What a Therapist Wants You to Know About Remote Therapy

I felt like a thawing glacier. Still chilly, I contacted my colleague, Jo-e Sutton, a certified holistic health practioner. She surprised me with her enthusiasm. “Zoom sessions are the greatest blessings that have come from this dark time.”

“Really? How so?” I asked.

“It saves so much time,” she replied with gusto, “It used to take me an hour to dress professionally, pack food for the day, schlep across town, pick up fresh-cut flowers, park, light candles, and make tea. Now all I have to do is get dressed (from the waist up) and, poof, there I am.”

“But how’s it working for your clients?” I asked, dumbfounded.

“They say they like it better because of the convenience.”

I could feel myself warming to the idea, yet still feeling the need for more insight, I reached out to Patti Ashley, a licensed professional counselor. She said, “I miss handing my client a tissue when they cry and offering them a soft blanket when discussing a challenging topic. In a virtual session, I teach my clients to do those things for themselves, which may be more empowering for them in the long run.”

With that, I replied to my clients and scheduled times to explore this strange new frontier. The next day, Sophie (another client, not her real name), wearing a pink, ruffly shirt, her deep blue pools for eyes that appeared larger than life on my computer screen. I could even see the thin red lines in her bloodshot eyes. I taught her how to pull herself out of the hypnotic state if needed. We laughed each time her cat walked across her keyboard, and she joked that her cat needed the session as much as she did.

By the end of the hour, Sophie looked refreshed and said she felt markedly better than she did before we started. We marveled that even though we were nearly 2,400 miles apart, we could feel connected. 

Fast-forward to today. It’s now been several years and hundreds of Zoom therapy sessions later. With hindsight being 2020, pun intended, here’s what I’ve determined to be the pros and cons of cybertherapy thus far:

 Cons

• No human touch: There’s no escaping the fact that we are social creatures. Even though pandemic restrictions have eased, many people feel like wilting flowers, not being able to bask in the sunlight of each other’s presence as often or as freely as they used to. It turns out that a critical component of a session’s value is the atmosphere the therapist creates.
• No control over the environment: In a virtual session, therapists can’t create the womb-like environment they prefer in order to assist the clients to feel safe and supported (to more easily open up and share their struggles, which is essential for the healing process). When you’re trying to soothe someone into their deepest memory at the heart of their core wound, leaf-blowers, clanking pots in the background, and kids running into the room can derail the process.
• Technological glitches: The power will shut off from time to time, the screen will freeze, and the client will get so caught up in their story they fail to notice their laptop screen has dipped below eye level, and we’ll be forced to listen to their sob story while looking up their nose.

 Pros

• An opportunity explosion: Remote therapy allows people to access mental health services from all over the world. Back in pre-pandemic days, if we lived outside a metropolitan area, we’d consider ourselves lucky if there was a therapist within a 20-mile radius. And we’d hope that therapist was a good one. These days, we’re not confined by geography. 
• A different kind of intimacy: On Zoom, even though you can’t read each other’s full body language, you’re just a foot away from each other’s faces. You can see each other’s eyes—the windows to the soul, larger than life—which, in some ways, helps deepen the connection.
• Reduced expenses and hassle: There’s no more factoring in gas and parking fees, transit, or other expenses to get to or from your session. For therapists, remote sessions mean we no longer have to pay for expensive office space. Similarly, in Los Angeles, where I live, it wasn’t uncommon to get a call from a client on their way to a session, saying they had to cancel due to gridlock. Now, with remote sessions, that’s not as common, and you don’t have to leave your house to talk to a professional. Any quiet, private space in your home will usually do.  
• Filters and backgrounds: Last and certainly least, even if we don’t have time to tidy our home office, virtual backgrounds save the day and give therapists a professional look (while masking the clutter of paperwork or unfolded laundry). Not to mention, if we need more time to dress our best for our sessions, Zoom filters make us all look better than in real life. This all applies to clients as well: no worrying about the laundry on the bed if you’re joining a session from your phone. The challenge with this, however, is if and when we do eventually meet in person, we’ll have to prepare ourselves for more wrinkles and dark lines than we’ve become used to seeing.

I’m fond of telling my clients that a crisis is a terrible thing to waste. And I just find it ironic that the isolation from the pandemic created more demand for mental health care than ever before. And it then created more supply for it, as well.

I circled back with Kappas last week to see how remote therapy continued working with him; I wasn’t surprised to hear he was more pleased than ever. As our conversation concluded, his phone pinged. It was a Facebook post from his colleague, “Seeing clients online is incredible. I used to think this work had to be done face-to-face. I just returned from a five-week trip to Italy, where I held Zoom sessions daily!”

With the upsides avalanching the downs, I can’t imagine we, in the therapeutic world, will ever go back to the horse and buggy ways of old.