It’s Probably Time to Switch to Telehealth with Your Therapist

Social distancing is becoming a vital aspect of preventing our healthcare system from being overwhelmed during the COVID-19 (Coronavirus) crisis. And on social media, people are edging into the question of whether it’s time to move to online therapy. Online therapy, which goes by the official name telehealth, is when you have a video session with your therapist via your computer or even smartphone. While this may seem like a strange, new idea, for many — especially those with special needs, in remote areas, expats, or people who travel a lot — online therapy plays the same role in their lives as it does for those who visit their therapist in an office. I have been doing online therapy for years with clients in different circumstances and for different reasons, and it has been very effective. But if this is your first time seriously considering the idea, here are some tips to make a smooth transition.

First, your therapist should already be familiar with the process and has hopefully already raised the issue with you. Together, you should prioritize safety, privacy, structure, and comfort. Switching online also takes a little willingness to adjust how you communicate, which can actually be a very healthy challenge for your working relationship.

In terms of safety and privacy, your therapist should be sure to have the address where you will be doing sessions and inform you of your patient rights regarding telehealth. You should have access to a HIPAA compliant (confidential) online video platform. If necessary, you should discuss a plan for how to handle urgent or crisis situations should they come up, such as intense emotions or moods that may require an emergency contact. And you should be sure that you have a good data plan and wifi connection, though still expect some connection glitches or delays to happen now and then and try to handle them with patience.

Just like people who work from home operate best with a routine and structure to their time, you should be sure to devote a space in your home to your sessions. You need to be somewhere that is comfortable and private without interruption. You should be sure that you are presentable (at least from the waist up) because your therapist needs to be able to see you. Most video platforms have a window where you see your therapist and a window where you see yourself. Some people find looking at themselves distracting, but if that’s you, you can move the window so you aren’t visible. If you don’t have a place at home that works, you may consider using a smartphone app and calling from your car. Obviously, you’ll still want to be somewhere private and free of interruptions which won’t be distracting. Some people even take advantage of this option and go somewhere peaceful and calming like the beach. 

Online therapy is definitely a different experience from being with your therapist in the same room. Physical togetherness can provide a level of comfort which you may miss at first. But the online video experience is rich with visual and auditory cues that make us feel closer. Obvious cues like facial expressions and the sound of breathing are very effective, and therapists are trained to look for “microexpressions”, or quick small expressions which may show unconscious feelings. 

When getting used to online therapy, it may help to have some “ice breakers” to make the transition smoother. Have your therapist give you a virtual tour of their office to make you feel more at home. Be direct and share your feelings of awkwardness. You may even open each session with an exercise imagining sitting together. 

Finally, there are many studies stating that online therapy can be just as effective as the in-person experience. It’s called the “talking” cure for a reason. Much of what’s called “therapeutic action” happens in the process of using our words: putting feelings into words for the first time, sharing painful or vulnerable parts of ourselves in words, and hearing words of care and validation for perhaps the first time. I’m sure you’ll discover that, once you start talking, you will soon stop noticing the change of setting and get right back into the therapy you value and want to keep.

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