UPDATE: I am now offering a hybrid of virtual and in-person sessions. Learn more about my private therapy practice here!
This is Tracy.
I was doing a telehealth video therapy session in the early weeks of the pandemic, when my two children opened my door and interrupted me.
I had told them not to, unless it was an emergency. Their reason? My youngest child couldn’t find her favorite stuffed animal, a large dog called Tracy. “THIS IS NOT AN EMERGENCY!” I yelled, followed by a whispered, “I think she’s in the basement,” and quickly closed the door on them. I turned back to my client on the screen, apologetically.
Working from Home: We’re All Human
Therapists often try to create distance between our personal selves and our professional roles. The belief is that it’s not helpful for our clients to see much of our personal lives because it might make therapy less effective. But now a client had seen me, a mom working from home during a pandemic, shut the door abruptly on my own children. Not my finest moment — but it is my real life!
Around the time that happened, I read about a weather reporter in Indiana, whose cat Betty had become a beloved fixture in the weather forecasts he was conducting from home. I’ve been on Zoom meetings where babies and dogs make an appearance, and a friend told me that her young son casually strolled through the background of her professional meeting with no clothes on!
Video sessions have given me a chance to see my clients in their homes. I’ve had virtual tours of clients’ kitchens, caught glimpses of their houseplants, pets, and kids, and seen a few in their PJs with bed hair.
Sometimes, we don’t like to admit to what’s really going on in our lives. At work, we like to put on our professional hats, and appear solely devoted to our jobs. We strive to appear as if we have it all under control. But none of us has it all under control. Turns out, we’re all human! We’re complicated, our lives are messy. We do our best. Maybe the world will be a slightly better place, now that we are forced to acknowledge this. Maybe it’s time to stop pretending we have it all figured out, and get real with each other. It might help us realize we aren’t so alone in our struggles.
Is Online Therapy Effective? The Upsides of Telehealth
Like most therapists practicing in era of COVID, I’ve been conducting all of my sessions over video these last several months. (Seems like an eternity!) The risks of being in close contact — my office is small — outweigh the downsides of video sessions. I conduct most of my sessions from my home — except on those rare occasions I manage to venture into my office and do video sessions from there.
If you could see my full body on the screen, you’d notice that most of the time I’m doing therapy in socks or bare feet. Why wear shoes when no one can see the lower half of your body? I love the convenience of online therapy, I can get ready for work in about 5 minutes! I know many of my clients enjoy the convenience, too, of having an appointment in an hour, start to finish, without having to travel.
I miss seeing clients in person in my office, but there are quite a few upsides. I’m getting a glimpse into my clients’ real lives, and they are getting a glimpse of mine. I once used a nearby basket of unfolded clean laundry to illustrate a point to a client. (There’s never a shortage of unfolded laundry available in my house!) And telehealth is effective. Research suggests that video mental health sessions are as effective as in-person sessions, and clients tend to feel satisfied with them.
And best of all, the convenience of not having to travel to sessions, park, etc. makes therapy more accessible, especially for those living in remote areas. The more I get used to it over time, the more comfortable I feel with video sessions. I can form a close, connected relationship with clients I know very well but have never once seen in person. I now plan to continue offering telehealth sessions even after the pandemic ends.
And now, unlike back in March, my children have learned that a lost stuffed animal is not enough of an emergency to interrupt a session.
Privacy: A Challenge of Telehealth
Although I have found a private area to hold my sessions, I know that can be a challenge for my clients. For people living with roommates or family members, without a private and sound-proof space, they may worry that the conversation will be overheard. I encourage my clients to find a way to get enough privacy to be able to hold a conversation where no one can hear it. That could mean scheduling it when no one else is around, asking family members to give you some privacy, or getting creative about where to meet.
Further Reading
This is an article by Lori Gottlieb, author of Maybe You Should Talk to Someone, about finding humor in remote therapy sessions — from the bathroom. https://www.nytimes.com/2020/04/30/opinion/psychotherapy-remote-covid.html
Review paper on tele-mental health outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919267/
P.S. A Helpful Hint for “Zoom Fatigue”
If you are getting tired during video meetings, try this: Change your settings (or move your screen view around) so you can’t see yourself on the screen. I’ve been following that tip from my dear friend and colleague, psychologist Dr. Kerry Makin-Byrd, and it has helped. I guess that tendency to check our own hair every few minutes is adding to our exhaustion.