May 20, 2020

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The Age Of Modern Therapy: A Virtual Approach

I recently attended a conference that focused on using remote therapy to work with children and adolescents. I was surprised by the number of providers talking about their anxiety, confusion, fatigue, and fear of virtual treatment. Some of the attendees discussed not taking on new clients, resigning themselves to phone sessions, stopping treatment with particular clients, and even shutting down their practice entirely. At that moment, I felt I could provide support.

We have heard from so many therapists that they have transitioned to teletherapy, but that the change has been challenging. Today, we hear from NYC therapist and MyWellbeing community member, Kyle McEvoy, about how to make the most of virtual therapy, and the surprising benefits that teletherapy offers!

Mental and medical health providers have been further forced into isolation, the nature of our professions.

Computer screens, tablets, cell phones, and the internet have become both our best friends and our enemies.

I recently attended a conference that focused on using remote therapy to work with children and adolescents. I was surprised by the number of providers talking about their anxiety, confusion, fatigue, and fear of virtual treatment. Some of the attendees discussed not taking on new clients, resigning themselves to phone sessions, stopping treatment with particular clients, and even shutting down their practice entirely.

At that moment, I felt I could provide support.  

Not physically seeing our clients is the most apparent negative; they’ve become a standardized square on our screens or a voice in our ear.

However, there are other concerns. Due to the lack of in-person energy, therapists lose control over consultation rooms, worry about privacy, and now have to think about technological difficulties!

These concerns are valid. However, I have had experience with working in virtual environments for therapy before and have endured, so I knew virtual sessions were possible.

Become familiar with your telehealth platform.

Familiarizing yourself with your platform is one of the most critical aspects of transitioning to virtual sessions.

Each platform has its quirks, flaws, and benefits. It is essential to know what those are and how to work within the parameters provided. For example, Zoom allows you to use their virtual whiteboard, whereas SimplePractice will only permit you to share your screen.

To further understand my platform (SimplePractice), I:

  • Ran trial sessions and collected feedback
  • Joined Facebook groups that targeted private practice providers, virtual health care professionals, and, most importantly, SimplePractice users, which allowed me to stay up-to-date on ideas, technical issues, tips, scheduled maintenance, and improvements
  • Watched various videos regarding different platforms
  • Read provider reviews, to have a balanced perspective of the technology.  

It’s important to remember that, similar to traditional face-to-face therapy, there will be good and unsatisfactory sessions.

Discuss apparent differences and check in.

One tip that’s part of my clinical approach is to highlight explicit observations and talk about apparent changes. Moving from in-person therapy to virtual therapy is one of the most explicit changes there is, so I spoke to my clients about what ‘virtual’ means. Some clients were apprehensive. Others? Unphased. Regardless, each person deserves a platform to discuss these changes.

Providers are aware of the defensive barriers that our minds construct to protect ourselves from intensified negative emotions. We now have a physical barrier between us. This new barrier can be a positive aspect of virtual therapy, because people may feel more protected, making it easier to be vulnerable and more authentic, or it can be a negative aspect, because it may hinder the connection between client and therapist.

We want to maintain connections. I encourage you to explicitly ask clients about their expectations, along with their feelings about virtual therapy and the therapeutic relationship.

Furthermore, it can help to share your honest opinions about this change. This may create a more authentic connection.

Mark moments of genuine connection.

One of the commonly discussed hindrances of virtual therapy is the relational connection. This new physical barrier is going to change the client-therapist relationship, but not all hope is lost. The moments where we hone in on the context of our conversations and forget about the room still exist.

These moments of genuine connections deserve to be marked. I have checked in with my clients about their thoughts on our attunement, and most have agreed that they feel as authentically connected during our virtual sessions as during in-person sessions.

This discovery had empowered my belief on our ability as therapists to transcend technology in treatment.

Be flexible, yet firm, and get creative!

Providers don’t always talk about the positives of virtual therapy, but there are many.

My first thought goes towards in-home treatment. Many providers shy away from this type of work since there are more uncertainties, but the amount of additional information given during an in-home session could take months to learn in a consulting room!

One benefit is that therapists get to see clients’ home environments. Your client may take you on tour and you may learn of things that may potentially interrupt sessions. Perhaps their room is fully decorated, or not at all; maybe their room is messy and cramped. The environment might be noisy or eerily quiet, incredibly dark, or even perfect!

Since there are new and exciting things to learn about your client, you might want to be a little more flexible about treatment, such as switching between video and phone, or weekly or biweekly sessions. It’s vital to recognize these changes and be curious about the reasoning behind them. Expect some level of discomfort and, for the quality of our therapeutic work, focus to ensure treatment regains its strength. Remember, this is as new for them as it may be for us.

Don’t be afraid to get creative. Try counseling in different locations within your home; implement online games you both can play to foster comfort and connection; add some plants to your decor; play Pictionary; and, whenever possible, prevent interruptions.

In-home work and virtual therapy are incredibly similar. Both can come with resistance, and it is quintessential to remember the reasons for seeking treatment initially.

With care, attention, and planning, virtual therapy can even help you make great strides in all facets of treatment! Get out there and be the best version of you!

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About the author

about the author:

Kyle McEvoy, LMHC & Founder of Collaborative Therapy, utilizes a client-centered base to therapy by adapting to individual needs. He focuses on the needs of the individual to support their internal/external relational system in a healthy and clear manner to reach overarching goals.  Kyle believes everyone has the capacity to better themselves if they're willing.

For fun, Kyle loves spending time with friends, exploring, traveling, relaxing with his dog (Otis), laying on the beach, listening to music, watching movies, cooking, snowboarding, yoga, meditation, drawing, and planting.  

He has helped people overcome substance abuse issues, explore individual identity (LGBTQ), cope with psychological/cognitive/developmental disorders, accept medical diagnoses, overcome sexual abuse/intimate partner violence, and a variety of maladaptive behaviors.  

Kyle utilizes an eclectic approach to therapy to ensure that clients receive the best of all modalities he is versed in. He is trained in Mentalization-Based Treatment for Adults, Adolescents, and Children; and Adaptive Mentalization-Based Integrative Treatment for Systems.