How is telepsychiatry working for you?

[Banana Smurf]

I was curious because my therapist never ended up calling and I was curious about the experiences of other people.

[aquarian]

My first video appointment with my psychologist isn't til April 1st.

[Wonderful.Cheese]

17 hours ago, Banana Smurf said:

I was curious because my therapist never ended up calling and I was curious about the experiences of other people.

I just saw my pdoc online from home 2 days ago and it went really smoothly technology wise. I am not tech savvy either at all. All I had to do was download this Microsoft meetup thing program and click on it and enter it and I was on camera waiting for her to enter me into the “meeting” (I was early by like 10 minutes before our scheduled appointment time).

Also, I didn’t even know my laptop had a camera until about 5 days ago. So, yeah.

Also, just yesterday I met with my tdoc online with a program called Zoom. All I had to do was click on the link she emailed me and it took me to a page and I was on the camera on my laptop and waited for her to “join” and then she did a few minutes later. It worked well but it was slow or lagging I think is the term. I saw her but it was not good quality of video chatting. My pdoc visit with the Microsoft program was much clearer and had no lagging.

So there you have it. I now know how to do telemedicine from home and I am tech savvy (not, haha ).

If you have any more questions let me know. 

[dancesintherain]

'Mine worked okay---not great, but good enough.  I think that it wouldn't work if I were in crisis.  We had a hard time getting me loud enough and her loud enough without background noise entering the picture.  I think i may take my laptop into one of the bathrooms (the only place that doesn't have a window to the really loud traffic).  Or I might try the phone version, but I suck at facetime and I don't see this being any better. 

It's not ideal, but it's better than going months without an appointment.  And because I steal her after my work hours appointment day/slot, I don't want to give it up.

[Geek]

Both my pdoc and tdoc use https://doxy.me/ which is a free, HIPAA-compliant telemedicine site. Tech-wise it's okay. I appreciate that I didn't have to download any software or create a login. They sent me a personalized URL. I went to the URL a couple minutes before my appointment, and there's kind of a "waiting room" - and it let them know I was there. When they were ready, they switched things on. The picture was clear and so was the audio, little to no lag. I wore a headset for the sessions, so that the mic wouldn't pick up the audio, but neither of them did that so the software seems to be smart enough to not require a headset.

So... tech-wise, it's okay. I hate it though.

They both wear glasses when they're doing this, I suppose because they need readers to see the screens - but they don't normally wear glasses in session. Also, these glasses then show reflections of the screens or windows or whatever so it's even harder to see their eyes.

I hate that I can't see their whole body. I rarely look at my tdoc's face (I tend to study her shoes), but now there's no choice.

And when I try to talk about something hard... I can't feel them in the room. So I'm still alone, and that sucks.

[Catnapper]

I had my first session earlier this week, and didn't care for it. The technology was okay, although for some reason my microphone wasn't working, so we had a phone call going at the same time. There was no lag between the phone and the computer screen, so that was good. But I still didn't like it - all the unspoken information wasn't transmitted in either direction. I have to do video conferencing at work all the time (and have for years), and I don't like it there, either.

The only good thing that may come of it is that my pdoc might introduce me to his two cats next week, which would be great! Otherwise, I'm hoping we can soon go back to in-person visits.

[echolocation]

2 hours ago, Geek said:

I hate that I can't see their whole body. I rarely look at my tdoc's face (I tend to study her shoes), but now there's no choice.

therapy is kind of a full body experience for me that involves very little eye contact. i curl up in my chair and stare at the paintings in her office when we talk about things that make me feel vulnerable, and begin to uncurl as it winds down. it's hard to look at her when we're doing more intense work.

i do EMDR with tdoc. it just occurred to me that that probably won't work via phone or video call. ugh.

[Dagr]

..

Edited April 22, 2020 by Dagr

[Catnapper]

I had my second visit with my pdoc today (he does therapy, too), and I disliked it as much, if not more, than I did the first time. The technology worked okay, but I really need to be in the same room with him. It's very unsatisfying to just have a little picture of his head.

Of course, part of the problem is that I live alone and don't have a very active social life, so my weekly pdoc appointments have an outsize importance for me. The only good thing is that the pdoc said today that he didn't like it either, and was looking forward to getting back to in-person visits.

The other big problem for me is that I feel like I can bullshit him over the screen, which I definitely can't get away with in person. It defeats the whole purpose to lie to him, of course, but the temptation is nearly overwhelming. I'll bring it up as a topic of discussion next week, so he will be better able to keep me on the straight and narrow.

