What will online therapy be like? A guide for clients who are starting to see their therapists online.
COVID-19 has changed our lives. One of the many things it’s changed is how we attend our therapy sessions. Gone (temporarily) are our weekly trips to our therapist’s office, replaced instead with a new method of communication: Video call, voice call, instant messaging, text or email.
For many, this transition can feel anything from odd to really damn scary. I keep hearing questions such as will it feel the same? Will our relationship change? How will I manage this new way of connecting? What if I can’t manage the technology? Mostly, the question I get is: Please can you give me tips on how to manage this transition? This article is therefore a response to this.
In terms of your relationship with your therapist, yes it will be different. They won’t be within arms reach and won’t be able to pass you a box of tissues when the tears arise. However, they will still be there. The will still be there for you, listening to or reading your every word. They will still be holding you in mind in the exact same way that they did before.
I see all of my clients online now, and my own therapist online too, and I feel deeply connected to everyone I work with. There is something special about working on video, call or instant message and that is that the noise is cut out. By noise I mean the other things happening in the room. Your sole focus is the screen in front of you or the receiver in your ear. Also, seeing your therapist from your own home may lead you to feel more relaxed than when attending a clinic and this really helps with the relationship and the work you do in sessions.
For people who do not feel safe at home or wherever they are, therapists offices can represent safe places. A place of calm. If this is you I am really sorry that this is happening for you and that you have temporarily lost that space. I hope that your therapist can help you create a feeling of calm for you wherever you are even though you cannot visit them.
Tips for starting online therapy
How can we make the transition online easier? By preparing. Here are my tips:
Before your meeting:
Write down your concerns and any questions you have about the new way of working: If you are concerned about whether you are tech-savvy enough for this new way of working, or what you will do if the internet or your phone doesn’t work at some point add that here too. When you see your therapist ask them these questions.
Tell your therapist if you think you will have any privacy issues during your meetings: To ensure confidentiality therapists ask clients to be in a quiet place where no-one will interrupt. COVID-19 and current lock down means a lot of people do not have the luxury of a quiet, private space. If this is you let your therapist know and they can offer to speak to you over instant messenger rather than voice or video. This way you will know that no-one else will hear what you are talking about.
Download the software you will use for the session onto your phone or laptop in advance: Having this already downloaded means you won’t have to rush when it is time to meet your therapist. Consider using headphones to increase privacy and cut out background noise if you are going to be talking.
Decide on the place you will see your therapist: If you can, find a cozy, warm part of your home (or wherever you are) and try to see your therapist from this same space each week. Maybe put some soothing items in this place just before each session, such as a candle, essential oils and a box of tissues. Over time this place will start to feel like a safe place. Do not worry if this is not an option for you. Wherever you meet will be ok.
Set your computer or phone up: If you are seeing your therapist over video link put your laptop, computer, phone or other device on a stack of books so that it will be high enough for the camera to be in line with your eyes. Place the device about an arms distance from you and you should be in a good position for the call. You can play with this in the session.
Just before the meeting:
Get into your comfortable clothes, get a drink and a pen and paper. This way you can take notes if something comes up that you wish to remember.
Stop doing anything non-therapy related 5 minutes before your session: Take 5 minutes before the therapy session starts to breathe, stretch or do anything that helps you leave behind your to-do list and get you into the mindset of the session ahead. If you are feeling nervous do a breathing or a grounding exercise (click on the words for instructions on how to do these exercises).
During the session:
Take it slowly: Research shows that meeting our therapist online makes us feel less inhibited. We are quicker to share intimate information than we would be offline. To ensure that you share at a pace that feels comfortable to you, take the session slowly, breathe and don’t be afraid to pause or allow silences to arise.
Ask how to hide your picture: If you are speaking to your therapist over video link and you feel distracted by being able to see your own face on the screen you can hide this. Ask your therapist how to do this.
Ask the questions you have about working online including what you will do to ensure you are safe and if the internet or other stops working.
Ask your therapist to show you how the technology works.
Pause and breathe if the video freezes or the audio cuts out: If something happens such as the call goes quiet, or the video freezes, its ok. It will pass or you will be able to switch to the plan your therapist gave you at the beginning. Focus on your breath or something else grounding.
After the session:
Take 5 minutes before you do anything else: Again, no travel time means it can be tempting to text, check your emails or switch immediately back to other tasks. Take 5 minutes to pause, to let the therapy session sink in. If you have a candle it can be nice to light it near the end of the session and then keep it burning for 5 minutes afterwards so that you keep the feeling of the session present.
Carry on with your day :)
That’s all!
Online therapy will feel different to meeting your therapist in an office. That is ok. It is ok to be worried about it and it is ok to speak to your therapist about this too. After your first session check in with your therapist about how you feel it went. After a few sessions it will start to become your new normal and you never know, you may never want to go back to meeting in an office again!
I wish you the best of luck during these uncertain times and I hope that you and your therapist continue to have a supportive and effective relationship.
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I am a Clinical Psychologist trying to get effective psychological advice out of the therapy room and into everyday life.
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