It’s the year 2068 and a client is seeking therapy. What will this process look like? What will psychotherapy look like? Will it be completely unrecognizable? As I reflect on the future of psychotherapy, I feel simultaneously exhilarated and terrified about the future of our field. Will people continue to seek therapy through internet research, word of mouth, and referrals from other professionals? Or will there be some new technological database or app that we cannot even yet imagine that will promise to match clients with their perfect therapist by swiping left or right?

I have many high hopes regarding where psychotherapy will be in in 50 years. My hope for the future is that our field will continue to advance in research and advocacy around equity and inclusion … that we can increase the efficacy of treatment and reduce premature dropout rates of marginalized populations … that the therapists available to treat truly represent and look like the people who could benefit from treatment … that therapy is widely available, accessible, and affordable for everyone … that the stigma around mental health continues to dissipate and that people talk openly and with pride about the therapy they are seeking.

While hopes of the future fill me with excitement, I have to admit that I also have a good amount of fear and dread related to what could happen. In my private practice, I highly value sitting directly across from my clients, putting away our phones and devices, and creating in-the-room human connections. When I’m engaged in video or telephone psychotherapy sessions, I often feel that some important factor is missing. I miss the in-person interactions that make me feel more connected to my clients. I also notice that my ability to feel and demonstrate accurate empathy decreases a bit when I’m not seated directly in front of my clients. And yet, as I reflect on telehealth, I am painfully aware of the convenience, increased accessibility, and new opportunities for care that it offers our clients.

I acknowledge that we have entered a time period in which our interpersonal relationships have shifted due to the intimate relationships we have created with the small devices we constantly have next to us. We have become enmeshed with these devices to the point that it has become anxiety provoking to be without them, even in private spaces like the bathroom. On one hand, these devices have afforded us increased interpersonal connections, in that the physical space between us and our loved ones feels less threatening when we can FaceTime and text at any hour of the day. Paradoxically, the same technology that reduces geographical distance from loved ones creates emotional distance and disconnection in in-person interactions. How often have we felt ignored or triangulated by our friends’ or our partners’ phones?

I think this use of technology has become, and will continue to be, our new normal—and of course that will affect the way in which we conduct psychotherapy sessions. My greatest fear is that technology will continue to progress and that clients will end up with robot therapists that are programmed to say the perfect empathic statements but who will be poor substitutes for interpersonal connections. Or that perhaps scientists will create some Black Mirror-esque implant for the brain, rendering people happy and well-adjusted all the time so that psychotherapy becomes irrelevant and outdated. My hope is that we can find ways to remain current with the changing times; to both utilize the convenience and benefits of telehealth while continuing to value our unique ability to connect so deeply with our clients.

In 1968, could any psychotherapists have predicted what our field would look like in the year 2018? Would the changes that have been made related to empirically validated treatments, changes in best practices, ethics, and technology in these past 50 years feel futuristic, unfamiliar, and unfathomable? Or is psychotherapy really that different at all? Do the common factors related to the importance of the therapeutic relationship and the basic tenants of what is helpful in the treatment room still stand strong? And will they continue to do so 50 years in the future?

Contributors to Psychotherapy Bulletin will be exploring these questions over the course of the next year—we would love to hear your thoughts, as well. Feel free to comment on this piece or submit an article for the Bulletin at: https://sapwebsite.wufoo.com/forms/psychotherapy-bulletin-sap-author-submission-form/

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Cara Jacobson, Psy.D.