[Dagr]

..

Edited April 22, 2020 by Dagr

[Unstrung Harp]

Pdoc (with whom I do therapy) and I have done two telephone sessions. I think we could do video if I want but that would make me uncomfortable. I tend to find Pdoc’s phone voice soothing from times we have talked between meetings during a crisis, so I don’t mind the phone therapy too much. Yesterday I put him on speakerphone because I was sitting in my car cleaning things while talking to him (no privacy in the house). I was sanitizing my keys and the steering wheel and as much of the phone as I could do without hanging up on him, so that was a little weird.

[fantod]

On 3/26/2020 at 3:41 PM, Banana Smurf said:

I was curious because my therapist never ended up calling and I was curious about the experiences of other people.

That's crappy of them, Banana Smurf.  Did they get back to you and apologize? 

 

On 3/28/2020 at 9:48 PM, Catnapper said:

The only good thing that may come of it is that my pdoc might introduce me to his two cats next week, which would be great! Otherwise, I'm hoping we can soon go back to in-person visits.

Bonus, Catnapper! 

My cat has commented audibly on some of my telephone sessions.  I hope my Drs appreciate that. 

I am loving not having to travel to my psychiatrist's office, as it was an extremely stressful  and inconvenient endeavor using transportation services for half a freaking day for a 15-minute med check.

My old therapist changed offices and terminated me in early March, so I still don't know what my new therapist looks like since we do telephone-only therapy.  It's weird but I'm grateful that I got referred at all and am able to continue therapy.

[Banana Smurf]

17 hours ago, fantod said:

That's crappy of them, Banana Smurf.  Did they get back to you and apologize? 

 

Bonus, Catnapper! 

My cat has commented audibly on some of my telephone sessions.  I hope my Drs appreciate that. 

I am loving not having to travel to my psychiatrist's office, as it was an extremely stressful  and inconvenient endeavor using transportation services for half a freaking day for a 15-minute med check.

My old therapist changed offices and terminated me in early March, so I still don't know what my new therapist looks like since we do telephone-only therapy.  It's weird but I'm grateful that I got referred at all and am able to continue therapy.

No, and I'm not sure how to get in touch with someone. I'm not sure she's seeing anyone right now, though, and her office is usually pretty bad at communication. 

I called my school for a counselor in the meantime, but it's not really been much working on issues directly, more how they affect how I function.  I think I'll ask my pdoc what to do when he calls.  

[fantod]

They sound like they don't really have their act together at that therapist's office, Banana Smurf.  I'm sorry.  It's good that you're advocating for yourself by talking with the school counselor and planning to speak with your pdoc. 

[echolocation]

my pdoc is calling me for a med check in half an hour, and then this afternoon i'm having a therapy session via zoom. 

i had completely forgot about this possibility, but this is activating a mostly-dormant phone phobia of mine that was quite bad as a teenager. i've gotten much better at using the phone and generally communicating in non-face-to-face ways, but it's like i'm back at square one suddenly. i'm feeling very afraid and nervous for this phone call, and apprehensive about the zoom meeting.

[0112358]

It felt really weird at first to do telepsychology with my tdoc. After I spent a few sessions talking about how it was weird, and why it was weird, I got used to it, and now it doesn't bother me at much.

I'd say at first it felt harder to connect, and harder to open up. That's not an issue now.

[Catnapper]

I'm still meeting weekly with my pdoc for meds and therapy, and still dislike it, although it's better than nothing. The only good thing is that he introduced me to his two cats this week, which was great as I am a huge cat lover. We have briefly talked about his cats a few times before, so it was nice to see them in person (more or less). The best part was hearing him use the voice he uses to call his cats - it was very charming, and made him seem more human somehow. 

[Gearhead]

I’ve been helping run online support groups, and the best part is always meeting people’s pets. I particularly enjoy the ones who get their faces right up in there and take over the camera.

Some time ago my dog Agnes discovered that if she licks the screen of my iPad, she can usually get the picture to change. So I had to stop taking Zooms sitting on the living room floor with my iPad on the coffee table.

[shesellsseashells]

@Gearhead Smart dog!

I'm with the rest of you.  Videotherapy is better than nothing but not the same as in-person visits.  I don't get out of the house enough and my pdoc visits tend to be my social outings for the week.  On the one hand, now I can have therapy without brushing my teeth or changing out of my pyjamas, but on the other, I miss the in-person connection.  Videotherapy feels less meaningful and real.

