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How to Make the Most of Online Therapy

The pandemic has highlighted an important fact about teletherapy: It’s a highly effective, invaluable alternative to in-person sessions. Even as states reopen and therapists return to their offices, many clients may prefer to stick to their virtual sessions because of the convenience—or do a mix of in-person and online appointments.

As such, we asked mental health practitioners to share how we can make the most of teletherapy. Below, you’ll find tips on everything from essential questions to explore between sessions to effective technical adjustments to ensure a smooth appointment.

Ask questions. If you’re new to teletherapy, you might have many questions about how the process works—from How private is it? to Can I text or email you between sessions? to What are the risks? Don’t hesitate to ask your questions, even if they feel silly, awkward, or obvious. Because they’re not.

Reflect on the week. Just like psychotherapy in an office, your online sessions will benefit greatly when you reflect on your previous appointment, progress you’ve made, and barriers you’ve run into, said Craig April, Ph.D, a psychologist in Los Angeles and author of the new book The Anxiety Getaway.

To explore further, April suggested asking yourself these questions:

  • What has been my biggest struggle since the last session?
  • How have I been reacting to my typical stressors or triggers?
  • Have I been feeling encouraged or discouraged when considering my progress? 
  • Where do I feel stuck since last session?
  • Have any new struggles presented themselves recently? Or are they the same? If seemingly new, are they just another variation of the old? 
  • Do I have any goals for today’s session?

Have a transition before session. With in-person appointments, clients often have a natural transition—driving their car, sitting on the train—that helps them to focus fully on their session. With teletherapy, however, “that time right before the session does not exist unless you specifically carve it out,” said Carlene MacMillan, MD, a Harvard-trained psychiatrist and founder of Brooklyn Minds

April suggested completing household tasks at least 10 minutes beforehand. As he said, “It’s hard to refocus on therapy if you’ve just taken your dog for a walk a minute before your scheduled session or you just finished helping your child with homework.”

Prior to your appointment, sit down in the same space as your virtual session. Similar to creating muscle memory, April noted, “the associations you’ve made with that space during your sessions will help take you into the therapy process.” It also might help to practice a 1- to 5-minute meditation to further ground yourself into the present and get ready for your session.

Ensure you have privacy. “If your sessions are within earshot of family members, what you share with your therapist will be inhibited” and hamper your progress, said April. One way to ensure privacy is to use a white noise machine outside your door or play a white noise YouTube video on another device, said MacMillan.

If a closed space isn’t available, have the session inside your car while parked on your driveway or somewhere else—which some of April’s (and other clinicians’) clients have been doing. 

Ensure comfort with small adjustments. MacMillan suggested turning off app, email, and text notifications, since they’re “very hard to ignore” and can fracture your focus. Download any necessary software ahead of time, and test your setup, making sure your camera and audio work, she said. If it feels awkward to see yourself on camera, click the option to “hide self-view” or minimize the image.

Prop whatever device you’re using to eye level to avoid holding it, said Jodi Aman, LCSW, a psychotherapist in Rochester, N.Y. and author of the forthcoming book Anxiety….I’m So Done with You! Charge your device beforehand; have a glass of water next to you in case you get thirsty; and know your preferences (e.g., using earbuds or not), she said.

If possible, minimize other devices using your Wi-Fi to give you a better, faster connection, said Regine Galanti, Ph.D, a psychologist based in Long Island, N.Y. and author of Anxiety Relief for Teens. Also, “make sure your therapist has a backup way to reach you in case the connection drops,” she added.

Provide feedback. Because some clinicians don’t have much experience with teletherapy, don’t hesitate to tell your therapist how they can enhance your sessions, Aman said. For example, you might ask them to improve the sound quality, sit closer to the screen, and increase brightness.    

Be fully present. Therapy isn’t the time to fold laundry or drink alcohol. This might go without saying—however, therapists have told MacMillian that because clients are inside their own homes, some feel they can do whatever they want during session. Instead, remember that your virtual appointment is a “time to be present with another human and focus on that interaction,” MacMillan said.

Like in-person therapy, online sessions are also effective. And after a few sessions, you might even find that you prefer virtual appointments—or not. Either way, by being intentional and trying out the above tips, you’ll know you’re certainly giving it your best.    

How to Make the Most of Online Therapy


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Margarita Tartakovsky, M.S.

Margarita Tartakovsky, M.S. is an Associate Editor and regular contributor at Psych Central. Her Master's degree is in clinical psychology from Texas A&M University. In addition to writing about mental disorders, she blogs regularly about body and self-image issues on her Psych Central blog, Weightless.


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APA Reference
Tartakovsky, M. (2020). How to Make the Most of Online Therapy. Psych Central. Retrieved on October 24, 2020, from https://psychcentral.com/blog/how-to-make-the-most-of-online-therapy/
Scientifically Reviewed
Last updated: 13 Jun 2020 (Originally: 14 Jun 2020)
Last reviewed: By a member of our scientific advisory board on 13 Jun 2020
Published on Psych Central.com. All rights reserved.