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Overcoming the Awkwardness of Providing Telehealth Services For Therapists

Dr. Kari Leavell, Grapevine Psychology

Let’s talk about overcoming potential initial awkwardness of telehealth services and removing that specific barrier from providing the essential support and continuity of care to your clients during this time. This would also enable you to serve your community and state with supportive crisis care to folks on the front lines.

First, (at this time) this is totally your choice. If you don’t want to meet this way, you get to make that call. I will ask you to keep this mind, though...the shifting to telehealth is happening for many reasons:

  • Therapists have a responsibility to model healthy social responsibility by heeding state and national recommendations for social distancing and self-quarantines.
  • Meeting virtually helps to reduce the risk for both therapists and clients of being unknowingly exposed to COVID-19 from an asymptomatic carrier… who knows, we could be one!
  • It becomes a confidentiality issue because if we are exposed or clients come up positive for the virus, therapists may have to release names of other clients who could also have been exposed to the health department to protect against continued spread.
  • In bizarre situations such as the one in which we find ourselves, it is normal to abandon our healthy routines and fall (back) into unhealthy patterns… Uncertainty and fear tend to do that to all of us. Therapists providing services to our clients is what fills our cup and gives us normalcy. Give yourself that element of routine through all of this!

So, let’s talk about how you can adjust to this (hopefully) temporary shift to telehealth at this time. It is expected that it may be awkward at first. At first thought, it seems impossible to feel connected over a screen. I agree…at first thought...

As a psychologist previously resistant to this telehealth “stuff” myself, I have been pleasantly surprised and even pleased by how quickly the screen seems to fade away (in as soon as 5-10 minutes). With any amount of rapport and connection, it will naturally fall into place and become about the client’s emotional needs and the support and skills therapists provide, just like any other session. When checking-in with my clients about their experience with telehealth last week, all of them expressed surprise and relief at how natural it felt. Fellow therapists, our clients and communities are seeking support and normalcy…we are uniquely trained to compartmentalize our own experience and provide this normalcy to help the larger mission of keeping panic at bay.

There will inevitably be technology failures such as lost connections, fuzzy video, or staticky audio. However, challenges often happen during in-person sessions, too…the folks mowing outside flinging rocks against the door or window, the weather outside is distracting, or mandatory fire drills occur in buildings. What gets you through those in-person oddities is the trust and safety that you have in the therapeutic relationship. Allow yourself to trust the alliance that you have created, and soon into your first telehealth appointment you will see how quickly the experience becomes normal.

Quick Tips for Engaging Telehealth Sessions:

  • Use a Bluetooth headset or headphones with a microphone to increase privacy and improve audio.
  • Prop up your device up (i.e., phone, tablet, or computer) so that you don’t have to constantly hold it.
  • Get creative about how to carve out privacy for your session. Ideas that others have shared include sitting in a parked car, in a closet, or outside on a lawn chair or patio furniture.
  • Hang a blanket on the wall for a backdrop and to prevent echo.
  • Give an extra moment before speaking. Delays and lags in audio and video will occur, and you may jump in before the other person has completed their thought. Slowing the pace in this way is generally good form anyway, and this may be the exact slowdown we need during this time of stress and hype.
  • Focus on the shared humanity of the current public health crisis. Maybe it is actually easier for clients to discuss difficult things in the comfort and safety of their own home, sweatpants, and shoeless-ness. There is room for the relationship with your clients to further deepen through all this, and for corrective emotional experiences to continue to happen.

If you are one of those for whom telehealth isn’t “your thing,” understand that your opinion doesn’t have to fundamentally change to be able to provide quality care under the current circumstances. I encourage you to consider trying it once or having a virtual meeting with a colleague to see how the brain adjusts to the context. If it lives up to your expectations (i.e., that it really isn’t your thing), then you can be satisfied with your openness in trying it. If it goes better than what you were expecting, then give yourself a pat on the back because you challenged yourself to be flexible in this trying time.

 
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