What is telehealth and how is it different from “regular” therapy? You may be asking yourself whether it’s right for you--and wondering how to make the most of telehealth. Whether you’re moving from in-person therapy to virtual sessions or seeking a therapist for the first time, read on to explore the key factors to optimize your telehealth experience.

What to Expect When You’re Expecting (Telehealth) Therapy

The only essential ingredients to any good therapy are your therapist and you, but it’s true that there are quite a few other factors that help create the therapeutic experience. As humans, we’re guided by environmental cues as well as time-based habits and rituals, sometimes not even consciously. These associations can be powerful in creating an atmosphere that is conducive to therapy. The weekly ritual of walking into the office, the soft lighting, the particular comfort of the chair--all these cues signal to us that it’s time to make the transition from everyday life to the therapeutic moment, to a distinct time to engage with ourselves in a different way. 

When people imagine themselves in therapy, they often imagine these features, and it isn’t always obvious how to recreate this experience with telehealth. It’s true that in telehealth, your therapist has less influence over the environment, but by the same token you now can customize your experience to suit your needs. Telehealth often affords us greater flexibility that can be an asset in scheduling with and even selecting a therapist. 

If you and your in-person therapist move to telehealth, you might find that your sessions feel a little different just by virtue of the technology, and that the overall arc of your therapy experience has a different feel than in-person therapy. There are ways to make this virtual experience as powerful as “regular” therapy in its own right. Indeed, to make the most of telehealth it can be helpful to think of it as its own unique experience, rather than a stand-in for traditional, in-person therapy. 

Consider some of the tips below to make the most of telehealth: 

Setting the Stage

  • Considering the feel of your space. With telehealth, just as with in-person therapy, the environment plays a role. If you’re working at a home office desk all day, consider moving to a different spot when it’s time for your therapy session. Not only will this likely be more comfortable, it can also help transition from a “work” mindset to a “therapy” mindset. Think about the vibe of a therapist’s office--perhaps one you’ve been in, or even one you’ve seen on TV. Probably there is a comfortable chair or couch, soft lighting, tissues, maybe a glass of water, tea. By all means think about setting up such a space for yourself! 

Consider also that with telehealth you have the option to show your therapist your world. It may feel meaningful to show them the art you created, introduce them to your beloved support animal, or even give them a tour of your living room to see your family portraits. If you’re working on sleep or sex issues in therapy, why not show your therapist your bedroom set-up so that you can co-develop a plan to optimize your environment? 

  • Placing your screen. When setting this space up, be sure to think about where to place the device you are using for telehealth. Try to find a place to set down your device, so that you don’t have to hold it during your session. Try to find a place close to an outlet in case you need to charge your device. It also might be best to position your screen somewhere that allows you to keep a comfortable posture (perhaps with the camera at eye level) so that you can feel fully comfortable in your space. 
  • Selecting items you might like to have during your session. It can be difficult to stare into a screen for an extended period; you might like to have a fidget toy or something tactile to play with to aid your concentration. If you expect that strong or painful emotions are likely to emerge in session, you may also want to have some objects that comfort or ground you, e.g. a weighted blanket, strong mints, or a soothing visual of some kind. You might talk with your therapist about the items that could be helpful to have on hand during your session. With telehealth, you don’t need to worry about portability of these objects and can enjoy having as many items or as elaborate a set-up as you’d like.
  • Creating privacy.  If you share a space with other people, you’ll definitely want to be mindful about privacy! Of course, if possible, you will want to schedule therapy at a time when there are likely to be fewer interruptions. If others are in the house during your session, however, you might consider using headphones to limit what they might overhear. Consider setting up a fan or white noise machine just outside your closed door, so that anyone walking by will not be able to hear the conversation inside. You might also like to have a “code word” with your therapist to signal if you have an interruption during session, so that they know to avoid disclosing confidential information until you are alone again. 

It’s also possible that your home is just not a private enough space for therapy. Between partners, kids and pets, you may prefer to have your telehealth therapy session at your office or in your car. In that case, you may need to get creative about setting the stage to signal “therapy time” instead of “work time” or “driving time.” Perhaps you can carve out a corner of your office as a “therapy zone,” or bring out a couple cushions to camp out in the backseat of your car when it’s time for therapy. 

Another option might be to “take your therapist for a walk” by getting out of the house and walking in a quiet area during your session. Neuroscience tells us that walking and talking can activate the brain to better process emotion, and after a long work day cooped up at a desk, you might welcome the fresh air and exercise. That said, be mindful of the location--it should feel peaceful and quiet!--and the potential for distraction. It may be hard to be fully open and emotionally present if you’re dodging traffic or worried about running into acquaintances in the middle of your session. 

Thinking through Technology

  • Software for confidentiality. Your therapist will be mindful of using encrypted and confidential platforms for your session--they may ask you to download and/or set up an account with a particular software, free of charge. Be sure to ask any questions about the software to set your mind at ease when it comes to confidentiality and ease of use. You can even ask for a brief “trial run” with the software before your session if you are particularly concerned about being able to navigate the technology. 

It’s equally important to think about confidentiality in your communications outside of session. Be sure to ask your therapist for their preferred platform for scheduling or sharing documents or other information. Email and SMS text are not secure forms of communication, so your therapist is likely to encourage you to use other platforms. It is your right as the client to communicate however you choose, as long as you are aware of the limitations of confidentiality, but to make the most of telehealth consider following your therapist’s guidelines for communication that best guarantee your confidentiality. 

