Online mental health care: Six questions to think about when choosing a provider

The ongoing COVID-19 pandemic is taking a significant toll on the mental health and wellbeing of people of all ages, from older people self-isolating to young children who can’t spend time playing with friends because of social distancing. A study on JAMA Network Open found that symptoms of depression were three times more prevalent among the U.S. adults surveyed during the pandemic than before it. The increase in the number of people experiencing depression and anxiety extends beyond adults. Primary care physicians and therapists are reporting more children and teens with symptoms of these conditions as well.

One option that may help you manage the symptoms of depression and anxiety is online or virtual mental health care. This approach has several potential benefits. If you’re at greater risk of suffering complications from the virus and worried about in-person doctor’s visits, online therapy may be a good option. It can also be more convenient since you don’t have to travel to a provider’s office for appointments. And researchers have found that online cognitive behavioral therapy is as effective as in-person therapy for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.

There are a number of virtual mental health care options available, including apps that connect you with a therapist or help you build and practice coping skills and stress management techniques.

What questions should you ask?

Just as you would when choosing an in-person mental health provider, there are several questions you should ask yourself and potential providers before starting online therapy.

Ask yourself:

• What is my goal? Consider what you hope to achieve under the provider’s care. Do you want to learn skills to help you manage depression and anxiety symptoms? Do you need medication management? Are you hoping to discover an underlying cause for your depression and anxiety? Have you experienced trauma or loss and need help dealing with the experience?
• What are my preferences? Does the gender of provider matter? Would you prefer video or phone-only for your sessions? What approach to therapy are you seeking? Some common approaches to depression treatment include cognitive behavioral therapy (CBT), interpersonal therapy, and psychodynamic therapy. CBT is also used to treat anxiety and some providers suggest exposure therapy to desensitize the patient to the triggers of his or her anxiety.

Ask the provider:

• What are your credentials and experience? The titles “therapist” and “psychotherapist” are not legally protected terms in some states, so anyone can claim to be a therapist. Find out if the provider is licensed and whether the license is regulated by the state where he or she practices. The provider will need to be licensed to practice in your state as well. Ask about the provider’s training, what degrees she or he holds, and how long he or she has been practicing. If you’re seeking care for a specific issue such as trauma, obsessive compulsive disorder, or marriage or family problems, ask the therapist what experience he or she has with that issue. If you’re looking for therapy for your child or teen, ask the therapist what experience she or he has treating people in your child’s age group.
• Can you prescribe or manage medication? Only psychiatrists or psychiatric nurse practitioners can prescribe medication. If you’re working with any other type of therapist, find out how medication would be handled. Could your primary care physician prescribe and manage your medication or would you need to be treated by a psychiatrist?
• How is my privacy protected? Ask the provider if the technology used for your therapy sessions is HIPAA-compliant. If you’re using an app, carefully read the security and privacy policies and find out if the developer sells users’ information.
• Do you accept insurance? Find out if the provider accepts insurance, and, if so, whether he or she is in your insurer’s network. Is online or phone therapy covered by your insurance? Will the provider submit claims for you or will you need to pay out of pocket and be reimbursed by your insurer?