychologist who is an expert in online mental health and founder of Psychcentral.com, a resource for professionals and patients, online counseling holds tremendous promise, because it eliminates many of the issues that keep people from face-to-face treatment, such as disability, distance, or hectic schedules.

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A 2013 study published by the National Institutes of Health determined that online therapy  is effective for diagnosis and assessment across many populations (adult, child, geriatric, and ethnic) and for disorders in many settings (emergency, home health) and appears to be comparable to in-person care.

A similar study, published by The Lancet, showed that Cognitive Behavioral Therapy, in particular, seems to be effective when delivered online in real time by a therapist, with benefits maintained over 8 months. So online therapy could broaden access to CBT.

But there are barriers to be considered, and caution is essential.

1. Privacy and HIPPA compliance. For many workers, the issue of privacy may be one of the most difficult to overcome. An open-plan office is an unlikely setting for deep personal revelations, and companies may be reluctant to build out “quiet rooms” that ensure that conversations aren’t overheard. For text-based computer sessions, or video counseling, encryption may be required--for the therapist’s as well as the patient’s computers.

2. Insurance coverage. Video sessions have been reimbursed by Medicare and Medicaid for over a decade in most states. But many other plans typically don’t reimburse for phone sessions, and in some states, they may reimburse video only in limited conditions. They may only reimburse when the client is in an underserved area, or there is no available provider nearby. If online therapy is provided by the employer’s benefit plan, the usual steps need to be taken to ensure that the therapist is in-network (or that the patient understands the cost ramifications if out-of-network). Both therapist and patient can check out online healthcare laws and reimbursement policies here.

3. Licensing. Normally, psychologists are required by law to be licensed in the states in which they practice. So that means the therapist should be licensed in the state where the patient resides, or the therapist might be considered as practicing without a license, and the patient won’t have licensing board recourse if an issue occurs.

4. Credentials. What is the therapist’s expertise and education? Just as you’d want to know this for an in-person consult, you’ll want to see evidence of education and accreditation before making a financial (and emotional) commitment. Also, does the therapist have training in online therapy, as recommended by the American Psychological Association?

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5. Professional behavior. Unless a session takes place over video or another technology that allows people to see each other, a therapist might walk away from the desk, leaving it open for someone else, such as a secretary, to view. How will they respond to difficult emotions? What’s the backup plan if there’s a technological glitch?

6. Use of workplace computers or laptops. Even with encryption in place, experts recommend using personal, not workplace, computers, when discussing personal matters. And it’s never a good idea to use a shared computer for any personal data. Network reliability is also essential, given the delicate nature of many therapeutic exchanges.

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7. Body language and nonverbal cues. While video conferencing helps with this, text-based or voice-only sessions don’t offer the nonverbal signals that an in-person therapist relies on.

IS YOUR COMPANY READY?

You may already offer online therapy as part of your health benefits package. If you’re considering it, you’ll of course want to discuss all of the issues with your insurance providers as well as with your IT team. And it might be time for a survey of your employees, to see how ready they are for this service.

And in the meantime…

THERE’S AN APP FOR THAT.

T2 Mood Tracker---a mobile application that allows users to self-monitor, track and reference their emotional experiences.

PTSD Coach--Provides opportunities to find support, and tools that can help users manage the stresses of daily life with PTSD.

Stress and Anxiety Companion--tools for managing anxious feelings and identifying triggers.

Stress Check--research-based assessment provides users with an overall stress score that illuminates their current level of stress.

HelloMind---helps lead the user to assistance with many forms of mental health.

Want more info on how to keep your employees in the know about healthcare trends? Check out our blog, 5 Ways Educating Your Employees About Health Can Have A Big Pay-Off. And when it comes to on-site benefits, you can’t go wrong bringing 2020 On-site and our eye services to your company. See why we feel so confident saying this--watch us roll!


 

Sources:

https://www.health.harvard.edu/newsletter_article/mental-health-problems-in-the-workplace

https://health.usnews.com/health-news/family-health/articles/2009/09/22/7-things-to-know-before-logging-on-for-counseling

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61257-5/abstract

http://navigatingtheinsurancemaze.com/articles/telehealth/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662387/

http://www.bestcounselingdegrees.net/online/

http://www.psycom.net/depression.central.html

http://www.win.net/cyberpsych.com

http://au.professionals.reachout.com/Online-counselling-Pros-and-cons

http://www.modernmedicine.com/modern-medicine/news/modernmedicine/modern-medicine-news/online-behavioral-therapy-found-effective-d#sthash.vOB1r2Ip.dpuf

http://www.camft.org/ScriptContent/CAMFTarticles/Misc/TherapyInAmerica.htm

http://www.psychologytoday.com/blog/the-mindfulness-approach/201007/online-counseling-therapy-service-skype

http://vision.middlebury.edu/~tkuo/finalproject_AI.html

 

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