While teletherapy has been a topic of conversation and consideration for some time now, COVID-19 has made what used to feel like a choice into something of a necessity in recent weeks.
While levels of stress and loneliness were rising to epidemic levels before COVID-19, physical isolation can deepen mental health vulnerabilities and make it more important than ever for you to proactively protect and strengthen your mental health.
If you are already working with an in-person therapist, we at MyWellbeing recommend that you continue therapy with your current therapist remotely at this time. If you are new to therapy, you can absolutely begin therapy remotely and continue in-person on the other side of the corona outbreak.
We understand that beginning a therapeutic relationship remotely can feel awkward, confusing, or just overwhelming, especially when your relationship with your therapist is so key to the success of the therapy. Our mission at MyWellbeing is to support you as much as possible in every step of your therapeutic journey, particularly the first steps forward. We have put together these 10 steps to start therapy remotely to take at least one question or concern off your plate.
This may seem obvious, but the first step to starting therapy successfully, remotely or not, is deciding to start therapy and committing to that decision. Know that therapy may not be exactly what you expected, you may not always feel comfortable, and you are challenging yourself to grow. Commit to the process in all its ebbs and flows.
Deciding to open up and practice vulnerability with yourself -- and someone else -- is no small feat. Recognize and celebrate that.
As you develop trust with your therapist and, over time, dig into your thoughts, feelings, and experiences, you can expect that you may face some resistance within yourself. You may doubt whether you have the finances or time. You may be tempted to walk away. Please don’t. This is the moment to lean in, with compassion.
Give yourself the time and space you need to process what arises in therapy. Engage in joy on therapy days. Know that there will be moments when you laugh with your therapist, moments when you cry, and moments when you aren’t quite sure what you think or feel or how to put words to it. The most beautiful aspect of therapy is it’s all of those things, it’s entirely yours, and everything is normal and okay.
It is often helpful therapeutically to engage in therapy at the same time and place each week. Often, these things are organized for you: you meet your therapist at the same time, on the same day, in their office. While quarantined, or when engaging in therapy remotely, you have more choice in where and when you engage in therapy.
I encourage you to continue to meet with your therapist at the same time on the same day. This consistency can serve as a “holding environment,” which can consciously and subconsciously create an environment of safety for you to be able to tolerate and work through higher levels of discomfort.
Along similar lines, I encourage you to choose a physical space that you can return to. This may be a sliver of your apartment, a particular part of your bedroom, a home office if you have one, or even your car if you are quarantined with others and seeking privacy. It might be a 2 block radius around your apartment if you need some oxygen. Consistency is key and creating and holding to your routine will serve you well.
Once you have your time and place sorted out, I encourage you to find your therapist.
You may already be working with a therapist who you love and transitioning to remote work from in-person. Cross this off your list and move on to the next step!
If you are beginning therapy and seeking a fit, take a deep breath, we’ve got this. A number of options are available to you:
If you are interested in working with your therapist in-person on the other side of the coronavirus outbreak, I recommend searching for a therapist in your area who you can begin with remotely and continue with in-person afterward. You can let your therapist know that this is your ideal scenario during your phone consultation.
Fit is the single most important factor for success in therapy. Gaining a sense of your chemistry with your therapist is a great step in choosing which therapist you’d like to move forward with and a complimentary phone consultation is a great way to begin to sense fit.
Every provider we work with at MyWellbeing guarantees a free phone consultation. Even if you have found a therapist through another outlet, I recommend inquiring if they are open to providing a brief phone consultation so that you can gauge your fit together.
If the idea of getting on the phone to “interview” your therapist is overwhelming at all, we at MyWellbeing have written up a guide for how to gauge fit during your phone consultation.
You will want to gain a sense of how you are feeling when you are communicating with the therapist. For example:
It can be very difficult to gauge full answers to the above in a brief 15 minute phone consultation. You are more likely to know a “no” than a “yes.” If someone feels like a “maybe, I’m not sure,” I encourage you to try.
Which brings us to our next point...
You likely will not be 1,000% sure whether or not a therapist is the right fit for you immediately. Sometimes, you are sure right away, and other times, you are never fully sure.
I encourage you to commit at least 8 weeks before deciding that therapy, or your particular therapist, is not right for you. This time will go faster than you think. This amount of time will allow you and your therapist the opportunity to begin to build trust and to bond. With that trust will come a level of comfort through which you can really open up, and you can both begin to make progress, together.
If you continue to feel stuck, unheard, or unsupported in that time, I recommend that you talk to your therapist about it. You do not have to wait. If you feel stuck in your first session, let your therapist know. You can always adjust and tweak your work together. If the work continues to feel groundless, you can discuss why that might be, brainstorm together best next steps, or decide to move on.
