So, here we are…it’s Fall 2021, and it seems like most therapy is being conducted behind a screen. There’s no doubt that meeting a therapist from our computers, at the click of a few buttons, is a different experience from commuting to their private office and sitting there with them. However, online therapy can be so convenient, and many studies have shown that it is just as effective as therapy done in-person (Barak et al., 2008; Godleski et al., 2012; Kessler et al., 2009; Wagner et al., 2014).

When I first start working with a client online, I let them know all the ways we can make their experience just as impactful as therapy in an office together. It takes some conscious effort, but tiny adjustments add up to create a comfy, private, and connected experience wherein you can feel safe to get the support you need.


Pillows & Privacy: We Set Up the Space.

First, we set up the spaces in our homes to feel cozier, private, and dedicated to therapy.

I ask clients to choose a private space in their home where they can reliably meet with me at our designated time, and then I encourage them to make that space special whenever we meet. How so? We take care of two major priorities in therapy: comfort and privacy. To increase the physical comfort of our designated therapy spaces, we bring in soft and cuddly things (like blankets, pillows, and even pets who don’t distract us) or other comforting tactile objects (like fidget toys and stress balls). I also encourage people to have something soothing to drink during the session. To maximize coziness, we can use relaxing lights, candles, and essential oils to both calm our nerves and signify that therapy has started.

After comfort is increased, it’s time to focus on privacy. To better guarantee that no one else can hear the therapy session, your best bet is to ensure that no one is nearby or your walls muffle sound well. Since those two options are not always available to us, we can use earbuds or headphones to block out the sound of the person on the other end, and we can use fans or white noise machines to muffle all of the sounds from coming from our room (for the best effect, place the muffling machines just outside of your room).

Connected to More Than Just the Internet: We Set Up the Tech.

Next, we set up the technology to reduce distractions and strain and increase our focus and sense of connection to each other. Before a session, it’s a good idea to ensure our Internet connections are stable and you know how to use the main features of the videoconferencing platform you are using. Chances are that you already have been using the internet for videoconferencing and you know some things that slow it down (like having multiple programs open) and speed it up.

During sessions, it’s best to have the device positioned so that you are looking at your therapist at or around eye-level. This helps us feel more connected and reduces eye, neck, and back strain. While there are many cool laptop risers you can buy, there are also many other creative, sturdy ways to raise the height of a laptop – I speak from experience! We can’t always get eye contact right because of the position of our screens, but we can try. On a related note, it’s helpful to remember that we don’t have to maintain eye contact throughout the session (although it can sometimes feel that way in video meetings). Just like we would in the office, we can take time to gaze at our surroundings and reflect during an online therapy session.

Another note on where we look: Unless it’s helpful for a specific therapy technique, we don’t need to focus on our own video. Sometimes checking ourselves out does more harm than good. I recommend only checking your “Self View” to ensure the other person can see you clearly, and then shifting your focus back to them. If you have options to minimize or hide what you can see of yourself, it is worth experimenting with those.

To further reduce distractions, it’s a good idea to turn off notifications on our device(s) but keep a phone nearby. We can set our phones (and some computers!) to “Do Not Disturb” mode. I cannot tell you how many people’s days I’ve made when I’ve pointed out this feature on the MacBook (it’s in the pop-out menu by the clock, in the “Notifications” tab…You’re welcome!). As for cell phones, I encourage clients to keep them nearby and charged, in case the Internet becomes faulty and we need to get on the phone to keep on talking. This happens rarely, but the transition is usually a smooth one in my experience.


Be A Little Selfish: We Set Up Ourselves.

Perhaps more important than the cozy, private, focused environment we’ve created is the way we as people come into the virtual therapy room. Before and after a session, we can practice routines and habits that allow us to fully absorb the benefits of therapy. Spending a few minutes sitting in our chair and sipping our favorite soothing beverage, writing in a journal, repeating an motivational phrase, or taking a short walk can do wonders. For the person receiving therapy, the transition between life inside the therapy session and outside of it was traditionally experienced as a bit of a ritual, through a commute and a waiting room. That transitional time is precious and best spent being gentle to ourselves. If that’s tough to do, try to at least take a pause between therapy and screen time – your eyes and mind will thank you.


Greetings from Online Therapy – You’ll Like it Here

There are ways to treat our physical environments, the technology we use, and ourselves before, during, and after a therapy session to make it just as impactful online as it is in the office. I hope these tips enhance your experience of online therapy, so that you can better enjoy the wonders of mental healthcare and technology all from the comfort and privacy of your (possibly candle-lit and cuddly) remote therapy space.

If you are interested in trying online therapy, contact us at Kathryn Grooms & Associates Psychotherapy. We’ll be glad to show you what I mean.

References:

Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2-4), 109–160. https://doi.org/10.1080/15228830802094429

Godleski, L., Darkins, A., & Peters, J. (2012). Outcomes of 98,609 U.S. Department of Veterans Affairs Patients enrolled in Telemental Health Services, 2006–2010. Psychiatric Services, 63(4), 383–385. https://doi.org/10.1176/appi.ps.201100206

Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S., Sharp, D. J., Araya, R., Hollinghurst, S., & Peters, T. J. (2009). Therapist-delivered internet psychotherapy for depression in primary care: A randomised controlled trial. The Lancet, 374(9690), 628–634. https://doi.org/10.1016/s0140-6736(09)61257-5

Wagner, B., Horn, A. B., & Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders, 152-154, 113–121. https://doi.org/10.1016/j.jad.2013.06.032