If you’re working in the mental health field, you don’t need us to tell you that COVID-19 has wreaked havoc on people’s mental health. In fact, it’s pretty obvious even if you’re not a counsellor, therapist, or psychologist. 

It’s hardly surprising that anxiety, depression, and obsessive disorders are on the rise. Many people have lost their regular routine, spent months alone at home, and been deprived of human touch. Demand for mental health services is likely to shoot upwards in 2021. 

Here are 5 types of therapy that are already popular, and probably going to draw even more attention and earn an expanded audience this year.

Trend #1: Remote EMDR therapy

EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a type of therapy that’s designed to reduce post-trauma distress. 

What’s the hype?

EMDR is unusual because it doesn’t involve talk therapy. Instead, patients revisit a distressing event or experience while moving their eyes to follow the movement of the therapist’s hand. Sometimes, instead of eye movements, the therapist could use hand tapping or auditory stimulus. 

EMDR works a lot faster than traditional psychotherapy, with even one session making a noticeable difference. A study funded by Kaiser Permanente found that after six 50-minute sessions, 100% of single-trauma survivors and 80% of multi-trauma survivors no longer had PTSD. A number of other studies also found that EMDR was effective for reducing post-traumatic distress. 

EMDR has been recognized by the American Psychiatric Association (APA), the World Health Organization, and the Department of Veteran Affairs. 

Remote EMDR (or rEMDR) is very new, but therapists have found that video conferencing platforms are pretty effective. It’s important to use one that’s secure so that you’re not violating HIPAA requirements. 

There are dedicated platforms for therapists to use for rEMDR, and tech solutions that let you use colored, moving lights to direct the patient’s eye movements. 

Who’s it for?

The APA conditionally recommends EMDR for people with PTSD, and the Department for Veteran Affairs also recommends it for military and non-military PTSD. 

It’s also often used to treat:

  • Panic attacks
  • Addiction
  • Anxiety disorders
  • Eating disorders

How does it work?

The jury’s still out about how EMDR actually works. The theory is that your mind can heal naturally, just like your body, as long as there’s nothing blocking it from processing events completely. 

According to this theory, EMDR removes the blocks that stop you from processing upsetting experiences since it changes the way your brain stores a memory. EMDR includes Adaptive Information Processing which speeds up the reprocessing of your memory. 

Some psychotherapists think that EMDR works in a similar way to exposure therapy, because the patient revisits distressing events and redirects their emotional reaction to them. Returning to traumatic issues while focusing on something else helps create new associations that override the previous triggers. 

EMDR is an 8-phase therapy, with each session lasting 60-90 minutes. It’s usually given once or twice a week, for 6-12 sessions. 

Who can benefit?

EMDR can help people with anxiety, panic disorders, or PTSD, who don’t want to spend months or years in talk therapy. It’s well suited for remote therapy during a pandemic, when people really need to see results quickly and can’t wait for an in-person appointment. 

What do the skeptics say?

A lot of people are skeptical about EMDR, especially because no one can definitively explain how or why it works. It’s not based on scientific research, but rather on the experiences of one woman walking through the woods. She went on to develop EMDR. 

Many psychotherapists accuse EMDR of being a shallow and superficial approach to psychotherapy. They feel that EMDR triggers traumatic memories in patients without actually resolving them, so it just causes more mental suffering. The jury is still out on this one.

Trend #2: Remote neurofeedback therapy

Neurofeedback, or EEG biofeedback, isn’t exactly an orthodox form of therapy, but it’s nevertheless hailed as one of the most effective biohacks for treating neurological disorders like depression, anxiety, ADHD, autism, and brain injuries. It’s been around for several decades in one form or another. 

What’s the hype?

The logic behind neurofeedback seems almost futuristic: patients get hooked up to a computer program through sensors attached to their scalp. The sensors track their brainwave activity and send it to the program, which then produces audio or visual signals. 

It’s like playing a video game, but using only your brain. The program shows instant positive or negative feedback about what the patient is thinking or how they are reacting, to train the patient to change modes of thought. Patients learn how to control their brain function, concentrate better, and avoid destructive mental loops. 

With celebrities like Tony RobbinsKerri Walsh-Jennings and Chris Kaman swearing by the tech, the neurofeedback industry has been booming in the last few years. Startup companies like Myndlift are developing ways to connect patients with neurofeedback practitioners for remote home-assisted sessions. 

Who’s it for?

Neurofeedback is very popular among parents of children with ADHD, autism and other neurological disabilities. It’s also often used for:

  • Sleep disorders and insomnia
  • Anxiety disorders
  • Depression
  • Chronic pain
  • PTSD
  • Traumatic brain injury (TBI)

How does it work?