[Catnapper]

16 hours ago, Gearhead said:

I’ve been helping run online support groups, and the best part is always meeting people’s pets. I particularly enjoy the ones who get their faces right up in there and take over the camera.

Some time ago my dog Agnes discovered that if she licks the screen of my iPad, she can usually get the picture to change. So I had to stop taking Zooms sitting on the living room floor with my iPad on the coffee table.

This is hilarious!!! Go Agnes!!!  🙂

[Catnapper]

A little over a week ago, I also had a video visit with a GP as my coronavirus symptoms had come back (all better now, thankfully). It was strange not to have any physical contact or have my vitals checked, but it served the purpose. It was nice not to travel while I felt like crap, though.

Having therapy / pdoc visits by video is overall much more distressing to me. I'll be so glad to see my pdoc in person again!

[Dagr]

..

Edited May 4, 2020 by Dagr

[shesellsseashells]

I couldn't manage to sit up in bed for my video appointment with my pdoc on Thursday.  (Also, I didn't feel like talking to him.). That is the epitome of laziness.

[Rabbit37]

I’ve had three sessions already, using the doxy.me also, with my iPad. The first time I was sitting in my bedroom, which is the quietest corner of the house, but the last two times I needed to talk openly without my adult kids overheating anything, so I sat in my car. Worked fine, except I have to pause if an ambulance goes by, and where I park is on a common emergency route. He laughed. 

I’m getting used to it, tho I don’t like it. Someone mentioned wearing readers... my tdoc always wears glasses, but now I have to wear readers to focus on the screen, don’t know if he finds that strange. 

[shesellsseashells]

Maybe I should switch up my appointment venue.  My quietest spot is in my bedroom, but somehow that seems overly personal and slightly invasive.  

[DogMan]

i have teleneurologist tomorrow

 

first neuro appointment in 10+ years

[sugarsugar]

Don’t know what video type you’re using but some allow a feature that blurs what’s behind you or shows a fake backdrop. If you have that feature, and I had to look for it, could be a plan. 

[echolocation]

i've done a couple video sessions with my tdoc using doxy.me. i set up my computer in my art room, which is quite private. the first one was okay, if not a little casual. we mostly talked about how weird everything is now and feeling lonely. it reminded me of skyping my sister during my years of phone-phobia. 

the second was the first session i've had with my tdoc that left me feeling unsatisfied/frustrated. it made me aware of how telling my body language is during the sessions. i got pretty upset and was trying to hide that from her. that normally doesn't fly because she's four feet away from me. with the video call, it took her quite a bit longer to pick up that i was upset. i was also very uncomfortable looking at the screen at her -- i don't usually make much eye contact when i'm emotional. it also felt somehow clumsier, like i couldn't express myself well or that she wasn't understanding me. it was awkward.

i'll be very happy to go back to in-person appointments.

[dancesintherain]

1 hour ago, echolocation said:

i'll be very happy to go back to in-person appointments.

I agree/

[DogMan]

On 5/7/2020 at 12:16 PM, DogMan said:

i have teleneurologist tomorrow

 

first neuro appointment in 10+ years

Neuro called in sick. So rescheduled to next Friday. 

 

No biggy. It is just to ask about lowering or stopping AED, since last seizure was 2011 

[Butterflykisses]

I really don't like it. I find is awkward. Then I get anxiety its not going to connect right. I am looking forward to going back to in-person appointments. 

[Catnapper]

I was just watching some TV interviews between news anchors and politicians, and I finally figured out what bothers me the most about telepsychiatry. Although most of these professional speakers seem to be able to look directly in the camera whether talking or listening, at times they will slip and look down at what is presumably the screen on which they are watching the other person. That made me realize that the part I probably hate the most about telepsychiatry is that I can't simultaneously look into my pdoc's eyes while allowing him to look into mine. Of course he and I don't keep full eye contact during our entire appointment, but we do look at each other a significant amount, especially when something deep is being said. I want to see his reaction when I'm baring my soul, and I want him to get a good look at me at the same time. I really miss that!

I wish someone would invent a screen so that the camera would somehow be in the middle so you could see and be seen at the same time. It will be such a relief to see my pdoc in person again! 

[Catnapper]

Here's a question for all of you telepsychiatry patients: If you had to pick between a telepsychiatry appointment or an in-person visit while you and the doctor both wear masks, which would you choose?

