Even on the cusp of the COVID-19 pandemic, I was skeptical. Telemedicine as a platform for mental healthcare just hadn't sold me.
In February, I told the Chronicle of Higher Education I wanted evidence that remote therapy would be useful in my work counseling college students. Effective counseling typically demands being face-to-face with a client, I argued, unconvinced that mental health counselors could build a powerful, productive bond without in-person sessions.
But it didn't take long for me to be transformed into a true believer. Not only has teletherapy proven its effectiveness since the coronavirus forced counselors and patients into the digital realm—a 10-year revolution compressed into a matter of weeks—it also deepened my clients' therapeutic experience in ways I never expected.
Now that colleges and universities face a fall semester conducted at arm's-length, students and their families can find reassurance in the surprising closeness we've discovered through virtual connections. While many universities will have students returning in the fall, it is clear that telecounseling is here to stay.
Adelphi University, where I help lead the campus Student Counseling Center, quickly pivoted from in-person counseling and was among the first schools in the country to shift mental health services fully online when the outbreak hit in March. Almost the entire student body left campus. Nearly overnight, some 95% of our clients were talking about the virus during remote sessions.
They remain worried about adjusting to this reality even as a new school year approaches: online classes, social distancing, depression, anxiety. Many feel more isolated. For many, COVID-19 significantly compounded difficulties they were already facing.
Offering a wide range of evolving therapy options is crucial to meet all these students where they are—and to foster resilience. Even before this season of anguish, it was clear that traditional counseling methods weren't always enough for today's troubled students.
The figures are devastating. Suicide is now the second-leading cause of death for teens. Across 163 colleges and universities, 36.7% of students seen in counseling centers during the 2018-19 academic year said they "seriously considered attempting suicide," according to the Center for Collegiate Mental Health.
Meanwhile, 33% of college freshmen in eight industrialized countries meet the full criteria for at least one mental health disorder, a 2018 World Health Organization study noted. In the past year alone, 3 out of 5 U.S. college students experienced overwhelming anxiety.
While individual circumstances vary, students—like all of us—have needed a sustained sense of community amid their stress and social isolation. They've needed bridges to one another, social solidarity with their university communities and professional support. They've needed a sense of belonging, engagement, hope and connection.
We help foster that interconnectedness through HIPAA-compliant teletherapy platforms, starting small with the therapist-client relationship. Together we have a new shared experience, seeing the clients' physical backgrounds at home and, in a way, joining them where their conflicts and resolutions take shape.
Their spaces become shared spaces where clients feel seen and understood.
For many students, we find the approach establishes more closeness with the therapist. In some cases, the electronic venue lets us get to know clients better.
Bonds like this nurture a feeling of social solidarity—of being emotionally tied to one another even as we honor distancing guidelines. Through teletherapy and other remote conversations, we have an antidote to isolation. That's crucial in limiting the anxiety disorders and depression that have begun to spike.
None of this is to suggest in-person therapy will vanish, but teletherapy will be our new normal, or at least part of it, for many months to come. Food service, events and communal living—all staples of campus life—are known spreaders of the coronavirus. University life brings people together in limited spaces, from dorms to lecture halls. That can be true in campus counseling offices, too.
Even if students can return to campuses by fall, it's a safe bet that much of campus life will continue to be socially distanced or remote at least through the end of the year. At Adelphi, we're mulling a hybrid model for our counseling services—a combination of on-site services and teletherapy to make sure we keep meeting students where they are.
As one client reminded me, the transformative experience of therapy is no less real just because it passes through a screen.