Call me “old school” but I’ve never been a fan of Teletherapy. Even before the Pandemic I had no interest in offering Teletherapy, but when everything shut down for COVID-19 I was forced to choose between closing my practice or switching to virtual sessions. Now that things are back to “normal” for the most part, I am back to seeing clients in person about 95% of the time. I do have a few clients who are unable to come into the office due to transportation issues or physical health problems and for them I do virtual sessions. However, client have reported to me that they feel they get a lot more benefit from coming in person. I have some thoughts and theories about why that is that I’d like to share.
First, so much is lost through the buffer of two screens like being able to see the whole person’s body language. Many clients I see struggle with anxiety which means that they hold their breath and/or breathe very shallowly. I can’t really tell how someone is breathing during a virtual session. I need to observe them in real time, in 3D, to really see their body language. Second, there’s no genuine eye contact through virtual therapy. While I can look at a client’s eyes on the screen when I am in session with them, I’m not actually making eye contact. In order for me to appear as though I’m looking right at the person I’d have to look into the little camera at the top of my computer screen which would mean I’m not actually seeing the client’s face clearly. Eye contact is so important for attachment and connection which are the most important factors in determining how effective/successful therapy is. Third, did you know that just being in the presence of a calm person makes you feel calmer? I am very good at regulating my nervous system so when clients are in my office they feel that energy as well. This is all lost through virtual sessions and screens. And finally, many of my methods are experiential and require being in person to do, such as alternating bilateral stimulation. I have a gadget called a Theratapper that I use for this and it is hand-held and therefore needs to be used physically. I also want to add what clients have said to me when I asked why they thought in-person therapy is more effective. Here are the top reasons:
- They don’t have complete privacy at home and don’t feel they can speak freely since other family members are there and they don’t want to have to do therapy from their car.
- They like getting out of the house and being in my office which is a safe space and separate from their daily living environment. They like being able to cry in my office and leave the emotion there rather than being at home for this.
- They feel more supported in my office since I’m there with them physically and can better help them calm down or process feelings if they are having a lot of emotion come up.
- They feel more connected and “gotten” when they come in person vs. doing a Teletherapy session.
- Those with social anxiety find that staying at home doesn’t challenge them since they are just staying in their “comfort zone.” Being in person is a way for them to work through social anxiety in real time.
In my opinion, the ONLY benefit to Teletherapy is the convenience of it. I know many clinicians will disagree with what I just said but that’s my view. I’m able to offer it if in-person isn’t an option because I do think that Teletherapy is certainly better than no therapy. However, before the Pandemic, many people did in-person therapy even though it wasn’t the most convenient and it was worth it. Just because we have gotten used to doing a lot of things virtually doesn’t mean that it’s the best method. I encourage you to seek out an in-person therapist if anything I’ve written resonates with you. I offer a free 30 minute consultation to see if we are a good fit!