This post was written by Courtney L. Washington, PsyD, CSAYC, HSPP, psychologist, Park Center, Parkview Behavioral Health Institute.

The only thing that seems to be consistent with living through a global pandemic is its impact on our lives and routines. Even spaces that feel sacred and special have been affected by safety precautions and restrictions. While these measures are necessary, they also feel disruptive to our process. Even though change is hard, we are resilient and remarkable beings. We can be thankful that technology gives us access to services that would otherwise be unobtainable. The use of technology for therapy and other mental health services is a privilege I strive to have gratitude for and utilize. 

I share in this experience of disruption from both sides of “the couch,” being a practicing clinician and a client actively involved in her own growth and work. As numbers of COVID-19 cases rise, so too do many people’s mental health concerns. For many, the idea of going to therapy is intimidating under typical circumstances. So, what do we do when it seems the only option is to engage in this vulnerable process through a screen? Does it work? How will I connect with my therapist? These are reasonable questions when considering engaging in services during this odd and unprecedented time. So, let’s explore what can you can expect from telehealth.

What is teletherapy?

Teletherapy is the administration of individual, family and group therapy through the use of technology. Therapy sessions are done via video using a variety of platforms or via audio through the telephone. Each medium offers benefits and drawbacks that are important to examine. Some of the positives of both mediums include convenience, relative ease with accessing care and the ability to connect despite barriers. Now, let’s take a closer look at each medium plus some additional aspects you might need to consider:

• Phone: Many people prefer using the phone because it is familiar, and they are comfortable conversing this way. However, when speaking on the phone, we often lose all non-verbal information provided through exchanges. At times, this can make interactions seem disconnected. For this reason, I often find myself checking in verbally with clients more frequently to solicit feedback.
• Video sessions: These sessions are the closest we can get to sitting in the same room with a person. As such, we receive more non-verbal feedback with the possibility of a more significant connection as the brain registers facial cues, body movements and silences in a similar manner. Despite this benefit, communication gaps may still be present, and the transmission of palpable feelings from one person to another can be less impactful. Additionally, one of the more challenging aspects of video sessions is the delay that often occurs. While this can be difficult and may feel like the client and therapist are disjointed, it is possible to find a productive flow in each session. For this reason, rapport with the therapist is imperative, as this relationship helps to establish the rhythm that works best for you.
• Additional aspects to consider with telehealth mediums: In addition to the audio and video aspects, you might also need to consider the physical space you have available, concerns with access to reliable internet and comfortability with sharing over the web. This window into a client’s world can offer helpful information and deepen clinical understanding for the therapist. Being at home may be productive in executing interventions and being able to apply the discussion in the “here and now.” However, video sessions can be particularly challenging for those with struggles related to body image or sense of self. Seeing their reflection may be distracting. Lastly, and maybe most important, is the ability to have a space to conduct your session. Therapy is challenging and vulnerable. It is vital to ensure you have sessions in a manner that allows for safety and privacy.

How to decide which forum is right for me?

Ideally, this discussion will occur with your therapist. It is essential to explore the advantages and disadvantages that each medium provides openly. It could be helpful to try each one, see which feels most comfortable and is the most conducive to your work. You know yourself best and what makes you feel comfortable. Choose the avenue that is the most productive for you. Also, don’t hesitate to speak openly and ask questions with your therapist.

While the medium may be different, patient privacy and confidentiality are still of the utmost importance. The therapist should continue to work diligently to follow HIPPA guidelines. They should ensure a private space free of distractions or other individuals to protect your privacy. Ideally, they will be transparent in confirming this with you at the onset of each session.

Additionally, the relationship remains the most critical factor in producing therapeutic change, but the research does support the efficacy of teletherapy. When considering this medium, keep in mind that the connection may be more challenging, but at the end of the day, your therapist is human and is doing their best, just like you.

With that said, it’s also important to acknowledge that if it isn’t a good fit, that’s okay. Don’t be afraid to try someone new. Don’t give up. Finding someone who works well with you is the key to a successful and productive therapeutic relationship regardless of the medium.

Tips for a successful teletherapy session

There are a few strategies that will help you make the most of your teletherapy experience. If you have a meeting coming up, try utilizing a few of these tactics to capitalize on your session fully:

• Place the appointment on your calendar.
• Discuss the plan ahead of time with your provider.
• Find a private, safe and comfortable space for your session.
• Make sure you have the meeting link or phone number handy.
• Try to arrive early, in case there is a check-in process or a software download.
• Be sure to bring a notebook, something to fidget with for comfort if needed and a drink.
• Try to block off a few minutes before and after a meeting to get into the right “headspace” and recover from an emotional session.
• Remember, telehealth may not feel the same or seem gratifying if you usually thrive on body language and eye contact.
• If you are utilizing video, try to take longer pauses to account for any video delay.
• If you are using the phone, make attempts to share more verbally if you are struggling or don’t understand.
• Before a session, consider asking yourself if others can hear you. If you are okay with the medium and are in a safe space to discuss difficult topics and process challenging subjects.
• Don’t forget to check-in with yourself and engage in self-care after each session.
• Remember to be patient and give each other grace.

Final thoughts

Therapy is important and challenging work that everyone can benefit from, especially during this trying time. It’s important to remember, regardless of what you are dealing with, you do not have to go through it alone. Living through a global pandemic has led to an increase in mental health concerns for many people. It is okay not to be okay, and as we move into a long, dark winter, things may feel more challenging and more isolating. Remember, the night is darkest before the dawn. It is the resiliency of the human spirit and intentional effort to do our best that will carry us through. We are stronger together.

Please, don’t be afraid to reach out for help or connection if needed. Call the Parkview Behavioral Health HelpLine anytime at 260-471-9440 or 800-284-8439. This free service is staffed 24 hours a day with experienced specialists who can guide you to the most appropriate care and resources for your situation.

Trusted resources

If you or someone you care about is thinking of self-harm, please reach out to one of these trusted resources:

Look Up
Call 800-284-8439

Text LOOKUP to 494949

National Suicide Prevention Lifeline
Call 988