CBT SoCal has offered therapy online via secure video platforms for years prior to the outbreak of Coronavirus. However, the current pandemic has challenged many businesses and services, including our own, to move exclusively online – at least for the timebeing.
Some people feel that speaking with a therapist by phone or video is not as effective as meeting in an office, face to face. Anecdotally, it can certainly be more intimate to speak with someone live in the same room versus through a screen. However, research increasingly finds that therapy provided online can be just as effective, as per this study on telemedicine for veterans with Posttraumatic Stress Disorder, and this study which actually showed online therapy to be more effective for treating depression than face to face therapy.
When providing Exposure with Response Prevention (ERP) treatment for Obsessive Compulsive Disorder (OCD) and other types of Anxiety Disorders, there are actually a number of benefits to doing therapy remotely, including:
CONTINUITY OF CARE:
If time, distance, illness, or other circumstance (e.g. home quarantine to decrease spread of a global pandemic) prohibits you from getting to our office, you do not need to discontinue treatment. Engaging in CBT for Anxiety or OCD is a very engaged process and really benefits from continuous sessions while in the heart of the treatment process. Doing some sessions remotely from home can help maintain progress on a helpful path towards whole health.
It should be noted though, that under non-pandemic circumstances, we would typically encourage clients not to rely on online therapy if leaving their home or coming to the office for any reason is a main source of anxiety!
It can be really helpful for your therapist to see your home environment directly from his or her own perspective. When you describe cleaning, checking, or other compulsions you may be doing at home in therapy, we rely on our own imagination’s ability to recreate the environment you’re describing, which may be incomplete. By way of online therapy, therapists are able to view your day to day environment in more accurate detail.
For example, in one case, efforts to help an individual with cleaning compulsions seemed to stall for some unclear reason. It wasn’t until we did a video session from her home prompted by unexpected car repairs that I was able to see she had quite a severe hoarding problem. Due to embarrassment, this information had not yet been disclosed to me, and may not have been for much longer if I hadn’t observed it via video. Once we could start to address that, we were again able to make much more headway on the cleaning compulsions as well.
LIVE EXPOSURE EXERCISES:
When addressing issues like OCD and Anxiety in therapy we often have clients do exercises designed to safely confront feared situations (a.k.a “exposures“) live in the office. Examples of this might include intentionally writing out a number associated with bad luck, systematically getting closer to an actual needle, or simulating an attempt to harm the therapist.
While doing these exercises together in the office can be very effective, being able to do them live via video in your own home opens up a lot more options. If you are someone that washes their hands excessively, or someone who repeatedly checks the stove or other appliances to ensure they are off, we can have you work on challenging those habits live in your own home environment, and talk through the discomfort that arises while it’s happening. As always, these exercises can be challenging, which is why it is so valuable to have live coaching and the ability to process successes we make in the place we actually want them to stay maintained.
ENHANCED LEARNING AND CHANGE:
Our ultimate goal in therapy is for any change accomplished in the office to generalize to your actual life circumstances. As stated before, there are definitely unique advantages to meeting in person in our office. At the same time, by practicing exposure and response prevention exercises live together in your home environment, we may see some quicker benefits to your day to day life and habits at home.
If you are interested in online CBT to address OCD, Anxiety, Depression or any other related issues, please contact us.
Martin Hsia, Psy.D. is the Clinical Director of CBT SoCal, and specializes in helping people with OCD, Anxiety, and Insomnia in Glendale, CA.