9 steps to prepare for online therapy

I have been exclusively working online now since the country went into lockdown in March 2020. I have maintained working online despite restrictions lifting as I personally don’t feel safe working face to face, as I am clinically vulnerable to Covid-19. If anything this move online has helped me develop my specialism of working with those who are in chronic pain and those experiencing long term illnesses. I have been able to work with people all around the country, without the distance between us being a problem. Also it has helped bring therapy to profoundly disabled people, who might struggle to leave the house.

One of the things I’ve learnt to do, as the therapist, in supervision and during my own therapy is to prepare the environment I am about to work in. I thought I’d share by top tips and things to consider when working online with a therapist.

Step 1. Lighting

It’s important to consider the lighting in the room you are working in and any light changes that might happen during the session. Sometimes the room might look bright, but then you start the camera and things look a bit gloomy, especially during the evening. I also consider if the screen is going to be affected by natural light changes- which impacts me personally around sunset- so when I am working then, I will shut the blind in my office.

Step 2. Privacy

You’re in your own home, it might not be possible to be home alone. It is important you feel you can talk freely and in order to do this it is important to make sure you feel you can’t be over heard and make sure that others know not to enter the room you are in during the work. A simple do not disturb sign might be considered.

Sometimes being in your home isn’t an option. I have worked with some people who decide to sit in their cars for therapy. From a safety perspective, I would never work with someone who is driving, but would be happy with sitting in a stationary car.

How I personally overcome this is to make sure nobody comes upstairs, where my office is and communicate when I am working, so there are no disruptions on my end.

Step 3. Tissues

Therapy can be a time to have a good cry- your therapist won’t mind and there is no need to apologise for tears, they are very welcome. When working face to face, I’d always have a box of tissues on hand. I can’t do that online, but a quick reminder that they might be needed.

Step 4. Internet connection

Check your connection before the appointment. Make sure the room you are in has good signal from the router or if you are working on 4G that there is sufficient signal. Theres things we can do during the session if the connection drops- such as turn off the video and as a last resort talk on the telephone. It happens! The internet is an unpredictable element sometimes, but its always good to have a backup plan.

Step 5. Technology

Think about the technology you are using, does it have the right software (if relevant)? Will the power on the device last for the duration of the session? Do all the features work (such as mic and camera)?

Essentially you can work on a mobile phone, which is fine, but it might hurt your arm to hold the phone in selfie mode for 50 minutes. Maybe consider something to hold the phone, or use a device such as a tablet or computer resting on a table in front of you. You could consider using some headphones if you wish. Personally I choose to use Apple AirPods.

Step 6. Drink

Talking for 50 minutes can dry out the vocal chords. You are very welcome to have a non-alcoholic drink at hand. If we were working face to face, I would always offer one. There is nothing worse than feeling uncomfortable because you need a drink.

Step 7. Comfort

You are going to be sitting in one spot for 50 minutes, choose somewhere you are going to be comfortable, including temperature. This is more of a challenge during the summer months, as opening a window might mean privacy is lost. Personally I use a fan to keep me cool during the summer months, so I don’t have to open a window. I also use cushions to support me, so I am sitting comfortably.

Step 8. Distractions

In todays society it is easy to get distracted, particularly by a mobile phone or another screen. I tend to put my do not disturb button on my phone. There is also deliveries to consider- try and make sure that there is someone to accept a delivery on your behalf, or schedule the delivery for another time.

On a different note- children. They might be in another room playing, but are you being distracted by the noise? Maybe consider scheduling therapy for when they are not around to create background noise.

Step 9. After the session

Consider what you are going to do to leave therapy. You are in your space, but it might be important to get up and move about- leave the room you were working in for a bit, go for a short walk, do whatever feels right for you, so you feel like you have physically left the therapeutic space when the call ends.

Conclusion

So there we have it! My 9 tips to preparing your environment for online therapy! When I started working online, I wouldn’t have thought about how important some of these things are, but it is the little things that can make a big difference for therapy going smoothly.

Counselling in a pandemic- what I've learnt

When I look back at the past year, I can see the world has changed beyond recognition. Along with many other things, the way I work also changed. In March 2020, I made the decision to stop working face to face with clients, to protect both myself and them, especially as I was pregnant in March 2020. It was a bold move and I am grateful that so many of the people I was working with trusted me enough to take our work together online. I am pleased to say the transition into the online world went really well, so much so, that it is something I plan to keep up, even post pandemic, especially as a return to work after a short break for maternity leave.

Pre-pandemic me would have been sceptical about online therapy and would have privileged working face to face, however the experience of actually working online has taught me how affective the work can be and in some cases it can be enhanced.

One key advantage to working online, is not needing to plan in travel time! Therapy in your own home means that arriving is just a button click away, no public transport, no driving, no parking. A big plus in the winter months. This might also open up coming to counselling for those who may find it difficult to get out and about, ensuring inclusivity.

For me personally, offering therapy online means that I can be more flexible about when I work and can offer a wider range of appointments, including evening slots. Unlike when I work face to face, when I need to consider the room availability of where I am working. From a clients perspective this means being able to offer the most suitable time for them, resulting in less missed appointments.

Another advantage is being able to choose a therapist anywhere you want. Sometimes people worry about bumping into their therapist out of context, what better way to avoid this happening than to choose a therapist from a different geographical location. Also it removes the fear of bumping into someone you might know in the waiting room.

I have also noticed that there can be a deeper connection with a clients vulnerable part of themselves, leading to wider disclosure of concerning issues. Maybe this is because of being within familiar surroundings and therefore more able to open up freely.

Online socialisation seems to have become part of our new normal. However, there is something difficult about group communications online. Thankfully it is much easier to communicate when it is a one to one situation. Many people are seeking connection right now. My belief is that online therapy can provide an opportunity for connection and facilitate a safe space in which to work therapeutically. Of course it is important that the client feels like they are safe where they are and that they feel able to open up and talk.

Now therapy online is not to be undertaken without caution. There are various ways of engaging with people online and it is important that you choose a reputable source and ensure the therapist that you choose to work with is registered with an awarding body such as the UKCP or BACP. You can search registers online. In addition to this, make sure you choose a method that is right for you. There are lots of online apps offering therapy, which have limited evidence to suggest they are affective.

Of course there are downsides to online therapy. Not having the right technology can be a block for some. You need to have a device which can connect to the internet and has a camera, where you can see the screen at the same time. For this reason, I am happy to work with people on the telephone, to make sure that I remain open to working with those without the right technology.

Most importantly, right now counselling could go ahead in a face to face environment with the right covid secure measures in place, however, this is never a 100% certainty. Although I don’t believe that online therapy will ever be a permanent replacement for face to face therapy for some, it is a good stop gap for now, which is why I would always be open to starting work with someone online, with the view of moving to a face to face environment when we can. This might be particularly relevant for you if this is a reason for not starting therapy now.

There are some clear advantages to working online and having done it now for almost a year now, I am pleased to say my own pre-judgements of the world of online therapy were wrong. If you’re in the same position as me, then why not give it a go and see how it goes and find out if it’s for you…