  • Phone or video? Most therapists will recommend or at least offer a video function to make the most of telehealth--after all, we don’t want to lose the richness of nonverbal communication, and much of our feeling of connection is generated in face-to-face contact! However, there might be situations that are better suited to phone. Perhaps the phone allows you to relax into your psychological world more easily than the visual demands of a screen, and you feel you can get “deeper” more quickly on the phone. Perhaps you find that it’s easier to share your intimate feelings without the virtual gaze of a therapist, and that you can be more fully honest and open with them on the phone than via video. Perhaps the phone feels more private--it’s easier to tell your family you’re taking a phone call in the next room, rather than setting up a video call on your laptop. If you feel that you are likely to have a more meaningful therapeutic experience on the phone rather than video, be sure to share that with your therapist.
  • Choosing the right device for video therapy. If using a video feature, consider ahead of time if you’d rather use your smartphone, computer or tablet for your sessions. All three options are likely to support the software you need, so consider your own personal preferences - would you like the portability of your phone? The nice large screen of your computer? Think about how the device you choose fits into your therapy setting and any props you might need to set it up. Think also if you’d like to be able to sit back on the couch, with some distance from your screen, or if you will be in a small, cozy space close up to the screen. Finally, if you are seeing a therapist as a couple, consider that the lens and screen of a tablet or laptop are likely to fit both you and your partner into the frame more easily (which will help your therapist be equally present with both of you).

Time for Telehealth

  • Creating habits and rituals around therapy. Part of the experience of in-person therapy is the ritual of going to a dedicated place at a dedicated time that stands outside the demands of everyday life. This simple travel experience can signal a transition to therapy that helps you switch gears from your to-do list to your deeper thoughts and feelings. To capture this same experience and make the most of telehealth, think about setting a few minutes before your telehealth session as a pre-therapy ritual. Some examples might be lighting a candle right before your session, taking a walk around the block, or arriving to your dedicated in-home therapy space a couple minutes early to get settled, taking a few deep breaths or stretching your body beforehand. Maybe you have a favorite tea to prepare ahead of your session, or you change into a favorite sweater that has become an informal “therapy sweater.” Your ritual can be simple or elaborate: what matters is that you create a transition to therapy so that you feel fully ready to begin your telehealth session at the appointed time.
  • Consider a regular day and time for therapy--or enjoy the benefits of flexible scheduling. If you find it hard to transition into therapy each week, you might prefer to keep a regular day and time for therapy, to help your mind switch gears more naturally at your appointment time. Likewise, once you identify your personal optimal therapy times (see below) you might want a recurring appointment at those times. Setting a regular day and time for therapy allows you to rest easy knowing you won’t have to to skip a week or meet at a really inconvenient time. 

On the other hand, you may find that scheduling your sessions from week to week allows you to time your sessions for when you really want them. Anticipating major family drama at an upcoming gathering in your hometown? You can time your session to help you get through that experience, and with the flexibility of telehealth, you can meet with your therapist even if you’re away from home. 

  • Finding your optimal therapy time. Telehealth can sometimes be squeezed into a busy schedule more easily than in-person therapy, but that doesn’t mean that all time slots will work equally well for you. You might find that a certain time of day lends itself especially well to therapy--perhaps you feel more alert and focused in the mornings, or more relaxed in the evenings when your partner is out of the house engaged in their own hobby. By the same token, even if you can technically fit your therapy session into your lunch hour, it might not be ideal--you might find yourself anxious or distracted by work tasks during your session and unable to make the most of telehealth at that time.

At the same time, telehealth can open up more available times than in-person therapy. Open yourself to all the possibilities that work best for you---maybe you wouldn’t want to drag yourself to a therapy office at 9:30 pm, but it’s actually a great time for telehealth because your kids are fast asleep and you finally have some peace and quiet. Or maybe in the past you’ve confined your therapy sessions to weekdays to avoid an extra commute on the weekend, but you really would prefer to meet with your therapist on Sunday mornings. Why not have your telehealth session as part of your Sunday self-care?

  •  Match your therapist to your schedule. Your therapist may also have more flexibility with telehealth than they might with in-person sessions, and may offer some days and times that you wouldn’t have guessed were available. When looking for a therapist for the first time, look for one who can keep your schedule and offers appointment times that work best for you, even if they are at unusual hours. And if you and your established therapist are moving to telehealth, feel free to ask them if you are able to adjust your schedule.
  • How often should you have therapy?  With telehealth, you may find that you would like more frequent or less frequent sessions than you did in person. The truth is that telehealth can feel a bit different than in-person therapy---keep an open conversation with your therapist about how telehealth feels different than working together in person. These conversations can help you determine what frequency will most support your progress in therapy.

Getting the Right Fit

  • Choose a therapist that has the right speciality.  Now that you aren’t confined to a particular location, there are many more people to choose from. If you think you would benefit from a particular type of therapy, or from working with someone with a specific clinical focus, telehealth can provide you with a plethora of good options that might have been inaccessible in person. Do a web search with the keywords of your chief concerns to get a sense of therapists and modalities that resonate with you, and don’t be shy about reading online reviews or getting recommendations from others in your network.
  • Choose a reputable group. It can sometimes be harder to get a “feel” for a particular group or therapist when looking online. Lots of people call themselves therapists, but aren’t necessarily well trained. Be sure to choose carefully. Does the website appear legitimate? Is the therapist licensed? Are they responsive to your initial inquiry--is there a phone number you can call? Again, does there seem to be evidence of a good reputation in your area or within the mental health community more generally? A reputable therapist will be more than happy to answer any questions you have about their expertise and should put you at ease about bringing up any concerns. Therapists understand the importance of fit, and should encourage you in “shopping” for therapists until you find one that feels right.

To get started with therapy, or to simply talk through telehealth options further, please call (215) 922-LOVE or schedule an appointment directly online through our website at www.therapyinphiladelphia.com/contact.  Any of our therapists will be happy to talk with you about the telehealth experience--and more importantly, we’re interested to get to know you and help you find a good fit!