Do’s and Don’ts of Teletherapy

This year has proven to be a learning experience from the very first day for me. I began pondering the reality of my own business in 2019. It was just a thought at that point. A day dream. I have always staunchly claimed I didn’t have a mind for business and could never see myself in private practice. In fact, I went to a training where while meeting dozens of new faces in the buffet line between sessions, I said the exact same thing when I was asked again and again about why I hadn’t already taken the plunge. I felt like I was on repeat and might have even gotten a bit bristly over their pitying faces, and ‘You’ll learn’ sort of comments. They didn’t believe me. They sagely murmured I’d change my tune, just you wait.

I was affronted! There was nothing that could convince me to change my life and how dare they pretend to know more about me than I did!

Then #2020 happened and here we are.

(Please note, I like to eat my crow with a side of Caesar salad and a baked potato.)

Now I feel like I pulled a Fresh Prince style make over of my life and everything got flipped turned upside down. I’m doing therapy in ways I never predicted, in a setting I never imagined, and having to eat my own words about where I thought I’d be in 5 years, let alone 12 months. Not only am I running my own business, building a practice from scratch, and technically being an entrepreneur, but I’ve also gone from an exclusively in-person practice to entirely online and over the phone.

Anyone else sometimes have to look in the mirror and ask if this is really our life right now?

I’ve traded a basement clinical office for my own home; leather arm chairs for a webcam; my empathy is being translated through a headset and a cellphone. Myself and a nation of other counselors have had to learn some new methods and considerations in a very short time frame. The ethics, the equipment, confidentiality and rapport. How do I build a relationship, how do I practice active listening, how do I mirror someone I can’t even see?

And you! The client! You’re being faced with the same challenges! Your therapist no longer can see you in their office and while that might seem trivial, it can feel like a loss. Where we do therapy can be just as important as how we do it; that comforting cozy couch, the eclectic decorations, that clipboard and mug of tea you’re used to seeing in front of you. Even your counselors smile, or nodding head can bring its own sense of security. It sets the tone, it welcomes you, it becomes familiar. Some therapists have even given up their spaces all together, to manage the financial change. Maybe your therapist is like me, and has shut down their office space for now with plans to re-open soon but with a changed look. 6 feet of distance. No business cards, no blankets and pillows. Art therapists and play therapists needing to cut some critical materials from their toolboxes and creatively find many more that can be easily disinfected in between clients.

Long story short – it’s all different now.

But there’s hope.

Just as I have learned how to navigate therapy in a whole new way, so can you. And actually, there may be even more benefits! (Hear me out!) Therapy can now be even more accessible to you. Any where, any time, in the safety and comfort of your home. No fees for parking, no cost of gas and travel time. I, for one, am more willing to have later appointments at night with teletherapy, since there’s no need to stress about getting home since I’m already there!

But we do still need to acknowledge that teletherapy is a shift, and one that we can do really well, or really poorly (as both client and therapist alike).

I’m going to share with you my top Do’s and Don’ts for Teletherapy, and the tips for getting the most out of your time learning this new way of connecting with your therapist.

DO find a private, calm and quiet place to do your therapy. Seek out a stable spot, where you can avoid interruptions and distractions. Close the door in a bedroom, or an office space. Heck, I’ve had folks answer my calls in their vehicles, parked in the driveway! It might be hard to find this space, but do your best, or talk to your family about setting aside the hour of time that you need.

DON’T have your appointment while you are in a crowded, public, loud, or distracting environment. Try to be away from kids and family if you can. Some people have liked having teletherapy appointments outside in their backyard, but I encourage you to consider how you feel about your privacy, depending on what your property might look like, or how close you are to your neighbours.

DO consider the environment you’re going to be doing your therapeutic work in. Your therapist typically tries to make their space supportive to the tasks of therapy. It is uncluttered, calming, often has symbols of inspiration in it. So feel free to set up a spot for yourself that brings these things to mind. Make it comfortable with blankets and pillows, a cup of tea or water, a favourite smell or diffuser, a favourite chair, paper and a pen. You’d be amazed how much this can help get you into the right mindset for your session. If you’re a fidgeter, like me, consider having something close at hand to keep your hands busy while you listen and talk – like putty, a fidget toy, even a smooth stone (as long as it’s not too distracting). I normally provide these for my clients in my office, so get creative and see what works for you.

