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Thoughts on Virtual Therapy, as a Therapist and a Patient

The pros and cons of tele-psychotherapy from two different points of view.

Edward Jenner/Pexels
Source: Edward Jenner/Pexels

I’ve been working as a therapist for a tele-health psychology platform for six months and I have some definite thoughts about this technology from both the therapist’s perspective and the patient's

From the therapist’s perspective, I like the convenience of the “commute,” basically from my bedroom to my living room, where my desk is located. I like working from home and if a client cancels, I can relax, run an errand, walk my dog, or even take a quick 20-minute power nap. Working from home also allows me to have my dog, Shelby, as I wouldn’t feel responsible about being a dog owner if I worked in an office each day.

Having worked in outpatient clinics for most of my career conducting face-to-face therapy, I do find doing therapy over Zoom more tiring. It’s not one session, it’s cumulative sessions—six, seven, eight in a row with an hour break for lunch, which I typically spend writing notes. It’s more difficult to grasp the nuances of emotions through total body language when I’m only seeing a client from the shoulders up. Additionally, I have to hope for a solid and constant Internet connection without interruption, which is something I no longer take for granted.

The ease of scheduling my clients is a definite plus but working from home as a tele-therapist is isolating. When I worked at a clinic, I had regular interactions with colleagues, which broke up the day and the intensity of this hard work. At this job, we have two voluntary peer consultation groups a week, run by a couple of the clinical directors, where we can bring up difficult cases and get feedback on them, which is nice. The groups are where we can also meet our colleagues.

I know my clients like the convenience of not having to leave home, of being able to fit a session in on their lunch hour from work, of being able to have a session at 8:00 AM just minutes after waking up. They like introducing me to their children, dogs, and cats. I feel as though they are more relaxed at home in a familiar environment, but they can also be less focused and more easily distracted. I also believe that clients are more prone to cancelling at the last minute if something else comes up, perhaps not taking the commitment as seriously as they would if the session was at a therapist’s office.

From the client side, I still prefer in-person therapy. Although I’ve technically terminated with my long-time psychiatrist, Dr. L., I always have the option of scheduling an appointment to check in with her if I am having a difficult time – and she continues to prescribe my meds. I had a couple of Zoom sessions with her during the pandemic and they were adequate for what I needed because I didn’t have any other choice.

© Photo by SHVETS production from Pexels
Source: © Photo by SHVETS production from Pexels

When I saw her back in the office after we were both vaccinated, I had a different experience. I felt much more present and I’m sure my experience was connected to our history together. If I was just starting with someone, my experience would be totally different. I found it easier to speak spontaneously, which has always been difficult for me, and I like being in the same room as her, feeling the connectedness. If and when I need to see her again, I would do everything possible to ensure sure I saw her in her office.

Tele-health psychotherapy is here to stay. Regardless of the pros and cons, access to therapy has never been more important as Americans experience increased rates of anxiety and depression due to the pandemic.

© Andrea Rosenhaft
Source: © Andrea Rosenhaft