Should You Resume In-Person Therapy?

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What’s your comfort level with Covid risk? If you, your therapist or a family member are at high risk of complications from contracting Covid-19, virtual is almost certainly your best bet, Dr. Bufka said.

“Obviously a big factor is whether you’re vaccinated or not, because if you’re not, the risk of going in person is greater for yourself and the therapist,” said David Mohr, a professor at Northwestern University’s Feinberg School of Medicine. You should also check if your therapist is vaccinated. Beyond that, Dr. Mohr said, it’s all about your comfort level. “If it’s extremely anxiety-producing to meet in person, it may not be productive.”

Is your provider taking precautions? The A.P.A. has recommended that providers take certain steps to reduce the spread of the coronavirus, including spacing out appointments, increasing ventilation, encouraging physical distancing and enforcing masking for everyone.

Don’t be afraid to ask your therapist about the measures they have in place, said Camilo Ortiz, a clinical psychologist and a professor at Long Island University Post in New York. “I would personally never be offended if someone asked me a whole lot of questions,” he added.

Who and what is being treated? Certain conditions may actually benefit from being treated remotely. Patients with autism, for example, may feel that virtual therapy gives them more control over their environment, Dr. Bufka said. Virtual sessions may also be better for exposure therapy, a psychological treatment that helps patients with conditions like obsessive-compulsive disorder or anxiety confront their fears. Instead of assigning exposure as homework, a therapist can observe it happening in real time. And teletherapy can be a good bridge to in-person sessions for people with severe anxiety or agoraphobia, or who are prone to panic attacks.

On the other hand, people with symptoms like paranoia may do better with in-person therapy because it allows for more nonverbal communication, which can help them manage any suspicion they might feel toward their therapist. Hoarders who are ashamed of their home may also feel uncomfortable doing video therapy. And when it comes to treating kids, face-to-face is usually better too, Dr. Ortiz said. In his experience, children tend to look at some other part of the screen or slowly tilt their camera up until it’s facing the ceiling when he’s meeting with them virtually. “I see a lot of kids with attentional problems, and this is the worst possible way to do therapy,” he said.

Do you have privacy? If you don’t live alone, can you close yourself in a bedroom or bathroom? Can you drown out your conversation with white noise?

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