Neurofeedback therapy works by training the patient’s thought processes in a similar way to rehabilitating someone’s physical movements. The repeated sessions teach the brain to avoid negative thought patterns and apply positive ones, so that the patient learns how to manage their brain frequencies… themselves. 

Who can benefit?

Fans of neurofeedback say that everyone can benefit. The treatment is non-invasive, safe for children, doesn’t require patients to talk about painful experiences, and improvements can be seen fairly quickly. 

Neurofeedback can be a focused, cost-effective therapy for people who are looking for quick relief for anxiety or depression related symptoms. It’s also used to improve concentration and focus for people with ADD.

What do the skeptics say?

There are very few studies proving the conclusive effectiveness of neurofeedback, and those that exist are small and/or don’t meet scientific standards for a double-blind, randomized trial. 

Opponents say that the improvements people make don’t last very long, and point out how much time it consumes to gradually change people’s thought patterns. 

Trend #3: Remote couples therapy

Couples are spending a lot more time together at home. Tempers are fraying, anxiety is high, patience is low, and there isn’t always the option of storming out until you feel calm enough to hold a reasonable discussion. This combination, especially in the face of the economic hardship that so many are facing this year, equals a perfect recipe for relationship issues. 

Therapists who can’t offer in-person couples counselling are running remote couples therapy instead.  

What’s the hype?

Essentially, couples’ therapy is like other types of talk therapy. Each person gets a chance to share their needs, resentments, and concerns. 

Remote couples’ therapy operates pretty much the same way. Typically, remote sessions are carried out through online scheduling and video conferencing software, so that everyone can see each other’s body language as well as hearing them speak. 

Therapists suggest that running couples’ therapy remotely can help clients feel more comfortable opening up, because they’re in a safe space in their own home. It’s also a lot easier to make time for a session when you don’t have to travel anywhere. 

Some people think that practicing communication skills from home helps people transfer them more easily to real life situations, because the whole therapy session is taking place in their normal residence instead of in an artificial-feeling environment. 

Who’s it for?

Couples’ therapy is great for couples who are seeing a lot of conflict, crisis, or anger in their relationship, and potentially an ideal solution during a period of lockdown or quarantine. 

How does it work?

Remote couples’ therapy gives people a safe space to investigate their patterns of behavior and become more conscious of the consequences of their actions. 

Meanwhile, the therapist facilitates the sessions by asking questions, helping each partner explore and articulate what’s really bothering them, and ensuring that things don’t escalate into a(nother) shouting match. 

It does require that both partners be honest and forthcoming about their emotions, and to listen openly to the other person’s feedback. 

Who can benefit?

Couples’ therapy isn’t just for couples. It’s a kind of relationship counseling that can also be good for parents struggling through their relationship with their children. 

What do the skeptics say?

Traditional relationship counseling relies on face to face interaction, so that the therapist can see and interpret the body language of each client and observe how they react toward each other. That’s pretty difficult to do remotely, even if you’re using a super-clear Zoom connection, because you can’t easily see the entire person. 

When couples are participating in remote therapy from home, they’re also a lot more likely to be distracted. 

Sometimes, taking people outside of their regular space to a completely neutral location can also help to defuse the tension between them and open them to seeing things from the other person’s point of view. That can’t happen with remote counseling, so there are both pros and cons to this option.

Trend #4: Remote addiction counseling

The stresses of a global pandemic, financial woes, and being stuck at home with one’s family 24/7 have elevated drug and alcohol consumption. We all might joke about how the pandemic has been great for wine sellers, but some people have developed serious addictions during 2020. 

Then there are others who were in the middle of treatment for serious addiction when the pandemic hit, and they had to stop attending their therapy sessions. Enter remote addiction therapy. 

What’s the hype?

Remote addiction therapy is often less threatening for the patient, especially for someone who’s just beginning treatment. They may experience less shame when they can hide behind a screen. 

It’s also a lot easier to make it to a telehealth session than an in-person session. The client doesn’t have to travel anywhere, or even change out of their pajamas. 

Some therapists see benefits in carrying out a therapy session when someone’s within their own home. The patient can potentially feel more comfortable opening up about their weaknesses. It also helps them transfer their new skills to their real life, because they’re learning those new competencies from home. 

Who’s it for?

Remote addiction therapy is recommended for anyone who’s showing signs of addiction. Although that’s usually addiction to alcohol or drugs, it can also be recommended for eating disorders, self-harm, impulsive shopping, and OCD disorders. 

How does it work?

For people to overcome their addiction, they need to understand what drove them to become addicted in the first place. Addiction therapy helps people recognize that their addiction isn’t just about the specific substance.  

