Written by Danielle L. Currin, MA, and Erica D. Marshall-Lee, Ph.D., ABPP on behalf of the Atlanta Behavioral Health Advocates.

I recently found myself in my therapy client’s car as he drove home from an errand. I requested that we wait to start the session until he was no longer driving, and rather than pulling into a parking space, he pulled into the drive-thru of a restaurant and ordered a coffee. I observed this behavior from the cupholder of his car, watching from his phone screen while I sat miles away in front of a computer in the clinic I worked in, contemplating how to address an issue that was not part of my initial clinical training.

Long before the COVID-19 pandemic, scientists and practitioners were interested in the effectiveness of teletherapy for numerous psychological concerns (Lim & Penn, 2018; Swalwell et al., 2018; Tse et al., 2015). Providing mental and physical healthcare remotely was typically considered in exceptional circumstances where clients may have limited mobility or transportation. It was lauded for its ability to increase accessibility of services (Adler et al., 2014; Polinski et al., 2016). Stay-at-home mandates in response to COVID-19 demonstrated an intense need for widespread remote services, facilitating a “good enough” mentality while clients and practitioners scrambled to adapt to unpredictably changing circumstances. Numerous studies and opinion pieces published in the first year of the pandemic highlight the limits of our understanding of teletherapy's efficacy (Markowitz et al., 2021) and the barriers that arise when in-person contact is wholly eliminated (Oesterle et al., 2020). However, the prevailing perspective was that given the rise in mental health concerns, providing care with a weaker evidence base was better than leaving people without care at all (Malapani 2020; Nealon 2021).

Restrictions have lifted and we have returned to something resembling “normal”, but in many ways, this “good enough” mentality regarding teletherapy has endured. In the early years of the pandemic, providers treated any kind of service, whether it was change-based therapeutic work or simply supportive listening, as better than nothing. Now our clients have options, and it falls on both clients and providers to decide whether the benefits of remote services outweigh the drawbacks. The benefits of offering teletherapy are numerous,........

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