Telehealth Therapy

A New Age of Tools of the Trade

healing hearts and minds from a distance

Text by Emily K. Alberts

TThe covid-19 pandemic changed our daily habits tremendously, and some of those habits are sticking around long after lockdowns have lifted. One such transformation is the public’s utilization of telehealth. As medical providers scrambled to find ways to safely administer healthcare during the pandemic, telehealth utilization for office visits and outpatient care grew nearly a hundred times higher than it was previously. Consumer willingness to use this technology increased, and regulatory changes were made to enable greater access and reimbursement.

“Insurance companies relaxed the rules of what constitutes a session so we could provide telehealth therapy.

Regulations require that all sessions be conducted with a video,” explains Nathan Cooke, a licensed clinical social worker based in the New River Valley. Though the term “telehealth” encompasses all aspects of healthcare, the highest increase in usage was in the field of psychiatry (50% increase) as well as substance use treatment (30% increase). Cooke has been helping adults, children, families, couples and others with mental health difficulties for more than 20 years and was able to adjust his services to meet the new challenges presented by the covid-19 outbreak. “I converted my tool shed into a telehealth studio office. It is set up to provide services via a professional webcam, lights and microphone. It is 100% HIPAA compliant,” adds Cooke. Ah, the new age tools of the trade!

[HIPAA = Health Insurance Portability and Accountability Act of 1996] Cooke found his way into the field of therapy because he understands, and is sympathetic to, the human condition. “Listen, we all suffer. I just want to be a guide for folks on their journeys. Also, I gain insights into myself when I’m being their therapist. We all are part of a community.” And just like many of his patients have been navigating this new, often isolating landscape, Cooke understands that although telehealth can offer tremendous convenience, there are drawbacks. “By working from home, I am isolated. For my mental health, I run or work out between sessions. Also, I schedule paperwork time in local coffeeshops, so I am physically around others.” But the perks of having zero commute, getting more time with his kids, and being able to work while traveling offset the isolation. “Many of my current cases are new to therapy and were drawn to telehealth because they can do it from their homes, workplaces or anywhere with a stable connection.” Cooke has noticed that people seem more relaxed and “free to really be themselves” when they are in their own homes.

In addition to the videoconferencing, Cooke also provides support via voice or texting. “That is done on my own time because I prefer someone reach out for help via text than wait a whole week to see me again.” Cooke is primarily focused on providing cognitive behavioral therapy (CBT). CBT believes that if you treat negative thinking and negative patterns, you can change negative feelings and improve overall mood. CBT is very effective with depression, anxiety, anger management and impulsivity. “Also, I am a trained mindfulness professional. Most of my sessions are a combination of mindfulness (mediation, relaxation skills and sitting-with-it) and CBT.” His website, https://cooketherapy.org/ offers a glimpse into some of his therapeutic tools and includes several books that can help teach children perspective and empathy. “Telehealth can be particularly challenging for children under 8 years of age, as they find it difficult to maintain focus during a remote session.” And the circumstances can be compounded when coupled with challenges such as anxiety and ADHD. This is where his deep breathing exercises, muscle relaxation techniques and imaging practices can be a great help. Finding “a little spot of calm” during the recent hardships we have faced as a global community is growing ever more important. Although we can form “connections” using social media, the increased use of social media during the pandemic has actually been implicated in the increase of mental health conditions.

Nothing replaces the support of having a dedicated, caring human being to listen and guide you through hard times. No pretention, no judgement, no stuffy office -- and it can all be accomplished while wearing pajamas and eating a pint of ice cream!

Reducing both the stigma and the anxieties associated with seeking mental health treatment is critical in today’s post-

pandemic climate. Any possible way that we can increase access and decrease roadblocks to receiving care should be utilized. Mental health is a lifelong journey, where we are constantly adding tools to our self-care toolkits. We have the tool of technology, so why not use it?

Freelance writer Emily Kathleen Alberts embraces this new landscape of tele-psychology and is grateful that the Mental Health Hotline - 988 – launches nationwide on July 16.