What is the difference? – Forbes Health

Teletherapy and Telepsychiatry are telemental health services that use videophone (like Zoom), phone calls, or other messaging systems to facilitate communication between mental health professionals and their patients. Several studies suggest that partnering with a knowledgeable and trained mental health professional can almost provide an equally satisfying outcome for in-person visits.

However, it’s all up to you, says Diane R. Gehart, Ph.D., professor of counseling and family therapy at California State University, Northridge, and a practicing psychotherapist. “If a client wants to be truly honest with their therapist, then telehealth is safe and effective. Otherwise, it is better to do therapy in person, as it is easier for the therapist to pick up on non-verbal signals. For example, it may be a little easier on a computer screen for a patient to hide the fact that he has not bathed in days or that he has just drunk alcohol.

For patients who are honest brokers, however, telehealth comes in handy. Many people prefer telehealth because it removes barriers like long trips, parking, or even the need to leave the workplace for a midday appointment. More and more private practitioners are offering teletherapy and telepsychiatry services, and many companies are fully dedicated to making online mental health services more accessible and affordable.

But before you start looking, make sure you understand the differences between teletherapy and telepsychiatry – and what to expect from each service.

What is teletherapy?

The term “teletherapy” generally refers to talk therapy, also known as psychotherapy. It is a professional relationship between a therapist and a client. The therapist uses a range of evidence-based strategies to help the patient explore issues in their life and find healthy ways to deal with the issues.

There are many different styles of therapy, but the bottom line is that a relationship of trust with a trained professional can be effective. In fact, research in The American psychologist concluded that psychotherapy clients were better off than 75% of untreated people.

Teletherapy practitioners include:

  • Psychologists (Ph.D., Psy.D.)
  • Licensed Marriage and Family Therapists (LMFT)
  • Certified Clinical Social Workers (LCSW)
  • Certified Professional Advisors (LPC)
  • Certified Mental Health Counselor (LMHC)

Teletherapy provides a supportive environment in which you can speak candidly with someone who is professionally trained to listen, being objective, neutral, and non-judgmental. Teletherapists also distribute research-based techniques – from spreadsheets to required readings to journaling – to help you develop healthier life skills.

What is telepsychiatry?

Telepsychiatry involves a psychiatrist, who is a doctor. A telepsychiatry session focuses primarily on psychopharmaceuticals – prescription drugs for mental health issues. It does not usually involve talk therapy.

Telepsychiatry can be synchronous or asynchronous. Synchronous telepsychiatry involves meeting your psychiatrist via your phone, computer or laptop in real time. During this time, asynchronous telepsychiatry may cause you to speak to a qualified health care provider who is not the first psychiatrist. Then the psychiatrist reviews a recording of your conversation and prescribes or adjusts your medications as needed.

The United States is currently facing a fairly acute shortage of psychiatrists, according to research firm Merritt Hawkins. Asynchronous appointments allow a limited number of psychiatrists to accommodate more patients.

Similarities in teletherapy and telepsychiatry

Therapy and psychiatry once required in-person appointments, but they have adapted well to the world of telehealth. These are two forms of mental health services that are covered by most health insurance plans, and they can both treat common conditions like depression and anxiety.

More importantly, both teletherapy and telepsychiatry have similar endings: they are aimed at helping people achieve mental stability and lead productive lives. The strategies they employ, however, are very different.

Differences between teletherapy and telepsychiatry

Teletherapy is all about initiating a conversation with your therapist, naturally creating a professional therapist-patient therapeutic relationship over time. The sessions give you a safe space to talk about anything, even things that you don’t normally disclose to other people in your life.

Traditionally, a session lasts around 50 minutes, although many therapists also offer the option of texting or texting outside of standard sessions. Depending on your arrangement, messaging can be an important part of your treatment plan.

Telepsychiatry, on the other hand, is more like a visit to the doctor. On your first visit, you are asked a lot of questions about your medical history, including any symptoms you are experiencing and any medications you are taking or have taken in the past regarding your mental health. Follow-up visits usually focus on how well the prescribed medication is working and whether it is causing any unwanted side effects. It is not uncommon for telepsychiatry appointments to be much shorter than teletherapy appointments – and much less personal too.

