Teletherapy

I’ll be honest, I didn’t love teletherapy when I was first forced into it during the start of the covid pandemic in March, 2020.  I felt that the efficacy of the work would be compromised by the fact that I would miss some of the body language and other nonverbal cues that I normally use to gauge the emotional state of the client(s).

I’ve been doing teletherapy exclusively since early 2020 and I’ve fully embraced it. Now that I’ve experienced how effective and convenient it is for my clients, I’m an advocate. I wanted to write an honest article outlining the pros and cons of online therapy.

First of all, what does teletherapy entail?  Teletherapy (also called distance therapy, online therapy, virtual therapy or telehealth) is therapy that is performed remotely via a computer, tablet or phone.  Through the video camera, I can see and hear the client in real time, and they can see/hear me.  I use a secure, HIPAA compliant platform via a system called Simple Practice.

Prior to the session, the client receives an electronic link for the appointment via email or text (depending on client’s preference).  The client simply clicks the link and they are automatically admitted to my virtual waiting room.  I join them there at our scheduled time.

Most clients have their teletherapy sessions in the comfort of their own homes.  Some, however, attend from their office at work, or in their car.  As long as there is a good WIFI signal or cell coverage, you can make a teletherapy session work virtually anywhere. I ask that my clients maintain a full view of their face during our sessions so that I can keep tabs on what is happening for them emotionally.

My preference with couples is that they are together in the same room, sharing a screen, during our time together.  I want them to experience the close proximity and energy of each other during our sessions.  That’s when their honest reactions to one another play out, which is really helpful for me to be able to see and help them process in real time.  In addition, a lot of what I do requires a couple to turn toward one another to directly engage.  This type of intervention isn’t as intense when they call in from separate locations.  The more emotionally intense the intervention is, the more impactful it will likely be.

Sometimes couples have no choice but to call in separately from two locales.  Although it isn’t ideal, it is better than skipping a session.  So, teletherapy is convenient in that way.  Couples usually need appointment consistency in order to gain the traction and momentum necessary for real change.  This is especially true at the start of therapy.

The only cases where I actually prefer that a couple attend from separate locations are: (1) if they are such high conflict (or avoidant) that they get too emotionally dysregulated/flooded to effectively work through triggering topics, or (2) they are in a contentious separation and are trying to navigate their relationship, a divorce, and/or co-parenting issues.   In those cases where emotional intensity would blow them out of the water, teletherapy from separate locations can take enough of the charge out of the session to allow some forward motion and healing.

• Time saver.  There is no commute to and from my office.
• Hassle free.  There is no worrying about traffic getting to, or parking at, my office.
• Efficacy. Research shows that teletherapy is just as effective as face-to-face therapy
• Accessibility.  Teletherapy is more readily accessible to people with disabilities, social anxieties or unreliable transportation.
• Location. Teletherapy is accessible to people who live in remote areas where local services are scant, or small towns where anonymity would be a challenge.
• Convenience.  You can squeeze a session in during your lunch break, or while the baby is taking a nap.  That also means that you have greater selection of therapists to choose from since you can schedule during the ‘normal’ daytime operating hours that most therapists offer.
• Privacy. You don’t have to sit in a waiting room with other people.
• Health.  There is no additional exposure to communicable diseases.

• Socially.  Sometimes it is good to get out of the house and be in the caring presence of another person.
• Nonverbals.  Body language and other nonverbal cues can be lost in teletherapy.
• Emotional containment.  Some couples are harder to keep regulated when they are in the comfort of their home.
• Modality options.  Some therapeutic interventions work better in person.
• Connectivity issues.  Sometimes the WIFI blips out, or the screen freezes when you are doing teletherapy, creating awkward moments during a session.  If you have weak WIFI, or kids in the house that are gaming or streaming during your session, you may not want to do teletherapy.
• Screen time. This is my personal complaint.  It can be really draining to be on the computer all day.
• Privacy.  Not everyone can find a private place at home or work to do a teletherapy session.
• Limitations.  Teletherapy is not available to people who lack access to technology and/or WIFI, or who lack the skills and confidence to use that technology.

I have been pleasantly surprised by how effective and convenient teletherapy is.  From my experience so far, the pros have outweighed the cons.

My passion is to help people live happier and more fulfilling lives.

I offer individual therapy and couples counseling in Portland, Oregon. I have a dual counseling license, which means that I can also serve residents throughout the states of Oregon and Washington via online therapy.

I’ve provided individual and couples counseling in Vancouver, Portland, Manzanita, Coos Bay, Eugene, Battle Ground, Olympia, Corvallis, Klamath Falls, Seattle, Medford, Bend, Cannon Beach, Clackamas, Camas, Ashland, Salem, Spokane, Klamath Falls, Tacoma, Beaverton, Lake Oswego, Hood River, all over Oregon and Washington…via online therapy.

If you are searching for in-person couples counseling, please contact me and I will give you a referral. If you are looking for someone close to your home, type ‘couple counseling near me’ into your browser and it should provide you with nearby options.