“My psychoanalyst told me he’s going to be on telehealth effective immediately given the shelter-in-place mandate. There’s no warning and he says the analytic frame is not as effective when using the phone. He says video is a more effective medium since we can at least look at each other although actual eye contact is impossible.  What can I best do to prepare as the idea of a hiatus from the work at this time is not an option I care to entertain.”

This is the story of psychotherapy patients across the globe as the pandemic has made its way from Asia and Europe to the rest of the world and to here, the US, a place where psychotherapy is part of everyday life for many.

And many have adapted. A large portion of in-office clients have continued their sessions via a screen or perhaps a phone. In fact, there are new faces showing up daily who are jumping into cyberspace for a crack at fixing their dysfunctional relationships and emotional ailings in a world of social distancing and quarantining. And still, some, who prefer to not navigate the world of human relationships, are doing better in forced isolation and house arrest.

That said, at the start of this process I thought long and hard about the transition. Well not long since it wasn’t exactly a slow shift into working with a firewall. I just sort of did it as it had to be done.  A relative novice to zoom, it was not challenging to figure out how to send invites and navigate between computer sound and headphones (for a slight bit of daytime variation). But as there is about a month under all of our belts I thought it a wise idea to assess that which might assist clients in adapting to this process of working in the world of online therapy.

If you are new to this or are continuing to adapt this process for yourself the following pointers might help. I sent them via email to my ongoing clients this morning as part of a slightly longer email. Needless to say, they were met with some humor but those that noted also were mindful of their behavior; I hope it is helpful to you.

How to Show up to Online Counseling

Now that we are well within the Covid-19 shelter-in-place environment, I wanted to touch base with each one of you regarding the use of telehealth options.

Based on our experience with telehealth and tele-analysis during the last few weeks, I have noticed some things that might help both of us. Please remember the following as they will help with our session and as best as we can to recreate the frame of the office in the world of online therapy. These will help you get the most out of your work with me on zoom, facetime or phone.

Plan your best for privacy and in an environment that re-creates the office as best. That is, it is not recommended that you lie in bed for example or while you are having a meal. I’m fortunate to have a space with a room and bathroom (and now microwave) within which to work and mimic the privacy maintained by my therapy office.

Have available to you a box of tissues to you should you need it.

Dress as if you were going out and coming into the office. For me, you might notice no big sweaters, etc., ( i am better able to control the temperature at my home office and am not cold.)

Lessen and minimize technological distractions, such as email pop-ups or a ticket-tape. (I know the latter is appealing given the market instability lately). This is particularly important for those using a computer screen

Find a few moments to walk before and after our session; this might be akin to driving to and from and will give you the space to process your thoughts.

There have been several sessions done from a car; if that is the best option then so be it. it is a wonderfully contained private environment and a better alternative to small or large distractions from kids, pets, etc., and although we love our kids and pets we can focus better in the session without them.

On another note . . . I wonder what the history of this will be and what will be our new normal, not simply with psychotherapy (where we know the face-to-face is always the ideal) but with all aspects of our lives going forward. Online therapy is here to stay. A thought for another time.

To learn more about telehealth options and online counseling, click here.