HYDERABAD: The Covid - 19 pandemic has changed human interaction as we know it. As people adjust to a new way of life where another human being is seen as a potential threat to health, they are relying more and more on technology to run businesses, work from home, talk to family members etc.
On these lines, psychological counselling too is shifting online, with any piece of furniture in the house turning into the proverbial therapist’s couch.
As therapy seekers make a transition to online modes slowly, we ask psychologists about the advantages and challenges of moving away from one-on-one counselling. Baijesh Ramesh, a clinical psychologist at Chetana Hospital in Secunderabad, says: “One of the biggest advantages of online therapy is that people save a lot of commute time. Many individuals who used to come from other cities for therapy are now glad that they can get it from home.
Along with accessibility, convenience and affordability are added advantages. However, if a person is used to one-on-one interaction, she might find making a shift to the online medium a bit irksome, but it’s not a major one. However, if a person is in a serious mental health crisis such as an individual who is hallucinating, in a manic state, severe depression, etc, online intervention has its limitations.”
Another challenge is that many therapists in India are not trained to provide therapy and counseling services online.
Apart from the Rehabilitation Council for India for clinical psychologists, there are no councils or legal monitoring bodies to provide guidelines, monitor the training, qualifications, and quality of counselling and therapy services being provided. To protect data privacy and lay down parameters for health services, the USA has Health Insurance Portability and Accountability Act (HIPAA) and Europe has General Data Protection Regulation. These Acts define what platforms qualify to be used for online therapy and to avail insurance based on parameters such as confidentiality and privacy, access, informed consent, competence and scope of practice, and record keeping. But unfortunately, these criteria are not clearly defined for online therapy in India yet.
Because of these limitations, it will be difficult for patients to get mental health insurance, which again is in a nascent stage in our country. “Also, we have a large population who do not have access to the internet and are not comfortable with online counseling services. Tele-counseling works better in these cases,” adds Baijesh.Dr Jayanti Sundar Rajan, consultant psychologist at Roshni Counselling Centre, says: “We are using online media like Whatsapp call, Skype etc, but connectivity issues can create a hindrance in online therapy. We are also giving therapy homework in excel sheets or audio files, and hence are using technology to the most.
I am afraid that after getting comfortable online, no one will come for one-to-one sessions. However, nothing can beat the efficacy of physical interaction. Also, getting up and coming for a session give therapy seekers a sense of commitment. Providing counselling online has also increased our work load as we have to take care of scheduling appointments and other tasks.” Madhavi, who has depression, says: “Online counselling works better for me as I do not have to get dressed or face traffic on the roads. However, connectivity issues make it tough.”