Is online therapy the solution here?

April 22, 2020 1:32 PM

I am badly in need of a therapist for some issues with paranoia that possibly stem from PTSD. Given the paranoia coupled with the specific issues I would like to discuss, I do not feel comfortable speaking with someone who lives in my city or any of the surrounding cities.

Is there an online therapy service where I can speak to someone who lives across the country, or is a better option to just use Psychology Today to find a therapist in another state (or part of the state) who can do tele-therapy? I feel like they're gonna question why I didn't find a therapist who's closer and then once the shutdown is over, I don't know if they would provide tele-therapy anymore.

posted by massofintuition to Health & Fitness (10 answers total)

The answer is that, yes, therapy is the answer. Right now, that means that remote therapy is the answer. I think you'd have a hard time finding a therapist who isn't providing this service right now. And I think you can ask about your concerns about when quarantining ends. That's a totally appropriate question right now. To some degree this is, after all, a business relationship — you have the right to make sure that you won't be cut off.

My personal opinion? You're extremely unlikely to find someone who will stop supporting you purely because it's a remote relationship.

You should know that therapists deal with all sorts of people with all sorts of fears and paranoias. They may very well ask you why you chose to find someone who isn't in your area, and you'll need to tell them the truth. But, being therapists, they'll use that information to help you.

So don't overthink this too much. Just focus on getting the help you need. Good luck!
posted by summerteeth at 1:41 PM on April 22, 2020 [1 favorite]

It will be difficult to find someone in another state who can do tele-therapy, as therapists can only legally provide treatment to patients in states where they are licensed. The rules on this may have been relaxed during COVID, I'm not sure, but if so, my guess is that they'll be tightened back up after it's over, so it would be better to find someone for whom that's not an issue from the start. My profile has a collection of information about PTSD, including on finding treatment, that you might find helpful. Feel free to memail me if you need help troubleshooting.
posted by quiet coyote at 2:26 PM on April 22, 2020 [4 favorites]

Also- any PTSD therapist who's worth their salt will be more than used to paranoia and suspicion. It's part of the gig! That said, it would probably be helpful to your therapist to understand why you made that decision as part of understanding the issues you're dealing with, so if they ask you that, it's probably for that reason.
posted by quiet coyote at 2:29 PM on April 22, 2020

Yeah, the limiting factor is going to be licensure. But it is possible to find someone who’s licensed in multiple states. At one point my wife was licensed in both Ohio and New Hampshire. It’ll just be harder to find. Assuming you explain your issues with local therapists during the process, it wouldn’t be unusual.

There’s also 7 Cups of Tea, which is an app in which you talk to unlicensed volunteers rather than professional therapists. I’ve never tried it, but it seems to be well-regarded.
posted by kevinbelt at 2:47 PM on April 22, 2020 [1 favorite]

I don't know that you can specifically request a therapist from (or not from) a specific location on Talkspace or Betterhelp, but it's probably worth looking at the sign-up process for both to find out how likely it even is that your assigned therapist would be from your area. Their support desks can probably elaborate, as well.
posted by Lyn Never at 2:59 PM on April 22, 2020

Unless you live in a very small state (even if you live in the smallest state!) you should be able to find someone in another city using the Psychology Today listings. If you're in Providence, you should be able to find who's in (checks Google maps) Woonsocket, or vice versa. You can narrow it down for your insurance provider, or private pay.
posted by chesty_a_arthur at 2:59 PM on April 22, 2020

Yeah laws may require the therapist to be licensed in your state. I use Better Help. Both therapist I have seen on there were local to my state. My current one is more local to my area. I don’t mind. But they also literally don’t know where I live, my phone number, my full (or I guess real) name, unless I share it. (I have shared this info.) Better Help itself does know some but not the therapist. Check the privacy information as to what the therapist knows about you or contact someone at the service you are interested in. Here is Better Help’s info about staying anon.
posted by Crystalinne at 3:46 PM on April 22, 2020

Using Psychology Today to find someone in a different part of your state seems very reasonable.

I’ve been seeing my therapist in California for two years over FaceTime, and I’m really glad that we do video as well as voice. It makes a big difference to me.
posted by Tell Me No Lies at 4:41 PM on April 22, 2020

Oh, and don’t worry too much about being paranoid in arranging a therapist. My first therapist was a 45 minute drive from where I lived and for the first six months I paid in cash so there would be no paper trail. My mother was a therapist for 30 years and refers to that arrangement as “tame“.
posted by Tell Me No Lies at 4:47 PM on April 22, 2020 [1 favorite]

As a therapist in training--cross-state licensing regulations have been relaxed, but it varies state by state. Some states allow out-of-state clients to practice in their state because of COVID-19 and others do not. That said, I agree it should not be difficult to find someone in the state (or licensed in the state) but not directly near you, and will probably be more secure in the future in case regulations are tightened again.

I suspect most of the therapists doing telehealth now are going to be happy to continue to do it in the future if their clients want it. You can definitely bring it up in intake, ask if they're planning to continue offering telehealth. They are unlikely to ask why you aren't seeking therapy with someone nearby, and will probably assume either no one nearby has openings and is on your insurance, or that you're seeking their particular area of expertise.
posted by brook horse at 7:25 PM on April 22, 2020