((PKG))  TELETHERAPY 
((Banner:  Teletherapy))  
((Reporter:  Zdenko Novacki))   
((Camera:  Dr. Marie Fang))  
((Map:  San Jose, California))    
((Main characters:  1 female))  
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
In light of everything that's happening with COVID-19, many 
therapists, who otherwise see their clients face-to-face, are 
now making the switch to exclusively teletherapy services.  
And this sudden switch has presented an array of unique 
challenges that might not otherwise apply to offering 
teletherapy. 
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
I'm Dr. Marie Fang.  I'm a psychologist working in private 
practice in San Jose, California.  And ever since I started my 
practice in 2012, I've been working with primarily face-to-face 
clients.  But as of March 14th of this year, I made the switch to 
exclusively teletherapy services.   
((NATS:  
Hi, Vanessa.  How are you doing today?))  
((Dr. Marie Fang, Psychologist)) 
There are many advantages to teletherapy and particularly 
lately, surrounding the social distancing precautions around 
COVID-19, teletherapy allows many people to access mental 
health care who otherwise wouldn't be able to access it or in 
order to access it, they might need to put themselves at risk.   
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
Teletherapy refers to all therapy services offered 
electronically, whether it be video, phone call, email or text.  
But colloquially, when therapists refer to teletherapy, most of 
the time they're referring to video therapy.  Teletherapy is 
subject to the same rules and regulations as in-person 
therapy with a few extras to address the need to maintain 
patient privacy.   
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
It does seem to be the case that the option of meeting a 
therapist through a screen caters well to some populations 
and not so well to other populations.  So, for myself, I work 
primarily with millennials who often work from home and are 
meeting via video for their work calls anyway.  So, the idea of 
meeting through video with their therapist doesn't feel very 
uncomfortable and many are excited to do so.  However, I've 
heard from other therapists who found that their clients don't 
even want to meet at all if it means that they have to put 
themselves on a video.   
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
There is research backing up the effectiveness of teletherapy 
showing that it's just as effective as in-person therapy when 
utilizing the same interventions. 
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
Within the current context of the COVID-19 restrictions, my 
practice has shrunk significantly and there are a number of 
factors contributing to this.  One big factor is my schedule has 
had to change.  Normally, I drop my daughter off at daycare 
in order to go see my clients and my daughter's daycare is 
currently closed.  So, I've needed to reduce my total hours 
available to see clients to about a third of what I typically offer 
to them.  So, I only have a few slots available on my 
schedule right now. 
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
I'm hearing from the majority of my colleagues that their 
income has dropped as a result of COVID-19 and switching 
to teletherapy.  For some, their income has dropped as much 
as 50 percent or more.  And there are some who aren’t taking 
a paycheck right now at all.  
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
We’re already seeing major impacts of COVID-19 on 
people’s mental health, especially for those under the 
mandate to shelter-in-place. They may feel literally trapped in 
whatever dysfunction might be going on in their 
household.  Generally speaking, my colleagues and I have 
so far seen an increase in anxiety in a major way.  If clients 
were already experiencing symptoms of anxiety, they've just 
kicked up into high gear.  And for those clients who, maybe, 
weren't otherwise experiencing anxiety, there is a greater 
sense of medical anxiety as well as grief over can canceled 
plans.  People have had to move their weddings and even 
funerals around because of the shelter-in-place 
mandate.  And for those clients who are prone to depression, 
isolation and loneliness have also contributed to increased 
symptoms of depression.  
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
In order for teletherapy to be successful, one of the biggest 
factors required is a great Wi-Fi signal.  Now most of the time 
when there is a spotty connection, if the therapist or client 
moves closer to the Wi-Fi signal, it's often resolved.  But 
given the nature of our current situation, it's not always an 
option to move closer to the Wi-Fi signal while maintaining a 
private confidential space for therapy.   
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
In my opinion, one major downside of teletherapy is it doesn't 
have that same kind of like special sauce that comes when 
you meet face-to-face.  It's kind of similar to if you have a 
loved one who lives far away and you're meeting via 
FaceTime or some other video means, it doesn't feel quite 
the same as when you're in-person.   
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
Because therapists have had to make this switch on such 
short notice, there are many factors that have created 
challenges for us, such as trying to get the necessary 
trainings in order to make sure we're on top of all of the 
ethical regulations to provide teletherapy and also figuring 
out technological issues just like everyone else in the world 
these days.  It's hard to figure out which platforms are HIPAA 
[medical privacy laws] secure and care for your clients’ 
privacy and trying to onboard your clients to those platforms 
at the same time.  I know therapists, who have tried one 
platform, had technological issues and then switched to two 
or three different platforms until they found one that really 
works for their practice.   
((NATS)) 
((Dr. Marie Fang, Psychologist)) 
One major issue that I've experienced meeting with my 
clients via teletherapy, particularly while the shelter-in-place 
mandate is in effect for some of us, is because there are so 
many people inside the household, it's really difficult to find a 
private space to meet with your therapist. 
((NATS))