Edited May 12, 2020 by Catnapper
{edited for typos}

[Gearhead]

Masks. I really don’t mind the masks.

[Blahblah]

Can't stand it!!! I am quitting altogether until I can see a therapist in person again. I don't have a regular therapist though anymore.

I've tried several new therapists now (through a popular online service) and it's been awful. It's not the same over a screen, and then 2-3 times, the call suddenly cut out & the woman said that it was my signal that cut out...yet the connection was 100%!   I feel a real lack of connection and commitment on their part, when it's a video (or blind) call....

I'm sure it's different if it's a call with a therapist that knows you & has seen you awhile, but to start with someone new, only through tele-therapy - I def do not recommend it. It is really not worth it!

Edited May 13, 2020 by Blahblah

[0112358]

18 hours ago, Catnapper said:

Here's a question for all of you telepsychiatry patients: If you had to pick between a telepsychiatry appointment or an in-person visit while you and the doctor both wear masks, which would you choose?

I'd stick with telepsychology/iatry over in-person with masks because:

1. Even with a masks on, there's still risk involved as far as COVID-19 goes.
2. Breathing and speaking through masks is annoying.

The only reason I'd see any medical professional in person right now is if I have to be there - like getting X-rays or MRIs.

[Banana Smurf]

Telepsychiatry, with phones, I kind of like not getting feedback from faces.  Facial expressions tend to confuse me and I imagine all kinds of things in them that aren't actually there.  

Edited May 13, 2020 by Banana Smurf

[Banana Smurf]

I missed my pdoc's call.  I've been trying harder to get a response from their office staff.  It is really annoying.  I am not sure if they are checking the voicemails.  I am also not sure if my voicemails are very clear.  I should drive somewhere with better signal and try again.  

[Gearhead]

I had a call with my pnurse today. It was much more efficient than an in-person visit. This might not be so if we didn’t know each other so well-we’ve worked to gather for 15+ years. I don’t miss going to her office at all. I hate the clinic she’s at now. I hate the protocols they’ve established pre-visit. Are you seriously fucking telling me that you need to measure my height again? I’m a grown-ass woman. My height has not changed in over two decades. Piss off.

[yarnandcats]

Tdoc via interwebs isn't a thing of joy probably because tdoc isn't a thing of joy. Staring at tdoc for 50 minutes through a screen while she says "um" dozens of times is frustrating beyond endurance at times.

However: not having to go out is absolutely fantastic.

[Banana Smurf]

I finally got ahold of my clinic and made an appointment for the pdoc appt I missed and the tdoc appt that I never got, which was made before they shut down.  I'm glad I got through to them, but I'm kind of pissed.  I guess it's mostly at the office clerk?  I am not sure if I should mention it because of the difficulty of getting a call through and she had clearly not listened to my voicemails.  However, she is pretty new and I would not like to get someone in trouble at work when everyone is getting laid off?  Idk

[Catnapper]

On 5/21/2020 at 12:29 PM, Banana Smurf said:

I finally got ahold of my clinic and made an appointment for the pdoc appt I missed and the tdoc appt that I never got, which was made before they shut down.  I'm glad I got through to them, but I'm kind of pissed.  I guess it's mostly at the office clerk?  I am not sure if I should mention it because of the difficulty of getting a call through and she had clearly not listened to my voicemails.  However, she is pretty new and I would not like to get someone in trouble at work when everyone is getting laid off?  Idk

I'm glad you finally got your appointments sorted out. Everyone here is dealing with enough problems as it is without having all these changes to how you see your doctor thrown in on top of everything else! 

[notloki]

I have to actually go into the office as I must pick up paper scripts (Adderall). So it goes this way: I pull into my doc's assigned parking spots and conduct my session with the doc on my cell phone. Then I put on my COVID gear and walk over to the office, hand the secretary a check and she hands me my scripts. I examine them and sign off on them.  

[Gearhead]

1 hour ago, notloki said:

I have to actually go into the office as I must pick up paper scripts (Adderall). So it goes this way: I pull into my doc's assigned parking spots and conduct my session with the doc on my cell phone. Then I put on my COVID gear and walk over to the office, hand the secretary a check and she hands me my scripts. I examine them and sign off on them.  

There’s something very Cold War intelligence gathering about that...

