Science
More Californians now get therapy via a video screen or phone than through in-person sessions
More Californians are talking to their therapists through a video screen or by phone than in person, marking a profound shift in how mental healthcare is delivered as record-setting numbers seek help.
While patients and providers say teletherapy is effective and easier to get than in-person services, experts in the field noted that teletherapy often requires a skilled mental health practitioner trained to pick up subtle communication cues.
Almost half of the roughly 4.8 million adults who visited a medical professional for mental health or substance use disorders in 2023 did so exclusively through teletherapy, according to a KFF Health News analysis of the latest data from UCLA’s California Health Interview Survey.
About 24% of adults used a combination of face-to-face and teletherapy in 2023, while roughly 23% got help exclusively in person, according to the survey of about 20,000 California households.
A recent national study of patients in the Department of Veterans Affairs healthcare system found a similar pattern: Fifty-five percent of mental healthcare continued to be provided via telemedicine, a figure that jumped after patients shifted to teletherapy by necessity during the COVID-19 pandemic.
Teletherapy is certainly more convenient, enabling patients to see their therapists from the comfort of home.
“It’s actually really effective,” said Joshua Heitzmann, president of the California Psychological Assn. “I think part of that is that it just allows more comfortability — people are willing to work a little bit more when they’re comfortable.”
Studies back that up: Teletherapy patients report getting better at rates similar to those receiving in-person therapy.
“Research has basically shown that there’s no difference between teletherapy versus in-person therapy — so, basically, as effective as in-person therapy,” said Tao Lin, a researcher at the University of Pennsylvania’s Center for the Treatment and Study of Anxiety, who recently conducted an analysis of several studies comparing teletherapy and face-to-face therapy.
But Lin said it can be difficult for a therapist to see hand motions or read body language during a video call, which could lead to therapists missing nonverbal cues about their patients’ emotional states. Lin’s most recent research, yet to be published, suggests therapy over the telephone “is less effective than video conferences” due to “more loss of information.”
And some people have trouble emotionally connecting with a therapist without seeing them in person, Lin said. Technical difficulties, not uncommon, can also interfere with clients building a therapeutic relationship.
Sacramento resident David Bain relies on teletherapy to treat his depression because mobility issues make it difficult for him to visit a therapist in person.
“It’s almost to the point where I wouldn’t be able to get the service if I wasn’t able to get it through telehealth,” said Bain, executive director of NAMI Sacramento, a nonprofit that provides support and advocacy to people with mental illness.
Bain said that his one-on-one teletherapy sessions have helped, but that he’s had less success with online group therapy. He recently participated in a 10-week dialectical behavior therapy class, but he didn’t get the connection and support he received in past in-person group settings, he said.
“There was probably me and two or three other people that were actually showing ourselves on screen,” he said. “Everyone else had their screens off.”
Teletherapy is increasingly offered through cellphone applications such as BetterHelp and Talkspace. Patients using these applications often pay a subscription fee, which insurance may partly cover, for regular sessions and contact with therapists.
Eunkyung Jo, a researcher at the UC Irvine, co-wrote a study published in 2023 that looked at patient reviews of eight of the most popular teletherapy apps. Many patients expressed satisfaction with their therapists, but the team also uncovered negative patterns.
Some patients did not get the therapy they paid for, often because of technical difficulties. Other patients reported their therapists acted disinterested or unprofessional, a finding Jo said could be tied to the relatively low pay therapists earn on some apps.
And several users mentioned in reviews that their therapist suddenly disappeared from the app without explanation. She said therapists in more traditional “pay-as-you-go” arrangements rarely discontinue treatment without warning.
Nikole Benders-Hadi, chief medical officer of Talkspace, said patients often can use their insurance to get therapy on the platform, at a typical cost of a $10 copay. Separately, Talkspace spokesperson Jeannine Feyen said that salary for therapists has increased since Jo’s study was conducted, and that full-time Talkspace therapists make $65,000 to $90,000 a year.
At BetterHelp, therapists earn up to $91,000 and the average patient rating last year for a live session on the platform was 4.9 out of 5, spokesperson Megan Garner said. A significant majority of patients reported reliable symptom improvement or remission, she said.
The number of Californians visiting a medical professional for mental health issues rose by about 434,000, or 10%, from 2019 to 2023, UCLA data show. It jumped by nearly 2 million, or 69%, from 2009 through 2023.
Even so, the transition from in-person therapy to teletherapy has left some behind.
The UCLA data show that Californians living within 200% of the federal poverty level — for example, a family of four with a household income of about $60,000 or under in 2023 — were less likely to use teletherapy.
