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Teletherapy Explained

March 2020 marked the time when my grandma finally learned how to use Skype and everyone over 65 (or maybe everyone in general) learned what Zoom is. In response to the Covid-19 pandemic, people have been forced to become technologically literate in order to stay gainfully employed, sane, or both.

For therapists and clients, the shift has been no different. In-person sessions have ceased to be an option and the terms “telehealth,” “teletherapy” and “virtual therapy” are now ubiquitous. Clients as young as 3 years old are doing therapy through a screen. It’s pretty surreal.

For those of you who might be leery about discussing deeply personal issues over a computer screen, here’s a little bit more about telehealth. A little demystifying might go a long way in getting the help you need during these uncertain times.

Teletherapy involves psychotherapy conducted in a virtual format – usually via telephone or video platform (this post will focus on the latter). With good quality audio and video (see below for tips), the content of your sessions can be exactly the same as those conducted in person. Telehealth usually does not involve the installation of any software on the clients’ end, and so technophobic clients need not fear – all you need is a device with a webcam (a smartphone, tablet, or computer) and an email address. Sometime before the session, your therapist will send you an email invite – simply click on the link embedded in the email, and voila – you have been ushered into the virtual office or waiting room. Other video platforms involve the therapist video-calling the client – in those cases, all the client has to do is answer the call similar to the way you’d answer a phone.

Plenty of positives have emerged from this new format. Fewer clients are arriving late or cancelling, since traveling to therapy has been removed from the equation. Many therapists have also expressed that they appreciate being let into their clients’ lives, and vice versa. There’s a certain automatic intimacy that comes from knowing that your therapist is experiencing the same world-stopping event that you are, and also that her window shades clash horribly with her wallpaper.

Some of our clients are actually thinking of continuing telehealth even once life gets back to normal. They appreciate the convenience of toggling between their therapy session and whatever else they are doing before and after. They like being able to do certain therapy exercises, like exposure therapy for contamination OCD, in the actual environment that triggers them. And for clients who were ambivalent about therapy to begin with, telehealth removes some of the obstacles -- like travel and being outside one’s personal, comfortable living space -- that might have delayed that initial appointment.

Regardless of whether you’ll be continuing with telehealth once life returns to normal, here are some tips to maximize your experience:

Check with your insurance company. Although many have made allowances for the current situation, not all insurance companies are reimbursing clients at the same rate as an in-person session. Call your insurance company beforehand to make sure it covers telehealth services. Therapists whose clients have moved temporarily out of state (e.g., college students returning home) may want to check with that state’s licensing board to see if they’ve temporarily lifted restrictions on conducting interstate telehealth.

Test your connection. Test your audio, microphone, and WiFi connection beforehand. Conduct a test call with a friend before your session, or use your videoconferencing platform to test the quality of your audio.

Find a private space. There’s a global pandemic. The closet or bathroom might have to do.

Minimize distractions. Take a 5- or 10-minute breather before your therapy session. During your session, put your cell phone on Do Not Disturb, or turn off the ringer. Put your work materials away and minimize any distracting screens. Pretend you are at an in-person session. If getting dressed and putting on makeup (which can also be a good mood booster) makes the session feel more legitimate, go ahead and do that.

Close the blinds. Make sure there isn’t a glare behind you, obscuring your face. Scan your background in general and try to keep it as neutral and neat as possible. Try not to sit too close or too far from the screen, and make sure your entire face is visible. And if you’re not wearing pants, make sure the camera is not picking that up!

Have a Plan B. If your connection becomes patchy mid-session, try another video platform. Your therapist can also make sure they have your cell number on hand and conduct the remainder of the session over the phone if need be. Or perhaps the phone will be your plan A, especially if you feel uncomfortable with video.

Laugh. Things will come up. Your therapist will find out about your cats. Your session might have to be in the bathroom. With so much pain and uncertainty going on, let yourself laugh at the absurdity of these moments. Those few seconds might accomplish more than your entire 45-minute session.

Do you have more questions about teletherapy? We are happy to answer them! Please contact us at (212) 696 1355 or to inquire further about therapy at this time.

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