The jury is still out, in my own little opinion, on the effectiveness of "teletherapy" vs. face-to-face therapy. Can someone get as much recovery out of a therapeutic relationship with someone over the phone or via computer as they can with someone right there in front of them? I just don't know. There's research saying it works, but I'm always reticent about things I don't know a whole lot about. Still,what I do know is that some people just don't have access topsychiatric care where they live, so if teletherapy can get them help they can't get otherwise, it's an interesting proposition.
I just happened upon a company called Breakthrough. I don't know them personally and haven't used their services, so I'm not endorsing them at all. But I think they offer an interesting service. (I would like to see moremedical professionalslisted on their team page. Seems overly weighted on the technical side.)
With Breakthrough, you can find a counselor and talk to them through phone, secure video, email or chat. If you'd like to learn more, here's their overview and here are answers to their most frequently asked questions.
As someone who has a LOT of trouble actually talking about what’s really going on in person, e-counselling has been great for me. I find it more effective than in person myself.
Hi Katherine,
Thanks for mentioning Breakthrough. I can understand your reticence around phone and online counseling. I think for patients with the time, money, ability, and will, in-person care is generally optimal. Of course as you say, the challenge is that many people don't have all of these. Telehealth is especially helpful in reducing the stigma around mental health.
If you are interested in more research on the effectiveness of online or phone counseling, a sample of independent studies is here:
http://www.breakthrough.com/effectiveness
I agree with you that we should mention more of the medical professionals that are working with us. We will be updating our team page soon to highlight them.
If you have any questions, feel free to email me at mark at breakthrough.com.
All the best,
Mark Goldenson
CEO, Breakthrough
Thanks for sharing a useful information. This form of e-counseling can help the people to clarify their doubts based on their problems. This will create better satisfaction of mind than reading any blog post or hearing from someone else.
Thanks for the mention.
That is great to hear!
I'm really glad actually that there are a variety of ways for people to reach out to help, since everyone is so different. What works for one person won't necessarily work for another.
Thanks for sharing that Mark. I do know that some studies have come out recently on online therapy/teletherapy. I've written about them here: .
And thanks for taking the advice on adding more about the medical side of your business. I think it will help people who are considering your service to see that there are psychiatric experts ensuring that it's done right.
Katherine,
I am glad you brought up the practice of electronic communication between therapists and clients,especially in the treatment of perinatal mood disorders. There are still some issues of concern and they include protection of confidentiality, skill of professional and range of knowledge on these mood disorders. I don't know that I like them in the absence of an initial face to face consultation and assessment, but I think different modalities of engagement has been a life saver, and life line, to those already involved in treatment. Five minutes on the phone can stave off an afternoon of panic. A brief conversation with an anxious spouse can get some one to the emergency room if they need.
I run a perinatal mood disorder program and initial phone calls for appointments are already the beginning of intervention, and that has been true in community mental health services for decades. We have referred families to higher levels of care (hospitalization) or closer resourcs, or contacted their current providers, and spoken to key family members, just from an initial phone contact and client consent.
So the question is really, how seriously do we perinatal mood disorders? It is our clinical thinking that should inform our practice, and in good practice, it always helps to have access to many modalities and interventions. Any modality, used poorly, will hurt our clients.
Sandra R. Wolkoff, LCSW
Director, Diane Goldberg Maternal Depresson Program
Ms. Wolkoff,
I completely agree with you in that moms should also aim to have a psychiatrist assess their mental state first and foremost.
However, many moms like myself, still struggle to find access to healthcare, not to mention that we have other financial responsibilities to our children. There are several options for moms that are having a hard time financially to be able to afford healthcare, such a sliding fees and afford able programs.
However, there are still many moms who cannot afford health insurance, like me, so I am stuck as a self-pay patient trying to figure out how to stretch my money, which is ironic because this is a source of stress that can make an overwhelmed mom feel worse.
The ideal thing is to find a psychiatrist and wait on their waiting list and pay the heavy fees, because who can put a price on mental health and doctors need to make a living too.
However, for those moms that are struggling to get to their appointments or have financial issues and for those professionals that want more flexibility, this option is heavenly. It allows moms to have an alternative until the opportunity to get assessed comes along.
I can say from personal experience that my therapist recommended that I am also assessed by a psychiatrist, as she can see my progress every week and I communicate with her frequently. Therefore, I believe this is a great alternative channel for moms who are struggling like I did.
Hope this helps slightly, I can by no means speak for all moms who have been through PPD, but I can honestly say that it is helping me on my road to recovery.
Sincerely,
Gioco
too fast thinking, too slow hands," how seriously do we take perinatal mood disorders?"
Hi Katherine,
I just wanted to add to your article my personal story.
I have been treated both in-person and in breakthrough.com, and I can compare the pros and cons of each.
I went face-to-face with an in-training counselor and I felt that it wasn’t effective for me. I was struggling with anxiety and stress, and making it to appointment was like climbing a mountain. First, you need to find someone that will take care of baby and have that added pressure of time. There is no flexibility and you still have to drive to the appointment. It’s not easy or private, and it is certainly not flexible. I had trouble keeping up because I didn’t want my baby far away from me for a second, which is one of the reasons I seeked therapy. My husband would drive me to therapy and take care of our baby in the lobby. Needless to say, it just added more stress.
All of this barriers are gone with breakthrough.com. I can easily re-schedule or cancel an appointment if something comes up. I am in constant dialogue with my therapist and I am making so much more progress.
I can easily send her a message in-between sessions, or even add some of the thoughts I keep on my journal about what is bothering me during the week. She evaluates my progress and suggests new mental exercises or techniques for the week, and I keep her updated to what work and what doesn’t.
Breakthrough takes insurance, if you have it. However, if you don’t have insurance and need to pay out-of-pocket like me, there are very affordable therapists that can help you get progress into becoming happier and have more peace of mind. There are not many psychiatrists, but it is more a therapy approach where you work out your deeper issues.
I have been lucky enough to find this since sometimes my husband and I took a break, which left me being a single mom. The website helped me because my baby napped during half of my session and I could have him nearby. It felt very private and it helps me open up much more than I would at regular therapy.
Instead of missing an appointment, I can show up in my pajamas if I am having a bad day and talk about it with my therapist. She sees improvement or regression.
I feel that for therapy to be effective, you need to commit to it and do it for long periods of time. The mind is resistant to change, so it takes time to get away from negative thought process.
The downside of video therapy is that the website sometimes freezes or there are communication difficulties, but this is solved by writing messages and my therapist was patient with this and we made up for time that we lost in case of technical trouble.
There is minimal set-up for video chat, and the upside is that if you have a vacation (like my therapist did) there is no need to interrupt your session because you can take your computer with you and dedicate one hour a week or more to improving your condition.
Hope this helps other moms that are on the fence. My advice is to give it a try and see if it works for you, and if it does you have gained a great ally on your PPD recovery:)
Sincerely,
Gioco