The data also show that residents in rural areas, where access to telehealth should provide a boon, weren’t using it as much as residents of urban areas.
For example, about 81% of San Francisco Bay Area residents who visited a medical professional for mental healthcare in 2023 did so either fully or partially via teletherapy. About 62% of residents in the state’s rural, mountainous counties did the same.
Those disparities are suggestive of gaps seen in remote-work patterns: Wealthier, urban Californians are more likely to work from home than lower-income, rural residents. By extension, Californians of greater means have more opportunities to arrange online appointments and may be more comfortable with them.
By comparison, low-income folks tend to go into the office for doctor visits, Heitzmann said.
Lower-income and rural Californians may also lack the reliable internet service necessary for good telehealth. A recent KFF Health News analysis found millions of Americans live in places with doctor shortages and poor internet access.
Lower-income Californians also are more likely to live in tight quarters, making privacy for an intimate therapy session difficult.
Regardless, teletherapy is now dominant. And it’s not just patients who enjoy the convenience. Many therapists have ditched expensive office rents to work from home.
“COVID allowed that,” Heitzmann said. “A lot of folks really just got rid of their offices and were perfectly happy converting their home into some kind of office and doing it all day long.”
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues.
Science
Video: NASA Announces Artemis III Crew
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transcript
transcript
NASA Announces Artemis III Crew
NASA announced the crew of Artemis III mission, which will fly to low-Earth orbit to test rendezvous and docking maneuvers with one or two lunar landers.
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“I am excited to welcome you as the next crew in the Artemis journey to successfully return to the moon — this time to stay.” “I’m honored by the role that I’ve been given. I’m also very humbled by the task in front of us. But first and foremost, I’m grateful.” “So with that, the Artemis II crew, comrade, hands you the baton. You got the controls.” “As you know, we had a significant anomaly at our Launch Complex 36A on May 28. We’ve redoubled our efforts and are moving forward.”
By Alisa Shodiyev Kaff
June 9, 2026
Science
Santa Monica Mountains’ last steelhead trout survived the Palisades fire — and even had babies
Scientists feared the Santa Monica Mountains’ last remaining steelhead trout were dead, smothered by debris flows unleashed by the Palisades fire.
But the endangered fish surprised them: A team of biologists recently spotted 30 of the rare trout — and 21 babies — in Topanga Creek.
“There was a lot of happy dancing in the creek,” said Rosi Dagit, principal conservation biologist for the Resource Conservation District of the Santa Monica Mountains, which works with public and private landowners to conserve natural resources.
That’s because the steelhead here are endangered, at both the state and federal levels. Once, they swam in most streams of the Santa Monicas, but their numbers plummeted amid overfishing and coastal development. Increasingly frequent wildfire has further stressed their habitat. Topanga Creek, a biodiversity hot spot, is home to their last known population in the mountains that stretch from the Hollywood Hills to Point Mugu in Ventura County.
The trout that were spotted, including this one, are part of a distinct Southern California population that’s listed as endangered at the state and federal levels.
(RCDSMM Stream Team)
The California Department of Fish and Wildlife spearheaded a complex mission to rescue trout threatened by the Palisades fire that sparked in January 2025.
Time was of the essence. The fire hadn’t yet been fully contained. But rain was on the way, which would sweep massive amounts of sediment from the denuded hillsides into the water. Fish are often killed this way.
Crews stunned the fish with electricity, scooped them up in buckets, trucked them to a hatchery and ultimately moved them to Arroyo Hondo Creek in Santa Barbara County.
Within days, Topanga Creek was choked with mud. Some assumed the fish left behind were goners.
But in March, the conservation district’s team found four. The following month, when water conditions were clearer, they saw more.
“These fish continue to amaze me,” said Kyle Evans, environmental program manager for the state Department of Fish and Wildlife, who had seen the damage to the creek. “I had seen populations get wiped out in similar situations. So when I heard, I was thrilled.”
Evans surmises the fish that survived were in an area of the creek where less charred material and sediment were swept in.
“These fish likely hunkered down, were hiding under some rocks or places to try to get away from the main concentration of flow,” he said. “And luckily they weren’t buried.”
The ones that were spotted were fairly small, around 6 to 14 inches. Rainbow trout and steelhead trout are the same species, but with different lifestyles. If the fish remain in freshwater, they’ll be considered rainbows. However, they can migrate to the ocean and become steelhead, where they typically grow larger before returning to their natal waters to spawn.
Topanga Creek hasn’t fully recovered from the damage it sustained, but scientists say it’s looking better. Surveys last year were “so depressing,” Dagit said, with very few animals, and stretches that were essentially transformed into flat roads from all the sediment buildup. Some of the riparian canopy burned right down to the creek.
