Telehealth or Teletherapy refers to therapy sessions that are conducted online through a video call platform such as Zoom, Doxy, or Google Meets (to name just a few).
This method of therapy became the norm during the covid-19 pandemic, when therapy was just one of the many services pushed online to protect public health and safety. While this was a reluctant switch for many therapists and clients, I have been pleasantly surprised by how positive the experience has been. I'm grateful to have the technology to support clients even when we can't see each other in person. While there are certainly drawbacks to not being in the same room, I have also noticed many benefits for clients such as eliminating commute time and transportation problems, feeling more relaxed in their own space, getting to use personal objects as part of therapy, and even having the comfort of their pets during sessions!
Most importantly, I can say that YES, based on the research as well as my own personal experiences, telehealth is just as effective as in-person therapy.
Check out the tips below to help you have the best online sessions!
Top 10 Tips for Successful Telehealth Sessions
1. Have a Strong Internet Connection
The worst frustrations and disruptions that occur during online therapy are due to poor internet connection. Cuts, drops, static, or delays in sound and video are damaging to verbal and nonverbal communication and make it much harder to feel like your therapist is really with you. It's important to have as strong of an internet connection as possible for your sessions. If you are having trouble with your connection, you might try plugging an Ethernet cable directly into your computer rather than using WiFi, or asking other household members to refrain from things like video streaming or downloads during your call. If you choose to use a cell phone for your video calls, try to stay on Wifi as mobile data connections are far less reliable. Some clients enjoy using their cell phone to have sessions outside such as in a park, in which case make sure that you still have enough bars for a quality call. Of course at the end of the day, some of this may be outside of your control. Make a back-up plan with your therapist, such as switching to a voice-only phone call.
2. Get Your Tech
There's no need for any particularly fancy gear to have a good telehealth session - just a few basics! Choose what device is going to be the best for your (desktop, laptop, tablet, cell phone - any will do!) and make sure that it has a working webcam and microphone. Give these a test run before your session. You might want to consider wearing headphones for better sound quality, prevention of feedback, and some extra privacy. Your therapist should also let you know in advance what video call platform you'll be using. Check if you need to download any programs or create any accounts in order to access your session call.
3. Set Your Space
Unlike an in-person office session, you'll need to choose and create your own physical therapy space. Consider where you will feel most comfortable while still having a strong internet connection, low background noise, and where others will not overhear or interrupt you. Ideally, you'll have a quiet, private room with a few things on hand like water and tissues that your therapist would normally provide. If your session might include movement, you'll also want to have some open floor space accessible. However, in reality this is not always possible! Roommates, kids, family members, and work schedules can easily prevent this, and that's ok! I've had very successful therapy sessions with clients while they sit in their car or walk down the sidewalk. If you're having trouble carving out space for your session, get creative and don't hesitate to ask your therapist for suggestions. At the end of the day, the most important thing is that you feel safe where you are having your session. It's vital that you tell your therapist if you have any safety concerns about having an online therapy session.
4. Maximize Use of Your Video
Nonverbal communication including postures, gestures, breath, and facial expressions are hugely important in communication and connection between you and your therapist, and this can be a little bit harder over video call than in person. It's important to get the most out of the visual information we do have. Do your best to angle you camera so that your face is level in the frame (rather than you looking down or up at the camera) and get as much of your body in the frame as you can without being too far away (usually this will mean your face and upper torso are in view). This also makes it easier to experience eye contact, which is one key way we feel connection with each other. Many people may prefer to hide their own video so that they can just see their therapist on screen instead of themselves (for example on Zoom their is an option for "hide self view"). If possible, it's also a good idea to have your device resting on something stable rather than in your lap or in your hand so that you can move freely without jostling the video that your therapist sees. As a therapist, I greatly prefer when clients use a computer rather than a cell phone because it provides a much broader and more stable view.
5. Avoid Distractions
Treat you session just like you would an in-person session and avoid distractions or multitasking. Turn your phone on silent, close unnecessary programs on your computer, and turn off other notifications that might ping on your device. Ask other people in your house not to interrupt you during your meeting. And if your kid or your dog ends up sticking their face in any way, it's ok! This is about intention, not perfection.
6. Protect Your Own Confidentiality and Privacy
It's so important that I'm going to highlight this point already mentioned in #3! While your therapist has a responsibility to use secure video call platforms and maintain privacy and confidentiality on their end, you are also responsible for maintaining privacy and confidentiality on your end. Protect the link your therapist sends you to access your session as well as any accounts or passwords needed to log in. Make sure you have a private space where others will not overhear or interrupt you. If needed, you might consider things like closing windows to the outside or getting a small sound machine to put by your door (there are also free sound machine apps). Depending on your circumstances, you might want to create a code word to signal that someone else has entered the room or that you need to end the call early. If people in your house don't know you're in therapy, make a plan for what you and/or your therapist will say if someone asks who they are. Most importantly, tell your therapist if you have concerns about safety, confidentiality, or privacy during your session. You're not in this alone - you and your counselor can work out a plan together!
7. Your Geographic Location Matters
Often, clients think that telehealth means they can have their therapy session from anywhere on the globe. I wish this were true!! Though we have the technology to connect over long global distances, psychotherapy is regulated differently across countries and between states. In the U.S. your therapist's license and insurance is authorized on a state-by-state level. This means that if you or your therapist go out of state, they can no longer legally have sessions with you. However, it is also true that many states have loosened their restrictions around this due to the covid-19 pandemic. Your ability to have sessions across state lines depends on the laws of BOTH states involved as well as your therapist's own business policies. To work through all this, be sure to tell your therapist ahead of time if you plan to go out of state and understand that you may need to take a break from therapy while you are gone just as you would with in-person sessions.
8. Remember Your Body!
Extra time with technology can often mean extra disconnect from our bodies - exactly what we don't want in our therapy sessions! Here are some simple things you can do to counter this and stay embodied while on the screen:
9. Create an After-Therapy Ritual
For me, ending video calls has always felt a little abrupt. We lack the physicality of walking or driving to and from a location, opening and closing doors, putting on a jacket, using our wallets and keys, even waving goodbye or seeing the other person moving away. All of these little actions signal transition to our bodies and minds. As a substitute, I have found it helpful to create a little transition time after therapy sessions. I recommend taking at least 5 minutes after your session for a small closing ritual. Choose anything that feels good for you and repeat it every time. Here are a few suggestions:
10. Communicate with Your Therapist!
Lastly, you might have noticed a theme in some of these - communicate with your therapist! Let them know how telehealth is going for you. Talk about any issues or concerns you have with any of the above tips or with online therapy in general. Ask them for help finding the privacy you want for sessions! Tell them if you love meeting online! Tell them if you hate it! Your therapist is there to support you, and I guarantee they want to know. Actually, this is true all the time, not only with online therapy! Honest, open, and consistent communication between you and your therapist is foundational to a good relationship and successful therapy.
As a somatic counselor and dance/movement therapist, I offer online therapy sessions to people in Colorado. If you're looking for support that's not dependent on location, commute, weather, or health concerns, I am here for you! Please reach out for a free consultation.