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  • Writer's pictureAlexander James

The Evolution Of Distance Therapy

Access to therapy is vital, and over the past year, with many appointments having to be cancelled, people have sought out appointments with an online therapist to ensure they are heard and helped.

However, the history of remote therapy or teletherapy goes back much further, predating the internet and whilst initially seen as a way to grant access to therapy for people who could not get an appointment or find a suitable nearby psychotherapist, ended up becoming far more vital.

The Early History Of Telehealth

The history of telehealth and teletherapy are intertwined, as its most early uses involve pre-internet forms of communication and are primarily focused on diagnosis.

One of the earliest telehealth requests ever actually comes in the form of Alexander Graham Bell’s very first call on the 10th March 1876, where he said to his assistant Thomas Watson.

“Come here – I want to see you.”

It later emerged that Mr Bell had spilt acid onto his trousers and needed help to avoid burning himself.

Some writers go even further back and claim that smoke signals and heliographic messages warning about diseases and plagues were a very early form of telehealth.

Nearly a century after Mr Bell’s call, telehealth started to emerge as more than a theoretical way of helping people but the future of healthcare and would start in the form of teletherapy.

In 1964, the Nebraska Psychiatric Institute set up a two-way video system between itself and Norfolk State Hospital, 112 miles away. This link was used in part to teach doctors remotely but also allowed for group therapy and specialist consultations.

Outside of larger installations, therapy was available by telephone as early as the 1960s and would expand onto computers with the rollout of ARPANET in the 1970s and the showcase of what computer-assisted psychotherapy could look like at the 1972 International Conference on Computers.

Whilst the seed for teletherapy was planted here, it would take over a decade for it to bloom.

Helping In Another Way

For some people, visiting a therapist is such a major step that it can become a barrier to receiving vital mental health treatment. For others, a suitably trained psychotherapist is not available nearby.

Teletherapy aimed to fix that and arguably the first step towards online therapy came from an early online advice column called Dear Uncle Ezra, based at Cornell Counseling Centre.

This provided rudimentary free advice for people with relatively simple problems who would not otherwise seek out therapy, answered anonymously by staffers at Cornell, including the former assistant dean Jerry Feist and former director Stever Worona.

Other examples would follow, from simple support groups public mental health chat rooms such as John Grohol’s Psych Central. Leonard Holmes, a pioneering psychologist, would be the first to offer personalised advice with an option to donate, but this would soon be standardised.

This expanded in 1995 when Dr David Sommers offered the first online therapy system that worked in a similar way to in-person therapy, providing follow-ups and therapist-patient confidentiality.

Many other therapists would follow, and teletherapy would become a standard service by the early 2000s. However, studies looking into remote therapy found that it was not simply more accessible therapy but provided a different kind of treatment, which worked better for some people.

The widespread adoption of videoconferencing and higher quality internet connections has enabled teletherapy to take a variety of approaches, from therapies that largely resemble in-person intervention to approaches that take advantage of the internet itself.

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