Auburn Marriage and Family Therapy program offers teletherapy services

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In order to serve the health and relational needs of the public while following guidelines to slow the spread of COVID-19, the Auburn University Marriage and Family Therapy program has introduced Technology Assisted Family Therapy Services, or TAFTS. These therapy services, conducted online, are designed to improve the mental health and well-being of clients from a safe physical distance. Center Director and Associate Professor Scott Ketring and Assistant Professor Lauren Ruhlmann in the College of Human Sciences’ Department of Human Development and Family Studies share everything you need to know about TAFTS and telehealth.

Explain what teletherapy is for individuals, couples and families during this period of physical distancing.

Teletherapy is providing therapy through a live video connection through the internet. The therapist offers the same treatment that is done with the person physically in the room, but the meeting is virtual and everyone is seen. Individuals, couples and families can receive services, and participants can be in the same room or different locations as long as everyone is in the state of Alabama. Therefore, if a partner is in Montgomery, and the other is in Huntsville, they can log in for couples’ therapy. In family therapy, the parent is required to be present throughout the session if the child is younger than 13. If parents seek therapy for their children between the ages of 13 and 18, the parent needs to be present at the beginning and end of the session.

For clients, what do they need to do to prepare (both emotionally and in the physical space they’ll be using) before a session?

Physically

You will want to make sure your webcam, sound and internet connection are in good condition. Also, make sure you have a photo ID for the first session. We need to know that you are the person requesting therapy.

  • You will receive the informed consent and assessments before the sessions. The therapist might make contact in a preliminary check (a day ahead of time), to ensure that the computer system works and you are comfortable with the process.

  • We recommend the use of headphones and that you find a room where you can be alone behind a closed door, with as little distraction as possible.

  • You may also want to set up a noise machine outside of the room and put a “do not disturb” sign on the door to protect your privacy.

  • We are required by law to make therapy sessions confidential, and room security is the number one reason for breaches in confidentiality.

Emotionally

While it is essential to test your bandwidth (quickly done on Google), sound and video and secure a quiet room without interruptions, it is more important to take care of yourself and try to eliminate distractions from your therapy environment. Creating a space and time to take care of yourself is a good habit. Some people keep a list during the week about what is happening and review that list before the session to clarify the most critical points.

The first session can be awkward. The same is true for any therapy. While teletherapy can be an adjustment, it can also be amazing and helpful in a crisis. Rather than trying to jump in and declare the problem, take a moment to listen to the therapist about essential therapy room tasks and behaviors needed to ensure safety and security within the session. Think about asking questions as the therapist reviews the informed consent. Clients who experience their therapist attending to their needs and providing helpful information start feeling comfortable with teletherapy in no time.

Accept the best parts of teletherapy. You certainly cannot bring your cat to the therapy office, but you can have the furry friend in the room with you during teletherapy, especially if her or she is quiet or mostly quiet. Keep a pad of paper nearby to jot down some notes.

Finally, think about your needs. Many people have found that expressing themselves online is more comfortable. Whether your anxiety is affecting your sleep and making your mind race or the loneliness of isolation is influencing your eating habits or parenting practices, it is good to know what you need.

What does a teletherapy session look like? What can a client expect going into it?

A client can expect a therapist who is concerned about their emotional needs and the functionality of the teletherapy process. Not all clients are suitable for teletherapy. Do not worry; the therapists are trained to help you identify if you feel comfortable and can benefit from online services. The priority is to ensure that our services are beneficial and that we are not causing you harm or making a difficult situation worse. Before the session, the therapist will have sent you an informed consent and assessments to help us know how you are doing. Additionally, the therapist will contact you before the session to make sure you have everything, and the equipment is functioning properly. The goal is to make you comfortable and ensure that the first session goes as smoothly as possible. You will walk away from the first session with a good idea about the weekly teletherapy routine, privacy/confidentiality and goals for making progress with your problems. The therapists will share some protocols and procedures for securing your privacy as you meet online. At the end of each session, the therapist will review your mental health safety plan, which is discussed at subsequent sessions.

If you complete the informed consent and assessments before the appointment, it will help the process. You might not understand everything, but at least reading it beforehand will help you identify questions to ask when the therapist reviews each section of the therapy agreement during the first session. Finally, you will have an opportunity to talk about your answers to the assessments. This will help guide treatment, so honesty helps.

What are some common concerns relating to COVID-19 that teletherapy could help with?

According to research from the University of Phoenix, the COVID-19 pandemic has increased the number of Americans who are lonelier now than ever before (40%). If physical distancing and quarantine continue, there will be significant implications for physical and mental health. The key takeaway from research about forced isolation that exists during a pandemic is that people need to remain socially connected while being physically distant. The good news is that relationships influence biological pathways and benefit both physical and mental health.

Isolation debilitates the immune system, impacts blood pressure and increases anxiety and depression. Teletherapy is a first step to remove isolation and plan for leveraging friends and family to improve well-being, decrease isolation and create healthy habits. There are benefits for those who initiate teletherapy; it can help clients strengthen their coping skills, self-care practices and social network integration, among others. For the client, the awareness of the availability of support often increases both physical and mental health. Therapy focuses on strengthening existing relationships. Being reminded that I have a friend, family member or minister who is there for me will increase my physical health. The effect is more substantial when I know that I have someone who is there for me and can call on occasion. Teletherapy, just like in-office therapy, works to not only improve social connections but to change negative thinking and behavior patterns that increase self-imposed isolation. Some struggles impact your physical and mental functioning and sharing those with a professional will increase the likelihood of constructive solutions.