Addiction therapy helps people spot which situations can push them back to addictive behaviors, and help them work out alternative ways to deal with stress rather than regressing.

The “category” of addiction therapy isn’t limited to one single type of therapy. Therapists use different methods of treatment, like CBT, talk therapy, group therapy, motivation therapy, etc. and that’s the case for remote addiction therapy too.

If you’re delivering remote addiction therapy, you’ll find it’s pretty similar to in-person treatment. You can run individual or group sessions, and ask the same questions you would in person. 

Many addiction therapy programs require the client to attend regular drug testing to check that they’re still working at staying clean. That can be tricky for remote therapy, but therapists can coordinate with local labs that are close to the client’s home to carry out drug screening.

Who can benefit?

Remote addiction therapy can be a resource for anyone who wants to keep up the progress they’ve made in defeating their addiction. This is especially true during a pandemic, because the extra stress can push a vulnerable patient back to their addictive behaviors. 

It’s also appropriate for new addicts, like people who realize that their pandemic drinking has perhaps gone too far. 

What do the skeptics say?

Actually, there’s pretty widespread support for both in-person and remote addiction therapy. Some people feel that addiction therapy can really only be done properly when it’s in person, but even they’ll agree that remote therapy is better than nothing. Many alcohol and drug addicts are also classified as medically high risk, which makes it even more important for them to avoid in-person interactions right now. 

The only real complaint is that some addicts need an inpatient program. They can’t defeat their addiction if they’re still at home, in the same environment that drove them to get addicted in the first place. It’s not easy for remote treatment to overcome that challenge. 

Trend #5: The “Open Dialogue” intervention

Open dialogue is a new development in the world of therapy. It was created in Western Lapland (it’s part of Finland, in case you were wondering, and it claims to be the true home of Santa Claus), and then adopted in other countries too that were impressed by its success. 

What’s the hype?

Open dialogue rests on using shared, open discussions (that’s the ‘dialogue’ part) between the patient and the therapist. One of the ways that it stands out from other types of therapy is that it involves everybody who has a relationship with the patient. 

It was developed to treat schizophrenia and psychosis. Open dialogue takes the approach that psychotic events don’t just happen within a person, but they are triggered by what happens between people. That’s why the method brings together everyone involved in the patient’s care. 

Therapists take an active part, letting go of their clinical approach and trying to take part in free flowing conversation. The aim is to help the patient find their own voice and stop feeling isolated within their mind. 

There aren’t many scientific studies into the effects of open dialogue, but those that exist have been positive. A 5-year Finnish study found that 81% of participants had no psychotic symptoms and 81% returned to full employment, thanks to open dialogue. Only 35% needed antipsychotic drugs, unlike in the UK and US where everyone who has a psychotic episode is given antipsychotics. 

Who’s it for?

Open dialogue is for anyone who experiences schizophrenia or psychosis. 

How does it work?

Although open dialogue is new, it’s based on established models, like family therapy, dialogical therapy, and social constructionism.  

Open dialogue relies on a quick response. It requires that therapists begin treatment within 24 hours. It also understands that psychosis doesn’t occur in a vacuum — it’s based on the relationships around the patient. That’s why the therapy has to include everyone involved in the patient’s care, including their family, social support workers, physicians, etc. Open dialogue responds to the whole patient, rather than just fixing symptoms.

The principles include accepting uncertainty in an open dialogue, instead of goal-oriented counseling, and having the therapist talk with the patient instead of about the patient. Therapists aim to help the patient develop new language for their psychotic experiences. 

Because it needs participation from a large number of people and demands a fast response, remote tools like video conferencing can be a big help. It’s a lot easier to gather an entire team remotely than to wait for them to travel to the same office or treatment room, and they are more likely to be able to make time for it if they don’t have to go anywhere. 

Who can benefit?

Although open dialogue was established for schizophrenia and psychotic experiences, it’s also been found to be helpful for anyone with extreme mental health issues. 

What do the skeptics say?

Although open dialogue has proved pretty successful in Western Lapland, it’s not been run on a large scale anywhere else. It’s a very time-consuming, intensive type of therapy that might not be practical for all therapists and all patients.

Skeptics also points out that so far, all the scientific studies have been too small, not transparent enough, and/or potentially biased. There are a lot of new types of therapy, but it costs a lot to investigate them all. Funding real study into open dialogue might mean taking money away from other types of therapy that have already been proven to work. 

It’s a Wrap!

So there you have it. Five popular, up-and-coming types of therapy that can be carried out remotely, so that your mental health services can carry on without a hitch throughout 2021. 

An earlier version of this article was published on the vcita blog.