Making the Most of Online Therapy

It was a bit of a rude shift at the beginning of the pandemic to go from seeing people in-person for counseling to move exclusively into online therapy. I wanted to take the recommendations from the CDC seriously about moving anything online that could be, but I had some skepticism that online therapy would be as effective. Fortunately, research shows that online therapy is equally effective in almost all cases as in-person sessions. So after the initial shock of moving to online and ironing out some tech issues, I embraced doing therapy online and have found it to be highly effective. It has also allowed me to be in counseling with a practitioner not in my area but who works in the same style as me, a difficult thing to find in a small community like Charlottesville. I wanted to share some things that I have learned that seem to make virtual therapy more effective.

We know that just showing up to therapy can be difficult. So we want to make sure you know that, however you are able to show up, we are glad that you’re there and willing to do the work.

If you’re able to put some of these tips into practice it will make the online therapy experience a little more comfortable.

1. Get some privacy

We want you to be comfortable and secure in the knowledge that what you say is confidential. We follow best practices with tech to make sure that everything is confidential from our end. There are some things you can do on your end to make sure that you have confidentiality. Having your living space to yourself while doing therapy can help you feel more comfortable. This might mean asking a roommate or partner to take a walk or run an errand during your session time, scheduling when you can be home alone, or asking for some help in childcare if kids are part of your reality.

Some people also find a white noise machine or a fan helpful for ensuring conversations are not overheard. These are most effective set up not in the room that you’re in but in the space next to your room.

For some folks, stepping out of the house or out of a workplace and into a car has been helpful. This has some drawbacks as there may be more distractions that can't be controlled, but we are happy to see you however you are able to show up. The important thing is getting there and engaging the best way you can for that time.

2. Set the tone

We put a lot of thought and effort into how our space is set up and know that the environment that therapy happens in can have an effect on outcomes. We use some aromatherapy as part of the ambience in our office, and you might consider doing something like this at home. Some people find pleasant smells to be a relaxing and comforting part of the environment during a session. Essential oils, lotion, or a favorite candle can be a nice addition.

Comfort items such as blankets, stuffed animals, or fidget toys can be another way to set the tone. Many folks find weighted blankets to be grounding, and having something to keep your hands busy can help those with shorter attention spans stay focused. Some clients also benefit from having a warm or cold drink, mints, or a sour or spicy candy to bring them to the present.

3. Begin and end with intention

If you are able, give yourself the kindness of a few minutes before and after the session to transition. Switching between work/school/studying and a more emotionally open place can be difficult. This is especially true if some of what you are working on in therapy is related to the environment you are just stepping out of.

Give yourself a few minutes to get comfortable. Maybe get a glass of water or tea and settle in. Write down a few things you want to focus on in session. Oftentimes I will start sessions with a short mindfulness activity to facilitate this transition, and it helps if you are also able to have a buffer.

Afterward, taking a few minutes to integrate what came up in your session is also a great gift to yourself. Rather than jumping immediately back in with parenting or a presentation at work, let yourself reflect and move into your next task with intention. Journaling a few thoughts or taking a quick walk can help synthesize and integrate the themes of a session.

However you are able to show up, remember that therapy is for you. It doesn’t take the perfect moment or Zoom background to find growth, and your therapist can meet you wherever you are.