The pandemic has made what was once a small fraction of the psychotherapy world into the norm—remote sessions. I have found that a majority of patients, and once-skeptical clinicians, are satisfied with remote psychotherapy and plan to continue on with it once in-person sessions are allowed. I plan on offering remote sessions as a foundation of my practice because of the many benefits it provides my patients. In this blog post, I want to describe what I believe are the pros and cons of video therapy, as well as details I think all potential patients need to know before starting remotely.
There are plenty of obvious reasons that remote work is convenient, easy, and time-saving. I found that many patients enjoy the ease of scheduling a session during the work day because the 50 minute session is quick enough squeeze in during a quiet time of the workday or during lunch. During in-person treatments, the time it would take to commute would make it a rather lengthy commitment on top of the 50-min session. Because of this, many patients preferred to come in before and after work, which were the most in-demand times for therapist and would often fill up quickly. Remote sessions lend themselves to more flexibility in rescheduling so that therapy is more consistent, and then more effective. I’ve had patients who are able to continue therapy while on work trips or vacations.
Less obviously, I’ve found that video sessions are surprising intimate, and are equally as effective as in-person work. Video sessions also allow for a session to still occur if the patient or therapist is slightly ill. In the past I asked my client to not come into session when feeling even slightly sick. Now we can still meet without the risk. Additionally, I can see patients from any part of California—not just the Bay Area.
There are plenty of downsides, however. The most serious downside are the technical difficulties that arise. Whether it is slow or choppy internet, a computer or earbud failure—it can be disruptive and frustrating. I’ve found that some patients have difficulty finding private spaces where they can have confidential and open conversation. Sometimes family pets, doorbells, a loud weed whacker in the background can cause disruptions. Some patients, and many teens, find that so much of their life is occurring online. So for them, in-person therapy is often a reprieve. The lack of this option for some clients during the pandemic has felt like a loss and they look forward to meeting in-person again.
I have continued seeing children during the pandemic for play therapy. There are many challenges that arise during remote play therapy, including the lack of access to my toy closet and my inability to hold boundaries the way I did before (I can’t even count the number of times I’ve been “carried” around the house when I asked to keep the session in one room). However, with the help of a “therapy toy bag” and online games, I’ve found play therapy to continue to be effective.
Before starting remote therapy I think there are a few things to keep in mind. Its totally normal to think its “weird” to start therapy with a therapist you’ve never met in person (and may never meet in person!). It can be uncomfortable to talk to a stranger about very personal aspects of your life, and it can feel more intense online. These feelings are important and often settle in with time. No matter how you are feeling, I encourage you to tell your therapist all the feelings that arise. I’ve also found that location is very important. If you can be alone, in a comfortable place, where you feel that you have complete privacy—that is ideal. If you cannot be alone in your home, I’ve found that some clients like having sessions in their car, or in quiet parts of a park or in nature.