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Showing Up for Online Therapy

A good portion of our lives these days has shifted from in-person interactions to online transactions including our work, school activities, shopping, banking, yoga class, book club, and yes, even our therapy. We can thank the recent world pandemic for propelling us into this new screen-based culture and where many of us have become quite savvy at Zoom rooms and video-based platforms for interacting with others, we may not be aware of how to show up for the more intimate appointments such as the one’s with our therapists.


Ideally, in-person interaction with your therapist is the preferred method for psychotherapy as the personal exchange with another human being is at the heart of what therapy is all about. However, studies have shown that online therapy has been proven to be effective for much of the population currently engaging in mental health therapy. Effectiveness is driven by a few factors: the quality of the online therapy (see my previous blog post regarding choosing quality online therapy for yourself), the readiness of the client, and a conscious tending to how to show up in this electronic, two-dimensional format. Today’s blog is aimed at how you, as a client in online psychotherapy, can engage via the screen in a way that sets you up for getting more out of your time in therapy.


First, consider that if you were entering the office of your therapist, it is highly likely that it will be clean, free of distractions, quiet, comfortable, and calming. Do your best to attempt the same environment for yourself. Choose a spot that is tidy and quiet. You can imagine that if you are positioned with in view of the pile of laundry that needs attending or a chaotic work desk, that this may not set you up for low-key, therapeutic atmosphere. Secure yourself in a place where you won’t be distracted by family members, co-workers, or anyone else. It is best, to power down your phone, or leave it in another room (that is if you are not using it as the method for accessing the online therapy room); at the same time close out any applications that could cause pings or alarms during your session. If there is a television or radio within the vicinity have them turned off.


Being comfortable is important. Find yourself a comfortable seat, perhaps with a few pillows, blankets, or cushions nearby for adjusting accordingly throughout the session. A few other items to consider that aid in comfort during the session may be: a glass of water, a cup of tea, Kleenex, a pen and notebook for the occasional note.


Contrary to the liking of many, your therapist wants to see you and to do their job properly, seeing you is essential. Your facial expressions, your body movements, your gestures are all important to your therapist’s job of supporting you. Framing yourself in the computer camera is an important feature. Should you be completely or even partially out of frame this becomes difficult for your therapist to connect with you and fully listen to you. Set yourself up so that you can be seen from the chest up with no portion of your face or head cut off from the camera. Equally important is your lighting; logging in to the therapy room while sitting in a dark room makes it difficult for your therapist to identify you and to engage with you. No need for special lighting, simply do the best you can with what you have available.


Many of my own clients find that online therapy appointments are best conducted in a place other than where they normally do their online meetings and work; they have set aside a location in their home or office that is separate from their normal internet engagement. For some this is as simple as sitting on the other side of the desk, moving to a different chair, changing rooms when possible, or shifting devices. This creates a clear boundary around the therapeutic space that is necessary for the process of psychotherapy and differentiates online work and online social activity as separate interactions from therapy.


A couple of subtle yet profound touches to potentially add for online therapeutic success are some of the following:

  • Consider slipping your shoes off if you are wearing them to promote a more relaxed sense in your body.

  • If you can have a window view or a live plant close by use this on occasion to divert the eyes from screen to help with screen fatigue while also leaning into the natural calming effects of nature.

  • If you must engage in a psychotherapy appointment in your parked car, change from the driver’s seat (a task-oriented seat) to the passenger or back seat.

  • When able, allow 10-15 minutes of self-time before and after a session to reflect and contemplate. Think of this as time to ready yourself for the session beforehand and to decompress after the session as a transition back into your daily life.


Online therapy is a new and still-changing method for engaging in mental health therapy. However, with conscious and intentional preparations and considerations, you can engage in online therapy in ways that are meaningful and enhancing to the therapeutic process while setting the stage up for effective personal change.

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