Virtual therapy helps clients and clinicians in rural Minnesota as demand hits record high


“We are going through very traumatic events in a short period of time with many unknowns about our destination,” said Dina Clabaugh, psychotherapist and founder and CEO of Insight Counseling at Duluth. “It only increased the anxiety, depression, isolation, trauma and grief.”

This is not necessarily bad news. Katie Erickson, clinical director of the Duluth Counseling Center, said many clients would come looking for help dealing with the stress of the pandemic, but eventually decompress the lifelong trauma that was hidden below.

Katie Erickson (photo courtesy)

“I think what we’ve found is that for a lot of these people, COVID has enabled them to get help, but now they’re really seeing the benefits of therapy and I think a lot of them they love it, ”Erickson said. “It was the little push to get them to go to therapy. And we’re not just working on COVID anxiety. We work on anxiety for the rest of their lives. “

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Common reasons people have sought therapy recently are anxiety; depression; stress related to the pandemic, parenthood or job stability; solitude; or increased substance use. Clabaugh said many clients are grieving as well, whether it is the loss of friends or family to the pandemic or the loss of a job or stability in life. People have also been stressed by political events such as the 2020 presidential election, or concerns about various online conspiracy theories regarding politics and the pandemic.

To meet growing demand, counseling centers have hired more clinicians in the past year, and some continue to add more therapists to take on new patients. Erickson said appointment openings for new clinicians will fill up in a week or two and then have a three to four week waiting list like the rest of the clinicians. Clabaugh said that when she opened Insight Counseling almost four years ago, she planned to have two or three therapists, but now she has 20 because the demand has always been so high.

Through telehealth services, they are able to refer clients to other therapists, both in the area and across the state, to see if they can get an appointment sooner.

“When people ask for help, they usually need it now,” Erickson said.

Although Erickson feared demand would decline as vaccines became widespread and places began to safely reopen, she has yet to see a reduction in hours.

At the Arrowhead Psychological Clinic, psychologist Dave Plude sees clients from Sandstone in Ely and Brainerd in Grand Marais. For many customers, using video or phone sessions has been a more convenient option in many ways. Plude said that once customers get over the technology learning curve, many people prefer to call from home or their car rather than driving up to four hours round trip for a session. one hour.

“It’s been pretty fun,” he said. “It’s nice to be able to provide good clinical care to people in small towns who may not have had as much access to it in the past.”


Dave Plude (photo courtesy)

Dave Plude (photo courtesy)

The boom in telehealth

Although telehealth has been offered in many clinics for some time now, it has never been used as much as it was during the pandemic. At Arrowhead, Plude said last summer, 80% of their sessions were done by video or phone, and they went 100% virtual last fall during the surge in COVID-19 cases. While many are now returning to the in-person sessions, Plude said many are okay with staying virtual. Some will begin the sessions in person and then switch to telehealth after familiarizing themselves with their therapist.

For family sessions, it’s easier to fit a virtual session into multiple people’s schedules, Plude said, because they don’t have to factor in travel time. Telehealth has also made winter planning easier.

“If your car doesn’t start on a cold winter morning in Minnesota, it might not need to go to therapy,” Plude said.

Erickson said the telehealth visits helped therapists stay in touch with area students when they returned home for breaks. They have even been able to serve customers in northern Wisconsin and the Upper Peninsula of Michigan if licensed in those states.

At Insight, Clabaugh runs therapy groups and support groups that help her meet more clients at a time to reduce the workload. She also said it was a good time for therapists to consider whether a client should meet less frequently to make room for other sessions. She has seen far fewer no-shows than before the pandemic, which is good because clients don’t miss sessions, but that makes it less likely that she can hold a last-minute appointment.

Other downsides to telehealth, Clabaugh said, include the dangers of breaching confidentiality if a customer does not call from a private or secure space. Therapists are unable to intervene if a client is experiencing dissociation or other dangerous situations that could normally be helped in an office.

Plude said that sometimes video sessions are preferred over hidden in-person sessions.

“If you can only see with their eyes, you are missing so much nonverbal communication,” Plude said. “Even people’s smiles or different facial expressions are quite complicated.”

Phone sessions are the least ideal because therapists can’t assess any body language, but sometimes, especially for clients who are less tech savvy, Plude said they can have a big impact on a client’s mental healing. .

U.S. Senators introduced a bill in early May to continue to access telehealth services with Medicare after the pandemic. CONNECT for Health is one of more than 20 bills presented to Congress on the future of telehealth.

But regardless of the specifics of insurance coverage or other future rules related to telehealth therapy services, all three therapists said they plan to continue offering video sessions at their clinics.

“It has reduced so many barriers to care for people and it has offered more flexibility for people to get services, so efforts are underway to be able to maintain some of these changes at the government level,” Plude said.


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