Does online therapy is a favored intervention for curing mental illnesses during the

pandemic?

Ni Putu Sitha Regina Pramesti

20/457796/PS/08180

Abundant factors have contributed to the increased mental health issues during

Covid-19. The combined presence of fear caused by the pandemic (e.g., worrying about a

family member with chronic disease) and financial hardships (e.g., fear of poverty) is

correlated with higher stress and anxiety (Salameh et al., 2020). Another finding by Gao et al.

(2020) showed that excessive exposure to social media (e.g., false information) also

positively correlates with anxiety and the combination of anxiety and depression (CDA).

These examples visualized the decreasing mental health and the urgency of attending

therapy. Specifically, the protocol of covid-19 suggested online therapy. Web-based

intervention usually consists of modules and exercises divided into the self-guided or

therapist-guided program, aiming to create positive change for people with mental health-

related assistance (Barak et al., 2009). However, the question is “does online therapy is the

best solution?” This essay believes that online therapy is a necessary and convenient

solution to mental health issues. However, another option, such as blended therapy, should

also be considered to a certain degree. This essay will elaborate on how knowledge and

experience of technology-aided treatment played a pivotal role that defined therapist

preference of online therapy and explain why coach-guided intervention programs are more

effective than self-guided programs.

Although licensed psychotherapists' have a neutral perception of the advantage

between web-based therapy and blended therapy, therapists who had already used

computer or media support in their practice are more likely to have positive attitudes about

e-therapy (Schuster et al., 2018). From this finding, the article assumes that therapists'

preferences in countries with less advanced online health services are less likely to use

internet-based intervention than blended therapy. When comparing disadvantages with

blended therapy (i.e., integration of face-to-face therapy and online therapy), therapists'

opinions were shifted. Despite online therapy benefits of having good accessibility,

flexibility, and cheaper cost, Schuster et al. (2018) mentioned that therapists were concerned

with the lack of nonverbal signals, missing important disease aspects and problems in the
therapeutic process, or dealing in crisis which is handled by blended intervention with less

challenge. This doubt about online therapy is caused because people were not familiar with

the empirical evidence of successful intervention online. One of the pieces of evidence shows

that meta-analysis of transdiagnostic and tailored internet-delivered cognitive behavior

therapy (ICBT) is effective for anxiety disorders and depression intervention (Păsărelu et al.,

2017). The writer believes that promoting positive attitudes about online therapy through

primary prevention, such as psychoeducation in health facilities and schools, will open

broader knowledge for psychologists' perspectives on online therapy and attract possible

clients in the future.

Nonetheless, blended therapy can be considered as a second option if clients do not

prefer online therapy. Because digital treatments were thought to be more suitable for those

with milder forms of depression, stakeholders recommended blended therapy: mild

depression (70%), moderate depression (57%), and 27% for severe depression. Meanwhile,

ICBT's recommendation rates are 47%, 16%, and 2%, respectively (Topooco et al., 2017). The

readers should bear in mind that the article was written before the pandemic. However,

some care systems are viewed as lacking in the preparation of internet-based interventions.

Thus, the writer believes that blended therapy should consider people with severe forms of

depression. Schuster et al. (2018) demonstrate that therapists also believe that higher

treatment intensification, quality, and suitability with a broader range of clients in blended

therapy are shown by a slightly higher mean than online therapy. As long as the therapist

and the client followed the protocol of covid-19, such as wearing masks, applied hand-

sanitizer, and socially distancing themselves, blended therapy would be beneficial for

decreasing risks such as suicides attempt that is more likely to happen for people with

severe depression.

Otherwise, if the client decided to use web-based therapy, coached-guided programs

are recommended online therapy that demonstrates similar outcomes to those found in

regular CBT; on the contrary, self-guided ICBT is concerned with clients' worsening signs of

deterioration. A contributing factor such as vulnerable people with low economic income

caused by the pandemic has limited access to available treatment services. In which self-

guided therapy is a more approachable intervention rather than human-guided therapy.

Self-guided online therapy usually has automated feedback support displayed by

automated emails or texts (Barak et al., 2009). However, Holst et al. (2017) show that

primary care patients value the need for face-to-face meetings with the therapist, which

guides the ICBT process through check-ups. The therapist's feedback can be done through

instant messaging sessions, telephone calls, webcam, or face-to-face meetings, which

provides individualized clinical treatment to clients that mimicked traditional therapy

(Barak et al., 2009). Because without meetings with therapists, clients are not pressured to

look at the therapist in the eye and easily lied. Holst et al. (2017) also mentioned the

importance of the client's perception that someone is attentively listening and encouraging

them. Self-guidance ICBT can give too much responsibility to the client, and they can crash

in solitude with the notice of the healthcare clinician. Thus, it is preferable to choose a

coached-guided program rather than self-guided therapy.

To sum up, increased mental health issues in the covid-19 pandemic are caused by

many factors: fear caused by the pandemic, financial poverty, and frequent exposure to

social media. These causes demonstrate that therapy, especially online therapy, is a solution

that desperately needed during the pandemic. However, some people will have negative

attitudes toward online therapy and vice versa based on their knowledge and experience of

technology-aided treatment. In which attitudes can be changed through psychoeducation.

Furthermore, clients with severe mental health problems (e.g., severe depression) can choose

blended therapy into consideration to prevent suicide risks. However, those with milder

mental health problems are recommended to use internet-based intervention, especially the

therapist-guided program, which is more effective than self-guided therapy.

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