Do I need both teletherapy and telepsychiatry services?

Some people just need to talk to teletherapy. Others need to talk about teletherapy and medication via telepsychiatry. And some may opt for medication exclusively, although many psychiatrists require their patients to undergo psychotherapy in addition to medication.

Keep in mind that not everyone who needs medication specifically needs telepsychiatry. Gehart says primary care physicians now prescribe much of the drugs used for anxiety and depression. But if you don’t respond to the medication, need multiple medications, or your doctor suspects you have an illness that would benefit from more expertise, telepsychiatry may be appropriate, she says.

How to determine the best care option for you

If you want to get drug-free treatment, teletherapy is likely to be your approach. You can search online for a therapist using tools such as American Psychological Association Psychologist Locator Service. Most therapists will clearly indicate on their website or through the APA locator if they are accepting new patients through telehealth. They will also note whether they accept health insurance and, if so, what the plans are.

You can also ask your health insurance provider for network referrals. Online therapy companies like BetterHelp and Talkspace also make it easy to sign up for therapy and select a therapist. Some are even covered by insurance.

the American Psychiatric Association has an online locator, too much. You can also ask your doctor to refer you to a psychiatrist. Some online therapy companies also offer telepsychiatry, such as Cerebral and Brightside.

If you are not sure which type of treatment is best for you, start with your primary care doctor. They should be able to help you determine your next steps.

Professional advice on choosing your supplier

Patients progress fastest with highly empathetic therapists and tailor their psychotherapy strategies to their specific patients, according to a 2018 study in Psychotherapy. Simply put, your therapist “understands you,” Gehart says. “The vehicle of psychotherapy works best with a strong connection, rapport, and feeling that the therapist understands your problem as you understand it.”

For many people, it makes sense to seek out someone who knows or shares your culture, lifestyle, neighborhood, job, family structure, race, or anything else that could impact your level of achievement. comfort. The most important thing is that you feel understood. All licensed therapists are trained to provide therapy, but some may also have additional training and experience in certain areas. If this is important to you, seek that expertise. Common areas of interest include anxiety, divorce, eating disorders, fertility issues, bereavement, the LGBTQIA + community, and substance abuse, to name a few.

You can often glean a lot of useful information from biotherapists posted online. And most offer a free brief introductory conversation or video chat where you can ask questions and gain a better understanding of who they are and how they operate.

Once you have started your sessions, you should know if you have the right therapist soon enough. “After four to five sessions, you should really feel like you’re making progress,” Gehart notes.

Since there are fewer psychiatrists, you may not have as many choices as with therapists. Yet, you need a supplier that you can be open and honest with. Some people might feel more comfortable with a referral from a trusted medical provider or an experienced friend. Psychiatrists should also offer a brief introductory phone conversation or at least have someone in their office available for you to ask questions. At this point, find out if you will be speaking directly with the doctor (synchronous) or with another clinician (asynchronous) during your appointments. You can also ask how easy it is to get in touch with the doctor, how long are the appointments, and anything else that concerns you.


Tutty, S, Spangler D et al. Evaluation of the effectiveness of cognitive-behavioral teletherapy in depressed adults. Behavior therapy. 2010; 41 (2): 229-236.

Turgoose D, Ashwick R et al. A Systematic Review of Lessons Learned from Providing Tele-Therapy to Veterans With Post-Traumatic Stress Disorder. Journal of Telemedicine and Telecare. 2017; 24 (9): 575-585.

Smith, M, Glass, GV. Meta-analysis of studies on the outcome of psychotherapy. American psychologist. 1977; 32 (9): 52–760.

Psychotherapy works. American Psychological Association. Accessed 05/25/2021.

Therapy. American Psychological Association. Accessed 05/25/2021.

Norcross JC, Lambert MJ. Psychotherapy relationships that work III. Psychotherapy. 2018; 55 (4): 303-315.

The Silent Shortage: Examining Trends in Supply, Demand and Recruitment in Psychiatry. Merritt Hawkins White Paper. Accessed 05/25/2021.

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