TELETHERAPY: The Challenges and Rewards of Video Counseling

Video sessions? Online counseling? Teletherapy? Telemedicine? teletherapy, online counseling challengesSo many terms I suddenly found myself both using and dreading at the same time. After all, my 30+ years of experience, my on-going training, my carefully-honed philosophy, and my own comfort level all have continually united over many years to let me know that in-person counseling was the only path for me. That was my firm stance.

However, in March, 2020 the world suddenly changed.
Covid 19 arrived, and with that pandemic challenge came the realization that I still had lots more to learn! Of course, I did know that some therapists had always seen clients who were not actually physically present in their offices. But I had always assumed that teletherapy wasn’t for me! 


Well….. I was wrong! In my newly adjusted “never-too-old-to-learn” mode, so much about how I meet with my clients has changed. I’ve had to quickly figure out how I could be/do the same as usual, while so much about how I now see clients is really not the same as usual. But those differences have turned out to be surface deep. Just the practicalities of how all this works. The actual work that my clients and I do together––that hasn’t changed much at all. At least once we got over the strangeness of this new way of meeting. 

The challenges of teletherapy (at least for me): I’ve had to learn the best way to position my computer, so more can be seen of me than the top of my head, a much-too-close view or that strange chin-up angle. Lighting––where and how bright it is––must be considered. One piece of advice I’ve gotten is to be sure no visual distractions are within camera range. Then there’s the need to be sure no human beings, pets, phones ringing, and deliveries arriving will divert from the business at hand.  And finally, it’s important to choose the video platform that works for both of us, with a minimum of disrupted connections. But these are all manageable procedural details. 

Fortunately, in my experience, the rewards of having video sessions outweigh the challenges: During these viral times, remote sessions mean we can all stay safe, without the awkwardness and difficulties involved in maintaining safety for in-office meetings. There’s no longer a need to be concerned about L.A. traffic interfering with on-time arrivals. It can be helpful when I get to briefly meet a pet, a partner, a child or anyone else that I’ve only heard about but would never otherwise have even seen. On the other hand, for my client who is uncomfortable running into others in my large shared waiting room, the privacy of meeting from home (or car) can relieve some anxiety.

As I write this, I realize I’m reinforcing for myself how much can be positive about video sessions. And my list keeps getting longer…..  Are you thirsty or hungry when we meet online? Food and drink are likely a few steps away. Have you been feeling a bit ill and not sure you should come in to the office? Not a problem! Did you forget to bring that letter you wrote at my suggestion, the childhood and family pictures we were going to view? Wait – they’re in the next room, so you can get them now. 

In my office are a number of props I’d always used to help clients regulate emotions, large art pads on which I can scribble some illustration of a concept, and other tools that were, I thought, an essential part of my approach. I imagined I’d have to work differently, would need to adapt to this no-tools world. But again, I was wrong. Certainly I miss those tools. I can no longer reach across to my client to hand him that special item. But what I can do is help him figure out what in his world can serve the same purpose. And this seems to work just as well and might even be somewhat more effective at times. 

The therapy world ahead will for me, be different and yet the same. I expect and hope to return to my office, when it’s deemed to be safe. At that time, for those who want to come back to my office, I’ll be there. Sanitizers, disinfecting supplies will be present and used liberally. Other recommended safety precautions will certainly be in place. However, considering all my new-found respect for the effectiveness of teletherapy, going forward, I plan to include that option as part of the mix of what I can offer those seeking help. 

If you’ve been considering starting or returning to therapy, if you’re not quite sure this is the right time, if you have some questions about how video sessions might work, I invite you to give me a call. Would you like to know a bit more about me? Take a look here and follow the links on that page. I offer a 15-minute complementary call (310-475-1759), so that you can get your questions answered and so that we can talk about how I can help.