Then came 32 inches of rain over the last nine months, scouring out and moving sediment, creating deeper pools. Dagit said they recently found newt egg masses for the first time in years, as well as a few adult newts and many frogs. Plants that provide cover are starting to recover.
She provided photos comparing certain pools last year and this year, some dramatically transformed. In September 2025, the Shrine Pool could have been an overgrown hiking trail. This April, it was filled with shallow water.
The Shrine Pool in September 2025, left, and the same location in April 2026, right, with RCDSMM’s Isaac Yelchin donning a wetsuit.
(RCDSMM Stream Team)
Topanga Creek is home to another endangered fish, the small but hardy northern tidewater goby, often described as cute. Not long before the trout operation, Dagit led a rescue of hundreds of these fish too. Many were repatriated to the lagoon at the mouth of the creek in a moving ceremony last June.
There’s still the matter of what to do with the trout that were moved to Santa Barbara County last year. Evans would like to bring them home to the Santa Monicas at some point, but isn’t sure if it will happen. On one hand, they could bolster the small, genetically isolated surviving population. On the other, they might inadvertently bring in a disease or bacteria. There is some time to decide. Evans estimates the creek still needs to recover for two to three more years.
For now, the fish are functioning fine in their adopted creek. Experts worried the trauma wrought by the move would disrupt their spawning process, but they had babies that spring. This year, they spawned again.
Science
Pacifica pier cracks, another coastal casualty as seas continue to rise
The Pacifica Municipal Pier was shut down and taped off Thursday after city workers noticed cracks running through the landmark structure and concrete chunks falling into the ocean.
It’s just one of many coastal California structures that have recently crumbled under pressure from a rising and relentless ocean.
Officials from the small, beach city south of San Francisco said the pier was closed due to “cracking, separation, and displacement of the concrete walkway and structural elements.”
It will stay closed while structural engineers asses its safety.
Photos taken by city employees show a wide crack that runs from top to bottom and across the structure as well. Other photos show a large horizontal crack under the foundation of a small restaurant on the pier, the Chit Chat Cafe.
The cafe was also shut down.
This is not the first time the 53-year-old pier has shown signs of stress. In 2021, part of it was shut down after handrails along the edge collapsed. And in 2023, after a series of storms pummeled the Central California coast, damaging parts of the pier, the structure was partially closed for more than year.
Those same storms caused extensive damage in Aptos and Capitola, 70 miles south, where piers and waterfront infrastructure were swept away or damaged.
In 2024, a 150- to 180- foot section of the Santa Cruz wharf was ripped off by powerful waves.
At least 10 of the state’s dozens of coastal public piers were closed for part or all of 2024 due to structural damage sustained in winter storms since 2022. At least five others have longer-term upgrades planned to address structural issues.
“These things are costly to maintain,” said Zach Plopper, senior environmental director at Surfrider. “They are a part of our California coastal culture in many ways, but we’re going to need to reckon with, one, the state that they’re in, and two, the continuous and worsening threats they’re going to experience,”
He said most of the piers were constructed in the early 1900s, and they weren’t built to withstand decades of rough seas, storms and rising sea level.
“With this incoming El Niño, which is forecasted to be significant, and this marine heat wave we’re in the midst of, we’re kind of in uncharted waters as far as what this winter could bring in terms of storms and swells to the California coast, and we’re likely going to see a lot more damage,” he said. “Not just piers, but roads and other coastal infrastructure up and down the state.”
There was no storm in Pacifica earlier this week, so no single event could be blamed for the destruction.
However, a 2025 report from an outside engineering firm, GHD, found that several sections of the pier were in “poor” or “serious” condition, and they recommended closure before anticipated storms or events that could “subject the piles to high winds, swells and large waves.”
The firm found several areas of the pier where concrete was missing and rebar was exposed and corroding.
“The pier has continued to experience high winds and large waves in a harsh marine environment,” the engineers wrote in the report, noting that continuous exposure to seawater or marine spray was “detrimental” to the structure.
A 2023 city report estimated it would cost $19 million to repair.
That same year, a state law was enacted to require local governments along the California coast to plan for sea level rise in the coming decades.
Sea level has risen some 8 inches, on average, along the coast in the past 150 years, Plopper said, and researchers anticipate another foot in the next 25 years.
“We’re going to see profound shifts on our coastline, none that we have ever experienced before, and building static structures on the coast just doesn’t work all that well,” he said. “We’re going to have to make some really hard decisions.”
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