Zooming Through the Day: Telehealth Therapy During COVID-19

 

Bridgette W. Gottwald LPC, NCC

Audio Version

Therapy sessions have gone virtual amidst the global pandemic, raising new challenges for therapists and clients worldwide.

Amidst the transition from in-person therapy to Telehealth, there have been countless challenges arising daily for therapists and clients. While scrambling to adapt to new video platforms, the main struggles to have revolved around privacy, transitions, technical glitches, interruptions from pets, distractions, fatigue, and more. The information below has been derived both from personal experience in working with my clients and what I have learned amidst the process.

Privacy

In capitalizing upon privacy, which is crucial to the therapeutic process, it’s imperative that we get creative. I have had countless clients go to their cars, closets, bathrooms, and even go on a walk outside amidst their therapy session. Whatever it takes! Surprisingly, some of these situations work better than you’d think. For example, being in the closet muffles sound because you are surrounded by clothing. Who would have thought?

 Transitioning

Taking fifteen minutes before and after the therapy appointment to mentally allow yourself to transition has proved to be tremendously important. This gives you the opportunity to have “a little space to rewire (your) brain to be in the right mode” for what you are about to do. Going right from day to day life or a work meeting, to therapy, and back can be “jarring” so it’s fundamental that you allow yourself this time.

 Cancellations and No Shows

If you are a therapist, be prepared for none of your sessions to be canceled. Personally, I learned this hard way and completely overbooked myself at the beginning of this transition. Typically, in a given week, therapists intentionally overbook their schedules assuming that at least 3-5 clients won’t show. Well, not during quarantine! People need their therapists now more than ever. With nothing else going on, there aren’t many reasons for people to bail on their therapy appointments. At Montefiore Medical Center psychiatry outpatient practice in New York, no show rates have “dropped from 25% to 30% of visits to almost nothing.” The fact that everyone is at home makes attending therapy sessions fairly efficient.

Although both therapists and clients report that they are missing the “non-verbal body language” that accounts for 80% of all communication, the convenience of telehealth therapy is hard to beat. It has been projected, that after things return to normal, some people will want to continue utilizing telehealth.

 Furry Friends Interrupting Therapy

Although it can be distracting, when this happens during the session (which has been frequently for me personally), I have actually encouraged it. You’re probably thinking why would you encourage a distraction - but I don’t see it that way. Pets are a big part of people’s lives, and bringing them into the therapeutic session (willingly or not) is not a waste of time! These animals serve as huge attachment figures, and it actually helps to build rapport and strengthen the therapeutic relationship.

 Tips for Making It Work for Clients and Therapists

Have you been intimidated to engage in Telehealth and just want to wait for things to get back to normal before seeing your therapist again? Unfortunately, that could be a long wait given the rate of how things are going. Below are some tips that may help you with the transition:  

  • Have a backup plan: If your internet cuts out, make sure your therapist can reach you on your cell phone so that you are able to finish the session with ease.

  • Shut down Zoom at a certain time every night: Establishing a routine during unprecedented times is important.

  • “Self-view” closeout: Normally when we are in person, we can’t see ourselves when we talk to someone else – this serves as a distraction and can also increase fatigue.

  • Check and communicate with your insurance provider to ensure that your treatment is being covered. Many rules and regulations have been loosened amidst this pandemic.

  • For clients: Find a private space so that you can express yourself without fear of someone hearing you.

  • For therapists: Review and ensure that you are practicing in a HIPAA compliant fashion.

  • Treat the session like an in-person one.   

  • Think outside the box, be willing to adapt, and get creative when challenges come up.

  • Understand that it’s ok to shift gears from your treatment plan to discuss more immediate stressors and how to cope amidst the pandemic.

 

Reference

Peterson, A. (2020). Your video therapist will see you now. The Wall Street Journal. Retrieved from: https://www.wsj.com/articles/your-video-therapist-will-see-you-now-11587906000