DON’T have your appointment in a place that makes you feel more anxious just being there, or just plain doesn’t feel conducive to counseling. If you feel triggered or disturbed by your environment, this might wash over into your therapeutic work and you’ll struggle to find that flow you had with your counselor. Try not to have your appointment with all your to-do lists and the overflowing laundry basket right beside you, or somewhere that you are concerned about others hearing you. Try not to do it someplace with no room to sit or relax. This time is for you, and it is a sacred space so only invite and cultivate the energy you want!

DO set aside time for your appointments. Just because you’re at home doesn’t mean you should have your attention divided! You are paying for this time with your therapist and the work is meaningful. So mark the time on the calendar, and work with your family and support circle to help you make this time stick. Be prepared a few minutes early, settled in your preferred spot. Set a timer on your phone or calendar to remind you that the call is coming. Many therapists offer convenient text or email reminders as well!

DON’T use this time for other tasks or forget to mark the time down. It’s tempting to tidy up, do the dishes, even drive while taking a teletherapy call (or to simply forget it’s happening all together) but for your sake and your safety, please try to avoid this. This time is for you and your mental health, and trying to do that while grocery shopping or visiting with a friend is disrespectful to your needs (and maybe to the therapist too…) Driving while talking on the phone, even hands free, can be even more tricky for therapy and I, myself, will not have a session while someone is driving. Why? Because I worry about them being distracted, being emotional, or even being mobile and I have no accurate way of knowing where they are should they need help. Most teletherapy appointments, your therapist will ask where you are, just to be sure they can send help should the worst happen while on a call.

 

DO have a reliable form of communication, such as your phone, or computer with steady internet connection. If you know you might have struggles with one or the other, be sure to notify your counselor. Take time to experiment with the best spots for reception in your house. Invest in a quality (but not exorbitant) webcam or headphones with a microphone to enhance your privacy and comfort. Some therapists have a particular program they like to use (Zoom, doxy.me, Owl Practice, Theranest) which enables video, so ask them what system requirements may be needed to use them, and have that set up before your next appointment.

DON’T try to use video or internet access when also using a lot of bandwidth elsewhere in the home; some connectivity issues can come up from too many things going on and with lots of streaming services running at once, you might notice your video feed dropping out. Talk to your therapist about best ways to connect. I’ve had plenty who have tried video and found their home networks a bit too patchy, and we’ve switched to different programs or telephone. Don’t suffer in silence. If it’s not working for you, talk to your counselor to see what solutions you can find.

DO give yourself time to prepare for, and end therapy sessions. Although I’m not missing the gas and mileage I would get from driving to and from various appointments, I noticed that I actually used that drive as a way of transitioning to the activity, so a great tip is to still give yourself a window on either side of the appointment to gather your thoughts, jot your notes, or re-center yourself after a session. Even 5-10 minutes before and after your appointment to do a quick breathing exercise or ponder what you learned and write out some notes to yourself can make a big difference.

DON’T jump straight from therapy back into ‘regular life’ as soon as you hang up the phone. This can be a jarring transition and may make it harder for you to parent, work, or socialize with family and friends. It’s a bit like accidentally shocking your fish by throwing them into a new tank of water. Give some time for your feeling to settle, sip some water, reflect or journal and you’ll feel more collected. Or reflect back on what you did during your car ride home in the past, like listening to a podcast or music. Most therapist offer a 50 minute session with 10 minutes set aside to round off the hour with paperwork, so it’s only fair you do the same thing for yourself as well and take that time before heading back to whatever is waiting for you.

Whatever way you do it, teletherapy is proving to be just as effective as in-person, although I’ll always miss being in the same room as my clients. But in the meantime, hopefully some of the above Do’s and Don’ts can help you get the most out of your future appointments!

Are there any other tips and tricks you’ve found helpful when trying teletherapy? I’d love to hear from you! Share your comments below!

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