Teletherapy: From the Eyes of a Therapist
Amy Butler Angell, MA LPC EMDR
When the COVID-19 outbreak began, I’ll be the first to admit that I didn’t know what to anticipate. I think that initially I underestimated the seriousness of the health emergency. Very quickly, though- within days- I found myself in my home office with my laptop in front of me, a blanket on my lap, and silence replacing the typical laughter and conversation of coworkers. Hours passed and I missed the slamming of the front door when clients and colleagues would enter, and the isolation set in for me. The viral outbreak escalated quickly, and I was left with the sadness of knowing that I didn’t even get to give a face-to-face “see you soon” to the clients on my caseload. It could possibly be weeks before we have another face-to-face meeting. To be honest, I felt disappointed and unsure of how the work my clients were doing could possibly progress throughout several weeks of quarantine.
As technology goes, I fall on the bottom end of the spectrum where competence is concerned, so when my supervisor suggested that we would be holding client sessions via the Zoom platform, I was paralyzed with anxiety. I can barely operate my iPhone, much less host a full meeting in an online platform. I reluctantly agreed to give it a shot, and was pleasantly surprised! I found Zoom to be fairly user-friendly, and many of the functions and processes are pretty intuitive. That was a relief. The more I used it and ran test sessions with colleagues, the more stable and secure I felt.
The first time I signed into Zoom to host a therapy session with a client, I was greeted by a rush of relief and excitement. It was SO good to see my client in person, and while I can’t say that it felt “normal”, we quickly settled into the patterns of Zoom sessions. While perhaps teletherapy would not be my preferred mode of completing therapeutic work with clients, it certainly does stand in nicely as an alternative to a large window of time with no contact.
I’ve seen clients do very important work via teletherapy. It takes a leap of faith, I think, because of course there are challenges associated with not being able to see one another’s facial expressions (when on the phone), or with slight delays and glitches (when utilizing an online platform). But for clients who are highly motivated, and for those who are willing to put in the time and consider in advance how they wish to utilize their teletherapy sessions, really amazing things can come out of it!
I won’t deny that there have been hiccups. I quickly learned that my home office is too far away from the router, and as a result some of my sessions have been spotty and with intermittent frozen screens. (I eventually relocated my office to a location in my home closer to the technology.) Fortunately, my clients are highly adaptable and always willing to fall back on phone sessions when necessary. Initially, there was a bit of a growth curve for myself and for my clients, as we learned to navigate a new platform, but many of those hiccups were quickly ironed out with practice and familiarity.
There are a few things to keep in mind, if you are entering into teletherapy with your therapist:
-Be prepared with the address of your location, as your therapist will likely inquire about this in case of emergency.
-Plan ahead to guarantee that you will have privacy for the duration of the call or online session. This is critical to the success of the therapeutic work. Remember that in teletherapy sessions, your therapist can only take so many steps toward protecting your confidentiality. Do your part to guarantee that your privacy is protected by securing a private environment.
-Transparent communication is critical, because your therapist may not be able to pick up on the subtleties of a bouncing knee or fidgeting fingers when you’re on the phone or online. Do your best to share with your therapist when your anxiety may be escalating, or if you’re feeling particularly affected by the content.
-Treat the session just as you would if you were meeting with your therapist face-to-face. Block out the necessary time window on your calendar, dress appropriately, consider the environment around you, and eliminate or reduce distractions that may be present, such as rambunctious pets, social media, disruptive roommates, etc. A general rule of thumb: If you wouldn’t do it/wear it/show it in a face-to-face session, then you probably shouldn’t do it in a teletherapy session.
-As with regular face-to-face therapy, spend some time outside of session preparing thoughts on what you’d like to focus on in the next session. This will allow you to make the most of your online session and to really utilize the time well.
Teletherapy takes a bit of adjustment, but fairly quickly, we can acclimate to the new process. For now, it’s the new normal, and this therapist feels reassured to know that this social distancing does not need to negatively impact the quality of therapeutic work that is done. Growth is possible and healing is possible- and in the midst of uncertain times, those two facts feel soothing and reassuring.
-Amy