In today’s shelter-in-place world, it’s not just people with compromised immune systems who are at risk. The anxiety about contracting the coronavirus, paired with the inability to relieve stress by going to most places and events that are now unavailable, is increasing the severity of psychological or emotional conditions, such as depression, anxiety, relationship issues, and other personal challenges for many.
Consequently, even in this short time, there’s more risk of substance abuse, suicide, domestic violence, and moving toward divorce. Others, who’ve felt fine before the coronavirus hijacked their ability to interact with others in ordinary ways, feel frightened or lonely.
These situations point to a crying need for therapy, yet the shelter-in-place order means that treatment can’t happen in-person right now. But help is still possible; it’s merely occurring in different forms. Many clients are transitioning smoothly from in-person meetings to phone, or video sessions via Skype, Zoom, or a different option. Others are less comfortable about either making the switch or becoming a new therapy client.
Telephone and Online Sessions Aren’t New Methods
Many therapists, including myself, have been providing phone and online therapy for some time, usually for special situations. A few examples: Someone moves too far away to continue office visits but wants to continue their treatment via Skype. A parent and adult child want to heal an estranged relationship, but one of them lives too far away for office visits. A couple wants to see a marriage therapist, but they live hundreds of miles away. Instead of in-person therapy, it happens on Skype.
As a former crisis line volunteer, I’m comfortable with telephone therapy; I’m sensitive to nuances of people’s voice tone, inflections, and frame of mind. Usually, adding the visual part via Skype, Zoom, or another online method is better, because body language and facial expressions convey so much more of our communication, and they’re missing in telephone therapy. Some clients prefer phone therapy, which works fine in many situations.
In video sessions, I can see smiles, misty eyes, and raised eyebrows. But some things are still missing. For example, a wife asked her husband during a recent Skype session with me why he was wringing his hands, which didn’t show on the screen. If she hadn’t mentioned this, I wouldn’t have known to ask him what was on his mind, because his face showed no angst.
While physical distancing is needed to help prevent the spread of the coronavirus, we do the best with what we have. Remote therapy is an effective way to gain help in living and loving more fully. Although the energy, chemistry, general aura present in office visits is lacking, there’s no reason to wait for therapy until it can happen in-person again.
Meanwhile, some adjusting is occurring for all involved. Clients who tend to view their therapists as all-knowing may be surprised to find that their technology skills surpass those of the professional’s. That’s not necessarily a bad thing. Realizing that their therapist, like them, is an imperfect human, can strengthen their bond, the “therapeutic alliance” which supports growth and change.
Because my online video therapy practice had been on a very occasional basis until lately, I’ve had to do some mucking around to remember which links and buttons to click for Skype and Zoom, which is humbling and also okay. I know that I don’t know everything. I’m good at therapy and writing and am left in the dust about many other topics. So, we’re all adjusting, while appreciating that the work can continue with both ongoing and new clients.
Both In-Person and Remote Therapy Have Advantages
Advantages exist for both in-person and remote therapy. Some people view office sessions as an excellent way to get some distance from their problems that concern them at home. They find that in their therapist’s office, it’s easier for them to see and deal with their challenges objectively.
Also, remote sessions lack the energy or chemistry that in-person sessions have; the former kind can feel more like watching a show on television instead of in a theater.
Yet, phone sessions can feel intimate while allowing a degree of privacy. For example, a mother and her adult child who want therapy to repair their estranged relationship may live too far away from each other for office sessions. The mother may choose phone therapy so she can hide her distressed facial expressions or body language when something her daughter says upsets her. She senses that it’s easier to control her voice tone and volume than her body’s movements. Also, she finds technology intimidating.
Both phone and video sessions save travel time and expenses for everyone. No one needs to leave home for therapy.
Helping People Gain Comfort with Different Options
Many people who are not now in therapy but would benefit from it may think they need to wait until virus-related restrictions are lifted. Others who’ve been seeing a therapist in-person aren’t comfortable with changing to remote sessions.
Some individuals who are already stressed may find it hard to commit to therapy that’s different from what they’ve come to expect, especially if they are at the stage of contemplating gaining professional help. Therapists can help them gain confidence in remote therapy by spending a few minutes trying out Zoom, Skype, or another service together a couple of days before a scheduled session.
Others may be okay with the idea of remote therapy, but economic hardships resulting from closures of places where they worked, to prevent the spread of the virus, may keep them from seeking or continuing treatment. Therapists tend to be compassionate. Many will reduce the fee for financially-stressed clients, or offer them shorter sessions at half the cost, e.g., 25 minutes instead of 50. Some clients find that shorter sessions force them to plan, sharpen their focus, and be more concise.
Maximizing Benefits of Remote Therapy
By treating remote sessions like in-person ones, therapists and clients will ideally bring their most constructive selves to them. We do this by dressing and grooming ourselves similarly to how we do for office appointments. Doing so can make a huge difference, even if it doesn’t seem like it would. We’re more likely to bring alertness and clarity into sessions when dressed for business rather than for lounging at home in pajamas or workout clothes.
What the future will bring in terms of where therapy will usually occur is uncertain. Remote treatment may become a standard way to be helped after the crisis has passed because people appreciate its advantages. Or in-person office visits will again be the primary way sessions are held.
Flexibility, resourcefulness, and the ability to adapt to changing circumstances are signs of mental health. Anyone who needs assistance or support can receive it promptly. Remote therapy is available, effective, and convenient.
Photo courtesy of Jessica Koblenz, PsyD.