Teletherapy also helps with other common mental health problems like anxiety, panic and obsessive thoughts. The International OCD Foundation has emphasized that over the last decade, teletherapy services demonstrate reliable results with both adults and children with OCD. The same is true for anxiety and panic.

We know that some of the most effective treatments for obsessive-compulsive disorder include exposure, sidestepping cognitive responses that are illogical or biased and cognitively supporting positive thoughts. These actions help clients slowly experience reactions that generate fear as less impactful and intense. They gradually create an inoculation to the fears, and their brain learns that the obsessive thoughts are unfounded.

So, if people feel they must wash their hands every time they touch a door handle, this treatment would help lead them to see that nothing terrible will happen if they don’t wash their hands. However, that is not necessarily true during this COVID-19 pandemic, because the media, doctors and scientists are reporting frequent handwashing is precisely what we need to practice. Imagine spending years overcoming the desire to continually wash your hands and obsessing about germs and cleanliness with the fear that you could pass on a virus that kills someone else, then COVID-19 comes along and throws you a curveball.

When everyone on TV says “wash your hands as often as you can,” it side-swipes the progress that many have made trying to give up their obsessive routines. In a typical life experience, it is difficult to step beyond the fears of passing illness to others. In a COVID-19 world, the external messaging from media and friends and the hysteria that can follow is a replica of an internal battle waged daily. Now imagine being unable to attend therapy. That is why teletherapy services can be a relief to so many people.

While these are only a few examples of the benefits of teletherapy, they offer a glimpse that teletherapy does demonstrate similar outcomes to in-office therapy. Clients join with their therapist, collaborate and rate the results of treatment just as positively with teletherapy as with in-office sessions. Because of these facts, the Auburn University Marriage and Family Therapy Center wants to ensure that those who need help have a cost-effective way to access it.

Describe the therapists who will be available, including their background and accomplishments.

There are 12 Marriage and Family Therapy Interns who serve the public. They are from different walks of life and have varying experiences. Many have lived abroad in Italy, Africa and South America. They have served in community agencies and therapy clinics. Multiple therapists speak Spanish, and services are offered weekly in Spanish. Two of our therapists are American Association for Marriage and Family Therapy Minority Fellows. These interns have 16 articles, either published or under review, and have given more than 30 professional presentations.

The therapists have paid internship placements within the community working with a wide variety of clients. They work at the Auburn Marriage and Family Therapy Center and satellite offices serving low-income rural communities, within programs helping marginalized, underserved youth and at organizations facilitating court-mandated supervised visitations between parents and their children.

Just as important is the diversity of the center faculty. The supervising faculty specialize in treating trauma, working with those in poverty, treating and supporting sex-trafficked children and women, psychopharmacology, addiction and medical family therapy. Each of the faculty not only presents at national conferences, but also trains professionals in Alabama on how to treat mental illness, improve relationships, heal from trauma and work through long-term physical disabilities. There is a peace of mind knowing that for every three hours of therapy, the faculty offer one hour of supervision. The training program is hands-on and collaborative.

How much do these sessions cost?

For staff and faculty throughout the COVID-19 crisis, the teletherapy services are free for the first 12 sessions. Auburn University students can utilize the service at a cost of $20 per session with no session limit. For others within the community, the therapy services are $50, regardless of the type of therapy (individual, couple or family). Clients can petition to receive a reduced payment obligation between $10 and $45. The reduction is based on family size and total household income. Clients who qualify also accept that the payment reduction is a service. Clients must agree to meet weekly rather than bi-weekly or bi-monthly. A client pays the entire $50 fee if they no-show an appointment or cancel with less than 24-hours’ notice from the start of their scheduled session. The reduced therapy cost can be rescinded if the client no-shows and late-cancels frequently in a short timeframe (e.g., three times in two months).

What advice would you have for someone considering teletherapy, but isn’t sure it’s right for them?

For those who are considering teletherapy, but aren’t sure if it is right for them, search and read about teletherapy on the web. There is a lot of information about teletherapy online. By educating yourself, you will gain a better understanding of what is available and the potential benefits and drawbacks. It is essential to evaluate your current relational, mental and physical difficulties. Weigh out your current life stressors and compare them with the awkwardness of seeking professional online support.

If you do decide to try teletherapy, go in being honest with the therapist about your hesitancies. It is good to create a collaborative spirit with the professional who wants to serve you. They will appreciate the clear and direct feedback and will be better able to address concerns and highlight the positive change. You will know within a few sessions how you feel about the process and can discuss with the therapist the benefits and any concerns you may still have.

For more information on Auburn’s teletherapy program and to schedule an appointment, visit http://www.mftcenter.auburn.edu/teletherapy.php.

Auburn University is a nationally ranked land grant institution recognized for its commitment to world-class scholarship, interdisciplinary research with an elite, top-tier Carnegie R1 classification, life-changing outreach with Carnegie’s Community Engagement designation and an undergraduate education experience second to none. Auburn is home to more than 30,000 students, and its faculty and research partners collaborate to develop and deliver meaningful scholarship, science and technology-based advancements that meet pressing regional, national and global needs. Auburn’s commitment to active student engagement, professional success and public/private partnership drives a growing reputation for outreach and extension that delivers broad economic, health and societal impact.