There’s no question that 2020 was a hard year for everyone. People are stressed, stretched and emptied out. Others are restless, bored and feeling hopeless. The need for quality mental health care has been high.

Due to COVID, therapists shifted the way they work with their clients overnight. In March 2020, both clients and therapists scrambled to make quick changes. Therapist had to adjust to their new roles as video therapist and clients grieved the in-person support they had growth accustomed to. Psychotherapy organizations quickly published guides to tele-therapy, complete with guides to the best HIPPA complaint platforms. While some had time off resting and bread-baking, the mental health field kicked into high gear, trying to meet the anticipated increase in demand for services. 

After providing remote therapy for the last 9 months, these are some of the elements I consider supportive to best using your online sessions. They are both actions I have taken with client as well as things I have observed my clients doing naturally in this adjustment to video therapy. 

1)    Give yourself transition time. The time we spent commuting to therapy gave us time to reflect on what we want to share in therapy, prepare and get connected with ourselves. Even waiting in the waiting room created this. Without this transition time, we are zipping from home life or work or family to therapy within seconds. Here are some ways to build in time for yourself to prepare for your session.

• Build in an extra few minutes to prep quietly for your tele-therapy session

• Make notes during the week or before session.

• Ask your therapist to begin with a visualization, meditation or a few minutes of silence or quiet.

• Ask for help getting settled or started.

• Ask yourself what feels most alive for you in this moment.

2)    Set up your space before therapy. Ideally, have a private place to talk, with good wi-fi access, where you can relax without distractions. Therapy can be vulnerable and emotional. Find a spot where going deep feels safe for you. If you are in your apartment with many others and poor sound-proofing, going for a walk or finding a quiet park can be an alternative. Or sitting in your car can offer privacy and containment. 

3)    Manage your device. Consider a laptop or tablet over the phone when possible for video therapy. The picture is bigger and this makes it easier to connect with the person on the other side of the screen.

If you are on a phone, have a place to rest your phone. Holding your phone in therapy doesn’t allow you to settle in and it’s bumpy.  The moving screen is hard on both parties in online therapy. If you have to hold your phone, have a place to rest your hand or elbow or consider just a voice call for that week. 

4)    How connected do you feel? Talking to others over the phone and video is something we do every day. We have habitual ways we connect in more casual conversation. But therapy is different than talking to a friend or family member. To create a different feeling for therapy, bring consciousness to the relationship with your therapist. For example, pause in moments throughout the session to ask yourself ‘can I feel my therapist here with me?’ What does their face or tone of voice tell you in this moment? Tuning in to the audio and visual aspects of the other person can make up for the fact that we cannot read the rest of their body language. also ask them if they can feel you or what they noticed about you. This kind of reflection can enhance the relationship with your therapist.

5)    Your location, body and posture. If you are working online all day, consider moving to different spot for your therapy session (i.e. from desk to a couch). Consider letting your body take on a different posture or position to signal to yourself that this is a different container than work. I have some of my client lay down or sit on the floor to mix things up. I have clients do this in the office however it’s easy to forget when online.

6)    Ask for support & share. If you are struggling with doing therapy over video or something about the session isn’t working for you, talk to your therapist about it. Let your therapist know what is impacting you and ask for help to change it. It’s okay to experiment. Sometimes, I talk to clients with the video camera covered or off to accommodate different comfort zones and experiences my clients might be having. Also it’s okay to share that you miss in person visits or your grief about the changes you going through with COVID. 

7)    Give yourself time after to reflect. Similar to the commute to therapy, there was the commute away from the office to reflect on the session Give yourself time after your session, even if it’s just 5 minutes. Write down a few notes to return to throughout the week, go for a walk, have a snack or lunch. Take a moment to integrate before the next part of your day.