How is psychotherapy more effective?
There is a broad consensus among experts that psychotherapeutic treatment should be face-to-face, as it has been shown to be significantly more effective.
Why is face-to-face psychotherapy more effective?
Psychotherapy is not limited to the application of certain techniques, but it is essential that the therapist takes into account the non-verbal communication with the patient, which includes the whole body (facial gestures are easy to modify, which is not the case with other areas). All this applies to the patient with respect to the therapist. In addition, gestures such as greeting and farewell, giving a pat of encouragement, etc., have a great influence on the outcome of the treatment.
What are the indications for internet psychotherapy?
This modality would be indicated for those cases in which there is an objective impossibility for the patient to come to the consultation, such as: living in an isolated place, suffering from disabling physical and/or psychological illnesses; also, whenever home treatment is not possible, or as a continuation of treatment if after a sufficient time of face-to-face psychotherapy the patient moves to another residence and prefers not to change therapist. If the therapist is a physician, the Code of Ethics of the profession requires that the patient be seen, even if initially, in physical presence (he/she may be seen by another physician in coordination with the future psychotherapist).
Is it appropriate for a patient who could come to a consultation to be treated over the Internet?
The Patient Autonomy Law clearly states that the therapeutic alternatives should be explained to the patient, highlighting the most effective one. For this reason, the patient should be persuaded to choose the face-to-face modality. However, if the physician agrees to such a request, he/she should explain and record in the medical record the limitations of Internet psychotherapy.
Is it legal to prescribe psychotropic drugs over the Internet?
Referring to private health care, the preparation of the medical record and the initiation of treatment must be carried out in physical presence, obviously including the prescription. With regard to the reviews, in case the patient is unable to attend the consultation, the prescription of drugs requiring a prescription, requires by law the original signature of the physician (this difficulty could be alleviated depending on the cases by sending the prescriptions by mail, picking them up by a family member, prescribing them by a physician close to the patient in coordination with the psychiatrist, etc.).