If you decide to move on, I encourage you to try at least one additional therapist and to prioritize that the therapist practices with a different technique or style than the first therapist you worked with. Describe the therapy that did not resonate with you during your phone consultation with your next prospective match and let them know that you are interested in trying something different. This way, you can begin to experience the breadth of types of therapy out there, and you can begin to understand which type(s) of therapist resonate most with you.
Therapy is a growth agent. Like other growth opportunities, you will gain out of therapy what you put in.
In the early days, you may not be entirely sure what to say. You may recount your day-to-day or you may find yourself sharing what happened to you in the moments before walking into the room (or video session), as that is what is top of mind. This is normal and absolutely okay. You can continue this way for as long as you like, as you are still able to weave in aspects of your life and begin familiarizing with your therapist.
When you are ready, I encourage you to practice vulnerability and to tap into the courage you need to dig a little bit deeper. Try to identify a few things that you’d really like to work on. They may be painful to think about or they may be things that you haven’t thought or talked about in a long time.
This is your time. Know that your therapist is there to support you however you need it and can be a partner with you in unpacking how you’d like to use your time.
If you continue to feel groundless or like you are grasping for tools and conversation starters, some practices can be especially helpful in organizing your time in therapy. Taking notes during the week is one example, which we will dive into next.
Throughout the week, practice mindfulness around when you feel especially stressed, triggered, angry, irritable, or tired. Think to yourself:
The first goal of this exercise is to brain dump. You do not need to “get” or “gain” anything from this other than to have a storage unit for your thoughts and feelings. Over time, you may begin to realize certain aspects of who you are and of your unique experience.
I encourage you to bring these notes to your therapy session and to share what you are writing, feeling, and learning with your therapist. You may not realize anything major the first time, or the first few times. You may find that after a few weeks, however, patterns emerge. Those patterns may be the keys to discovering some of the themes or learnings at the root of what you’re going through. Those discoveries may help you better understand yourself, your relationships, and your surroundings, enough to begin to craft a life that resonates more deeply with who you really are and how you’d like to grow.
Therapy is a unique and special experience that not everyone has been through or can understand. Sometimes, those you are closest to aren’t the people you feel most comfortable discussing therapy with. Support is not only extremely helpful for the therapeutic process, it’s really fun, and something to double down on.
If you have connections in your personal life who engage in therapy and support your journey, I recommend setting a regular reminder or regular practice to check-in with them to discuss what you all are learning. This can be an immensely helpful support and gratification network. You can also deepen and strengthen your relationships.
If you do not have these connections in your personal life, I recommend engaging with mental health advocates and organizations that build these communities. MyWellbeing offers a series of free or low-cost support groups, for example, through which you can build interpersonal support and relationships with others who are seeking a deeper emotional understanding and experience.
Therapy, like any training or education, takes time. While many of us wish it were otherwise, change does not happen overnight and it’s important to set reasonable expectations. For example, if you have no training in computer programming, you probably wouldn’t expect to open your laptop and be able to code an app. Similarly, as ready as you are or want to be, you may not have a breakthrough in your first session. You may not have a breakthrough in your first ten sessions. Learning, processing, healing, and growing all take time.
Know and trust that over time, acceptance and change will come, whichever you need most. You will begin to notice triggers in your day-to-day life that you respond differently to. You may respond with more space, more calm, or less reactivity. You may gain a deeper understanding of yourself and those around you. You may begin to feel more in touch with your deepest desires. You may feel more productive at work, more rested in the morning. You may make healthier decisions. It’s likely that you will notice the change very gradually and the shifts will feel subtle at first. After longer periods of time, you will look back and be surprised at how much has evolved.
Like education, you don’t know exactly what you will gain from each course, and you don’t know exactly what you will gain from each therapy session. However, in hindsight on the other side, you will realize quite how much you’ve learned and grown.
Finally, practice patience with yourself and your loved ones. We are collectively going through an unprecedented international pandemic. Our lack of control over our external circumstances can trigger many of us to grasp for control in our personal lives. This is absolutely normal.
Therapy, your thoughts and feelings, and the thoughts and feelings of your loved ones are often not things that you can control. They are things that you can invest in, things that you can seek to better understand, and things that you can come to accept and to love.
Now is an important time to remember, note, and commit to the things that will help you to persevere. Your mental health is equally or more important than your physical health and now is the time to prioritize it.
Social distancing does not mean that you need to be socially distant or alone. We are here to help you connect with the care that you need. Reach the MyWellbeing team at [email protected] or follow us on social at @findmywellbeing for free wellness tips and perspective.
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Alyssa Petersel, Co-Founder and CEO of My Wellbeing and author of Somehow I Am Different, graduated from Northwestern University in 2013 with dual BA degrees in psychology and international studies, graduated summa cum laude from New York University in May 2017 with her Master's in Social Work, and graduated from The Writer's Institute non-fiction program at CUNY Graduate Center in May 2017. A native New Yorker, Alyssa now lives in Brooklyn and enjoys running, coffee, community, and social justice.
