James D. Herbert tells one of his patients to go into the bathroom—with a laptop.
Although his request may seem odd, Mr. Herbert, chair of Drexel University’s psychology department, in Philadelphia, is with a client.
Sort of.
Mr. Herbert is one of many mental-health professionals across the country who use teletherapy to counsel patients online. With this particular patient, Mr. Herbert is treating obsessive compulsive disorder, which results in frequent handwashing. Through teletherapy, Mr. Herbert can interact with the patient while he is in the actual area where the behavior manifests itself.
The trend of treating patients online is spreading rapidly at the nation’s colleges, especially to deal with anxiety, one of the leading reasons students turn to counseling centers.
According to a 2013 survey by the Association for University and College Counseling Center Directors, nearly 6 percent of the 380 colleges participating in the study now use some form of teletherapy. While that number might not seem high, it’s up from less than 0.5 percent in 2012.
Mr. Herbert predicts more colleges will be trying the approach soon. “It’s growing by leaps and bounds,” he says.
‘Being at Home’
At the University of Florida, students struggling with anxiety can visit its counseling center and, after an initial, in-person consultation with a counselor, can elect to start a seven-week program called Therapist Assisted Online. The program works like an online course, complete with videos and online activities. Once a week, students meet with their specific counselor, one on one, through a videoconference for 10 to 15 minutes to discuss their anxiety.
That means students visit the counseling center only once and can do the rest from the comfort of their dormitory room. “They like the idea of being at home,” Brian C. Ess, a counselor at Florida’s Counseling and Wellness Center, says.
Last year about 100 students enrolled in the online program. At least two other colleges—Loyola Marymount University and the University of Kentucky—are testing Therapist Assisted Online for possible adoption.
Things work a bit differently at the Savannah College of Art and Design, where counselors offer weekly group webinars to help students manage stress.
During an eight-week program, counselors teach a different stress-management tool each week, and students may attend as many or as few of the sessions as they like. As students learn to meditate and relax, they can choose to use a webcam for two-way viewing or simply use audio or chat features to talk with counselors.
“We’re really trying to make connections with students,” says Tamara S. Grosz, the Georgia college’s director of counseling and student accommodations. “Because if we connect with students, we can destigmatize the services so students can seek access earlier.”
In the stress-management group, which the college has offered for four years, participation varies from three students to 12 students each week, Ms. Grosz says.
Privacy Concerns
The technology brings convenience, but it also comes with new challenges for counseling centers—and their patients.
Chief among them: Could hackers gain access to online counseling sessions?
“We can never 100-percent guarantee that won’t happen,” Mr. Herbert says, but he does use software, called VSee, that is certified as compliant with the Health Insurance Portability and Accountability Act, the federal law requiring patient privacy. “The thing you have to remember is that people can tap your office,” he says. “There’s never a 100-percent-secure environment.”
Jed Magen, chair of Michigan State University’s department of psychiatry, says one concern for such online-counseling services is whether the online environment is as effective as in-person counseling for maintaining personal connections between therapists and patients, but the fear disappears quickly.
“Over time, people kind of forget about the screen,” says Dr. Magen, who has used teletherapy to see patients across Michigan for nearly a decade. “When they come on the screen, it’s still, ‘Hi, how are you?’ It’s still a connection.”
College counselors have faced new legal issues as well. Current laws require therapists to be licensed in the state in which they practice, so they may not be able to provide mental-health services to students in different states.
That is especially relevant to students who may be in a different state for holidays or vacations, officials say.
But Mr. Ess says that, despite the challenges, the online approach is a good fit for today’s students.
“I can’t drive by a bus stop and not see students looking at their phones,” he says. “There’s a comfort now that wasn’t there before that allows us to do this.”