Teletherapy introduces unique challenges such as unstable internet and lack of privacy, which can hinder effective communication. Establishing a contingency plan is essential for addressing these obstacles. Prior to therapy, a technical check ensures clients are familiar with video software and helps troubleshoot issues. Privacy concerns can be mitigated by confirming that clients have a secluded space and suggesting the use of headphones or scheduling during quieter times. Flexible communication methods, like switching to phone calls, maintain care continuity amid connectivity issues. Regularly discussing the teletherapy experience with clients helps address technical problems and enhances therapeutic outcomes.
Prior to the pandemic, most people went to in-person therapy, so many of the therapy techniques were based on in-person care models. For example, we might complete a patient worksheet or genogram (similar to a family tree), or even a safety plan with a patient in the room. At the start of the pandemic, we quickly realized the difficulty in completing paper interventions during therapy sessions. This was overcome through technology. Many platforms and electronic record companies worked with their customers (us therapists) to build platforms that allow for sharing of documents and even screen-sharing. Today, I can complete a genogram, safety plan, or pretty much any paper intervention with a patient just as conveniently as I could in-person, and that same care is now far more accessible to patients.
The hesitancy from the clients to do telehealth the first time continues to be the biggest challenge. It took some convincing as some clients felt it would be too impersonal and be difficult to open up and share over the screen. I ask the client to give it a try and if they do not prefer it then we would meet the next session in person. Most clients quickly realize that it’s easier to save time of travel. The client feels a sense of relief, as if it is more confidential, as they don’t wait anymore in the waiting room, where they can run into others. Many clients can now meet during the work day when they were not able to before. They are looking at me and I am looking at them, closer up than in the office. I work with many couples and it is easier for all to see each others expressions at the same time. Some clients still prefer having the client/counselor experience of personal connection. For them, I will always have space for in person sessions.
Overcoming Challenges in Teletherapy One unique challenge I encountered in teletherapy was establishing a strong therapeutic rapport and connection with clients through a virtual platform. While traditional face-to-face therapy allows for nonverbal cues and subtle nuances in communication, the digital barrier of teletherapy poses challenges in fostering a sense of trust and rapport. To overcome this challenge, I implemented creative strategies to enhance engagement and connection during virtual sessions. For example, I encouraged clients to personalize their virtual backgrounds or incorporate meaningful objects into the frame to create a sense of familiarity and comfort. Additionally, I utilized video conferencing features such as screen sharing to facilitate interactive exercises and visual aids, fostering a collaborative and dynamic therapeutic environment. Personally, navigating this challenge reinforced the importance of flexibility and adaptability in teletherapy, as well as the creativity and innovation required to overcome barriers and maintain the therapeutic alliance in a virtual setting.