Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy

Dr. Hannah Zeavin: Deep Thoughts on Teletherapy


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At the beginning of the COVID-19 pandemic, thousands of psychotherapists were forced to migrate their practice to teletherapy or secure video.  While many have embraced this new mode of practice and have even found enhancements to their delivery of therapy, others are eager to return to the office or adopt a hybrid model.  Dr. Hannah Zeavin, author of the The Distance Cure: A History Teletherapy, joins us for a conversation around the history of teletherapy as well as systems-level implications for the wide adoption of teletherapy. In this conversation we cover:     

  • the biggest misconceptions that psychotherapists are likely to labouring under with respect to the history and deployment of teletherapy
  • a discussion of the reality of every therapeutic exchange - whether virtual, in the office or otherwise - being mediated in some respect and existing within a "frame"
  • the evidence-base around teletherapy
  • 3rd party payers stance towards teletherapy and whether a distinction between in-office therapy and teletherapy remains relevant
  • the dysfunctional focus on "activities" vs "outcomes" in an insurance-driven mental health system and how teletherapy could unwittingly accentuate this dynamic
  • consideration of therapy-process related factors in the context of teletherapy (e.g., client seeing the clinician within their home environment & vice versa)
  • implications of the the appification/commodification of mental health services via digital platforms
  • the dangers of "batch processing" and "gamification" in the provision of therapy within a commodified mental health system
  • the potential for the digital distribution of services to create “winner takes all” outcomes and the danger of a cost leader further commodifying mental health via call-center models or similar
  • Potential unintended consequences of national licensure around the commodification of mental health services 
  • Dr. Zeavin's thoughts on the questions clinicians and practices should be grappling with right now in the context of tele therapy

Hannah Zeavin is a Lecturer in the Departments of English and History at the University of California, Berkeley and is on the Executive Committee of the University of California at Berkeley Center for Science, Technology, Medicine, and Society and on the Executive Committee of the Berkeley Center for New Media. Additionally, she is a visiting fellow at the Columbia University Center for the Study of Social Difference. Dr. Zeavin’s first book, The Distance Cure: A History of Teletherapy is now out from MIT Press, with a Foreword by John Durham Peters. She is at work on her second book, Mother’s Little Helpers: Technology in the American Family (MIT Press, 2023).  Dr. Zeavin serves as an Editorial Associate for The Journal of the American Psychoanalytic Association and is a co-founder of The STS Futures Initiative. Other work has appeared in or is forthcoming from American Imago, differences: A Journal of Feminist Cultural Studies, The Guardian, The Los Angeles Review of Books, Real Life Magazine, Slate, The Washington Post, Logic Magazine, and beyond. Dr. Zeavin received her B.A. from Yale University in 2012 and her Ph.D. from the Department of Media, Culture, and Communication

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Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural TherapyBy Dr. Pete Kelly

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