Getting the most from online and telephone therapy


Evidence, and our own experience, has shown that online and telephone therapy are not second best to in-person therapy - they are just different. Being aware of these differences, and knowing how to work with them, can really help you to get the most out of your online and telephone therapy sessions.


Creating a therapeutic space


One of the biggest benefits of accessing therapy remotely is that you get to meet with your therapist from the comfort of your own familiar surroundings. You are in control of creating the therapeutic space, and you can design it to meet your personal tastes and requirements. Creating an atmosphere which feels safe and relaxing can really help to put you in the right frame of mind for engaging with your therapy sessions.


When choosing a location for your sessions, it is important to find a space that is comfortable, quiet and as distraction-free as possible. Try to make your surroundings peaceful and appealing – somewhere that you will enjoy spending time. This could be making a pile of cushions to relax on, or wrapping yourself in a blanket. You could also try creating a calming atmosphere using candles, aromatherapy or incense.


A warm drink can help you to relax and feel at ease, so consider putting the kettle on as part of your therapy preparations. Having pets nearby can also be very reassuring and calming, as long as they don’t demand too much attention or interrupt your sessions!


Getting familiar with the technology


If you are not familiar with the technology which you will be using to meet with your therapist, it can be helpful to practise using it before your first session. For online video conferencing services like Zoom, make sure that you download any necessary software ahead of time and test your set-up to make sure that your camera and audio are working. You could even arrange a call with a friend or family member to get familiar with the settings.


If you find it awkward to see your own image on the screen, select the option to “hide self-view” in the settings. If you are worried about background noises distracting you during sessions, you might want to try using earphones or ear buds to help block them out.


It can be helpful to minimise the other devices sharing your Wi-Fi to give you a better, faster connection. You should also check that no other apps are running in the background of your device as this could also slow things down.


Make sure that any devices (e.g. phone or tablet) are fully charged, or that you have the charging cable to hand – it can be very frustrating if your battery runs low and you need to interrupt your session to find the charger. Also, find somewhere to prop your device at eye-level, so that you will not need to hold it during the session.


Technical issues during sessions can be very frustrating, but sometimes these things happen. The therapists at Acorn Psychotherapy always take an alternative contact method to reach their clients, and the Psychotherapy Agreement provided to clients explains the steps to take if the connection is lost. This means that, should a problem occur, you will know exactly what to do.


Being fully present


Being fully present and in the moment, can really help you get the most out of your therapy sessions. This can be harder when having therapy from home, as there may be distractions which could steal your attention away from your session.


Therapy should be a time to deeply focus on yourself, so avoid having anything in your eyeline which could draw your attention away – such as a pile of laundry that needs sorting. It is also really helpful to turn off app, email or text notifications as they can be very hard to ignore, and can easily break your focus. If possible, turn off (or mute) all devices apart from the one you are using for your session.


Try to make sure that you have anything you might need during your session to hand, such as a box of tissues or a drink. Making these arrangements in advance will help you to keep your focus during your therapy.


To help avoid any interruptions, it is important to set clear boundaries with any other members of your household. Make sure housemates or family members know that you will not be available for the duration of the session, and that you should not be disturbed. Putting a sign on your door to remind people of this can be really helpful.


Protecting your privacy


It can be hard to speak freely with your therapist if you are worried that other people can overhear you. Taking steps to protect your privacy can help to minimise these concerns, allowing you to engage in your sessions fully.


As discussed above, if you live with other people make sure that they know you will not be available during your session, and ask them not to disturb you. If you have pets that are likely to cause an interruption, consider putting them in another room or asking someone else to keep an eye on them.


It can be helpful to choose a time of day for you therapy when you are less likely to be disturbed or overheard, such as during the school day if you have children. You can also use earphones so that other people in the house are not able to hear what your therapist is saying. If it is simply not possible to have sufficient privacy at home, you can get creative and come up with an alternative setting, such as a quiet park or sitting in your parked car on your drive.


Creating a transition before and after therapy


In-person therapy often has natural transitions into and out of sessions, such as the journey to and from the location where the therapist works. This can really help clients to get into the right frame of mind before a session, and to reflect and process on the session afterwards. If you are meeting with a therapist remotely, it can be really helpful to recreate these transitions as part of your therapy routine.


If possible, try to sit down a few minutes before your session is due to take place, so that you can settle in and relax before you get started. You may want to try a few minutes of meditation during this time, or a short grounding technique, to really help you feel fully in the present and ready for your session.


The ending of online and telephone sessions can feel quite abrupt as they stop immediately after the connection is terminated. It can be really helpful to take some time after your session has ended to process any overwhelming emotions and reflect on what you have discussed. You could use this time to meditate, journal, or go for a walk. This can really help you to transition back into the “real world” after the end of your session.


Give your therapist feedback


Your therapist’s goal is to help you to get the most out of your therapy sessions so, if something isn’t working for you, don’t be afraid to give them feedback. For example, you might need to ask them to sit closer to their screen, or to put an extra light on if you are having difficulty seeing their face clearly. If you find that the communication method isn’t working for you, let your therapist know so that you can come up with an alternative. For example, some people can feel self-conscious using platforms such as Zoom, so it might be worth giving telephone therapy a try to see if it feels better. Don’t be afraid to let your therapist know what is and isn’t working for you.


Kathryn Perry


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