More than nine out of 10 therapists are seeing clients through telehealth, or videoconferencing programs, as a result of the coronavirus pandemic, according to a study from the American Psychological Society.
Therapists says that using telehealth has some unexpected benefits. “When people are in their own space, sitting on their own couch petting their dog, they often are a little more comfortable opening up,” says Prairie Conlon, LPC, NCC, an Accelerated Resolution Therapy (ART)-certified therapist in Madison, Wisconsin.
People who might otherwise be intimidated to see a therapist or feel stigma around getting counseling are often more comfortable taking part in teletherapy, Conlon says. The New York Times recently reported that many therapists have been pleasantly surprised with the results of telehealth and plan to continue using the service after the pandemic subsides.
So how should clients prepare for a telehealth session? The first step is to connect with a therapist who can determine if telehealth is right for you, Conlon says. People grappling with depression, anxiety and life changes are usually good candidates for the service, she says. Those with certain personality disorders and other concerns may not be.
It’s important to have a strong internet connection, says Jennifer Street, LCSW, an Accelerated Resolution Therapy (ART)-certified therapist in Houston. Therapists are required to use a video program that is HIPAA-compliant to ensure the privacy of the session.
Clients should find a comfortable and private place in their home. Headphones might help both sound quality and privacy. “I’ve had clients do therapy in their closet. I’ve had clients even sit in their cars although the internet connection is not the best,” Street says.
For her part, Street tries to make a virtual session feel as much like an in-person visit as possible. She sits in her home office, to give clients a sense of consistency, and adjusts the camera so she is looking in their eyes. She often asks more detailed questions about her clients’ mental state, since she is unable to see some of the nonverbal clues, such as body language, that provide insight in to their feelings.
When performing ART with a client through telehealth, therapists prepare more extensively since ART can stir strong feelings. During ART, therapists use bilateral stimulation of the eyes to put clients in a relaxed state. They then help clients reframe traumatic memories, eliminating the physical and emotional symptoms of trauma that accompany the memory.
To perform ART through telehealth, therapists enlist a trusted family member or friend to either stay with the client or just outside the room. “A lot of time with ART and trauma work people can be really triggered,” Conlon says. “There really needs to be someone there who knows what is happening and can help if the client becomes distressed.”
Clients pledge to stay in the room during the session, so their therapist can closely monitor their reactions. Street makes sure that she has the client’s address and cell numbers for both the client and companion.
“When we’re not physically with the client, it’s important to take steps to make sure that they are safe,” Street says. She also makes sure to ask clients at the end of the session if they felt that their needs were met. Without being able to see her clients’ posture and demeanor, it can be harder to gauge their feelings. As for clients, Street says, “You have to go an extra step in your vulnerability to speak up if something is not working for you.”