If you are considering a therapy in the near future but have had second thoughts because of the likelihood it will be via video call, I offer some reflections on the past eight weeks which may allay your fears.
Surprisingly, it’s worked!
I have offered video sessions for a number of years now, but only to those whom I have met in person initially. Where a relationship and a therapy has already been established, it has never proved too difficult to pick up on our work when we moved to a video session.
During the pandemic, however, there have been some I have only met via video link and to date, all sessions have been conducted remotely. I had expected that this may mean for some awkwardness and interruption in the relationship building but, by and large, this has not proved the case. The rapport seems to be almost as easily built over video as in person; the remoteness has not meant that it has been difficult to feel empathy and, surprisingly, I have been able to pick up on visual cues almost as easily as I do when meeting someone in person, despite only seeing their head and shoulders.
Voice-only sessions obviously preclude access to visual cues which has meant I must occasionally pause the conversation and ask what the client experiences in their body and, admittedly a little awkwardly, I’ve had to confirm whether or not they are crying, but even those moments haven’t proved to be too big an interruption to the work.
The car seat is the new therapy couch
The biggest drawback to remote sessions has been that I cannot control the therapy environment. In my practice rooms I can better ensure quiet, privacy and when those tears come, that there is a tissue to hand. As everyone is locked down in their homes it is the client who must consider these factors and as much as I might flag up these points before session, there have been occasions where dogs – or children, or even partners and parents - have demanded attention and intruded.
Whilst some therapies have benefitted from fact that the client is in their own home and is seemingly more relaxed and more open, for others the unexpected anxiety of speaking privately when a family member is known to be in the next room has proven an obstacle.
So in many instances clients have received my call from their car which, of course, benefits from being moveable to a more discrete location. As there have been so few people outside there hasn’t been many worries about passers-by looking in, and some have remembered that their cup holder is big enough for a coffee mug.
There have been odd moments where the interior light has blinked off and plunged the call into darkness, so I would advise getting familiar with your car’s controls.
Oh, and bring tissues.
The technology works – for the most part
I’ve used a range of video calling technologies – FaceTime, WhatsApp, Skype, and the suddenly very popular Zoom. In my research I felt assured that all were sufficiently secure with encryption and despite some fear-mongering stories of “Zoom-Bombing” and international hacking, all platforms have proven secure if a few simple precautions are taken (with Zoom I’ve found it best to use the waiting room option to vet entrants to the conversation, not that anyone unexpected has asked to join).
All the platforms have been as reliable as each other – which is to say that where conversations have seized in mid-sentence and faces have frozen in a pixelated rictus, it has been due to failing Wi-Fi or 4g signal. The networks have seemingly suffered from high demand and there have been times where we’ve forsaken video for voice-only to reduce the bandwidth of the call. Such moments haven’t proven too difficult to negotiate, however, and sessions have continued well despite the interruption.
We’re all in it together
I trailed the probability of moving to video or phone calls as early on in the pandemic as I could but when the transition came, it came suddenly. In acknowledgement that there would be no continuing therapy otherwise, many accepted the move to remote sessions without objection and have made allowance for the occasional drop in signal. If coronavirus hadn’t dictated it and I had instead chosen arbitrarily to offer all therapy remotely, I believe many would not have tolerated the hiccups.
I do acknowledge that some have not been pleased to receive sessions remotely, but even then it has been understood that the circumstances are dictated to us; we’re all having to adapt in these unique times.
Lockdown may be slowly lifting but we’re not yet clear of social distancing measures, or the likelihood of further quarantining or viral outbreaks, which means we’re probably looking at a blend of face-to-face and remote sessions going forwards, depending on circumstances.
I’ve always maintained that a therapy is a collaboration and the move to remote sessions has relied upon, and proven exactly that point; we have to do this, so let’s work together to make it work.
But you’ll have to remember to bring the tissues.