Blue? Stressed to the max? Here's how online therapy might help

A combination of online modules and brief check-ins with mental health counsellors could increase access and reduce wait times.

Newfoundland and Labrador first province to introduce program

Psychologist Sarah Pegrum speaks with reporter Ramona Dearing through a Skype call, similar to one that will be used in a new online service. (Sherry Vivian/CBC)

In her Mount Pearl office, psychologist Sarah Pegrum clicks open an online program that may make it faster for people to get help.

It offers information and strategies that could benefit people with depression, anxiety or addictions.  

"Hopefully they'll be able to access those services when they need it, as opposed to having to wait," said Pegrum. 

The Department of Health and Community Services is introducing a new program that's a combination of traditional therapy and online therapy.

Sarah Pegrum is a registered psychologist with Eastern Health. (Sherry Vivian/CBC )

A key goal: to shorten wait times for those needing counselling.

Pegrum, a registered psychologist with Eastern Health's Adult Community Health Team in Mount Pearl, said those waits can be as short as a couple of months or as long as two years.

How it works

While Therapist Assisted Online, or TAO, doesn't exactly roll off the tongue, the way it works is easier to understand.

Over the course of six weeks or longer, people will work through a series of online modules on their smartphones, computers or tablets.

The modules include videos, mood trackers, interactive exercises and mindfulness techniques.

As Pegrum scrolls through the material, a narrator offers an observation. "With people, what goes on on the inside is much messier than what they show on the outside," the voice intones. 

It's not all digital. People will also talk to a counsellor every week. 

But instead of the standard 50-minute therapy session, the sessions will take around 15 minutes, and those check-ins will be done by telephone or Skype. 

Better outcomes, less time  

Students at Memorial University have used the same program since 2015. 

Peter Cornish, the director of the Student Wellness and Counselling Centre, reports that outcomes have been the same as using face-to-face therapy.

"Or in many cases, particularly for the treatment of anxiety, it's even better," said Cornish. "You're getting better outcomes by spending less time with an expert."

And that time savings has made a significant difference when it comes to what the centre can offer students.

Now those who need to talk to someone can walk in without prior appointments and see a counsellor that day. 

The government has just announced a similar initiative in several communities across the province. That program, called Doorways, offers one-off mental health and addictions counselling for people who aren't in crisis but who want to speak to someone quickly. 

Peter Cornish is the director of the Student Wellness and Counselling Centre at Memorial University. (CBC )

Pegrum hopes the government's online therapy works as well as it has at Memorial University. 

"The difference that this online therapy could make is that a person could get access to some information and resources sooner," said Pegrum, "so they'll be able to do things online and in their own time as opposed to not getting anything." 

Coping skills are key

Cornish says the online therapy is never forced on students but instead only offered if they agree they'd like to try it. 

I think we're leading the country with innovation.- Peter Cornish

He believes that one of the key benefits is that people put in effort of their own, learning coping skills and doing related homework.

"What we're surprised at is that many people actually say, 'You know what, I don't need an hour-long [counselling session], I'm ready to work on this on my own but it would be really helpful to come in and check in with you on this work.'"

Pegrum says it's also a big plus for people who are working and don't have time for face-to-face sessions, or who might find the notion of walking into an office intimidating.  

"If a person wants to look at these skills or do these readings at two in the morning because that's the time that works for them, they can do that," said Pegrum. 

Helpful for depression, anxiety, addictions

Not everyone who asks for counselling within Newfoundland and Labrador's public health system will be encouraged to do the online therapy. 

People will be assessed first, to see what their problems are and what might be the best way to help them get better.

Pegrum says the approach is not as effective for those with post-traumatic stress disorder or obsessive-compulsive disorder.

However, Pegrum says the online modules can work well for people dealing with depression, anxiety or addictions.

Counsellors will be able to see the results of mood surveys that people fill out online, allowing them to see if there's improvement or if a different approach should be tried.

This anxiety monitoring log is part of the new online therapy program the Newfoundland and Labrador Department of Health and Community Services is introducing in an effort to reduce wait times for counselling. (Sherry Vivian CBC )

Newfoundland and Labrador is the first province in the country to offer the program. 

"I think we're leading the country with innovation," said Cornish, whose efforts to improve mental health services at Memorial University have received national attention. 

Fifteen clinics throughout the province are set up to offer TAO, including St. John's, Corner Brook and western Labrador.  

The government of Newfoundland and Labrador has already spent $35,000, and plans to invest another $100,000 in the upcoming fiscal year. 

People interested in getting more information on either TAO or Doorways can call the Health Line at 811. 

An image from Therapist Assisted Online, an online therapy program. The image is part of a section on anxious thoughts and how to cope with them. (Sherry Vivian CBC )

About the Author

Ramona Dearing

Ramona Dearing has worked as a reporter, host and producer at CBC's St. John's bureau.