[Unstrung Harp]

I had my phone therapy appointment with Pdoc today, and was really thrown that my neighbor and her daughter were sitting out on their porch, which is like twenty feet from my car. I had the windows closed, so sound was probably muffled, but found myself talking quietly on speakerphone and turned down the volume on my phone. It made me a little paranoid and I didn't like it. And she was probably wondering why I was sitting in my car talking on the phone for an hour, even if she couldn't hear, so overall I felt very self conscious. Pdoc is making noises about going back to office visits in two weeks after the stay at home orders are most likely lifted, and I have mixed feelings about that.

Edited May 27, 2020 by Unstrung Harp

[Banana Smurf]

I talked with my psychiatrist today and it was a little short.  I think that it was helpful to check in, though.  I talked with him about switching my ritalin from my sleep doctor to him, if my sleep doctor agrees, to lessen my number of doctors because I'm afraid of losing my insurance.  

He said I would still have to follow up with him even if my psychiatrist prescribes, so he is prescribing it.

Edited May 29, 2020 by Banana Smurf

[sugarsugar]

Finally have an appointment with pdoc next week on the HMO video system, whatever that may be. It might be using my phone since my other electronics have one issue or another. I’ve done video conferencing but not with a pdoc so should be interesting. I’m hoping for a good camera angle or something. Mainly I count on him reading my mood and issues better live than in email. I think it’ll be ok. 

[jarn]

I like tele - it saves the trip to the hospital (where pdoc still is).  I feel like the service is the same and don't feel like there's a lost connection.  I feel like our appointments are as helpful as usual.  I just feel bad for pdoc still having to go into the hospital!

[Catnapper]

I continue with my weekly pdoc appointments, which also include therapy. It's better than nothing, but I really do miss being in the same room, and having simultaneous eye contact. I can see how not having to make a trip to the office would be helpful, but I'm lucky that's not been an issue for me. 

This week I tried to share my screen and show him a few kitty photos of my two late great cats, but it didn't work right. Every so often I get to see his two cats on screen, and that's been the high point of the whole experience for me.

I keep trying to talk him into getting an office cat, but he hasn't bit yet! 😀  He's in a multi-provider practice, and no word yet on when they're going to open back up. It's hard to believe that it's nearly July and we haven't seen each in months! I live alone and have been in a bad depressive episode, so he was one of the very few people I actually was seeing in person regularly, and I miss that.

 

[Antecedent]

I gotta say, all the evidence shows that teletherapy works just as well as face to face therapy but I HATE IT so far anyway. MAybe new tdoc will be better. Maybe it works really well for people who choose it in the first place. I expected to like it but nope

[sugarsugar]

My recent tdoc appointment was a video fail. I did all the troubleshooting and finally called in and had a phone appointment. Better than nothing I guess. 

[Catnapper]

Yes, I've ended up on a phone call after the video froze, and I don't like it. I don't like the video, either, but it's better than nothing. Living alone during this pandemic is making me crazier than usual and I really miss being in the same room with my p/tdoc. It's not like I miss physical contact with him, since there wasn't any, but a video image is so completely inadequate. It's just really frustrating, and it doesn't seem like there's an end in sight anytime soon. 

The good news is I was finally able to get screen sharing to work so I was able to show him some kitty pictures, which was helpful and lightened the mood a bit. 

[coraline]

@Catnapper

 

...never mind..

 

 

 

 

Edited October 19, 2020 by coraline

[Banana Smurf]

I decided to schedule with a new therapy clinic because the phone system at my old place was hard to get through.  It happened to have some therapists that were doing in-session appointments.  I was pretty grateful for it because I do not know if the phone sessions were helping as much.  I also do not have very much insight into my mood so it is helpful if they can notice if I am disheveled and smell weird or if I cannot stop moving and have bizarre clothes on.  She specified in person only to the receptionist after my first session so I do not know if that means I am super batshit.  

Edited October 6, 2020 by Banana Smurf

[MiaB]

I've been having fortnightly telephone appointments with my pdoc since this country went into lockdown in March.  I suspect we will continue this way until the end of the year.  I think she would do video conferencing if I asked, but I am majorly anti that - I have found working from home with endless online meetings via Microsoft Teams has just killed any desire I have to pursue psychiatric appointments via that route.  I don't mind the phonecalls and we get a solid 30 minutes in per session.  I just have to take copious notes because my recall of phone conversations can be a bit dodgy at times.

Another plus is that her office is in the city centre, which is a stressful 20 (from my place of work) to 40 (from my home) minute drive that I always have to calm down from after I arrive there.  I'm not missing that one bit.

Edited October 6, 2020 by MiaB