My transition from in person to online therapy

With the unpredictability of the Coronavirus and the subsequent lockdown, a glaring question came to my mind as a practicing therapist, ‘what am I going to do about my clients?’ With the country being in lockdown initially in March, it seemed that my sessions would come to a standstill especially as I did not fully understand how I will take the sessions online.

Would I be able to build a rapport with someone I have never met? Would they feel comfortable sharing their deepest traumas with me through a screen? How would I fill the void of physical presence? Such apprehensions are natural whenever a transition is made from in person to online therapy. But since this was not a usual transition and more forced by the circumstances, it seemed a bit daunting.

More questions came up related to how long this switch would last? Do we revise the goals of therapy for existing clients? Do we open the Pandora’s box for certain clients that are now in a crisis situation? All this and much more had to be looked into but I have to say, I was pleasantly surprised in many ways about how smooth this move was for me.

Online therapy also opened doors for people who may have otherwise been hesitant to reach out, as they feel more comfortable with a video call then actually going to meet someone, which undoubtedly requires more effort and time.

Many new clients reached out to me during the pandemic and despite my initial apprehension, the rapport with the new clients that I have only met online is not very different from the ones I have met in person. I am aware that this may not be the case for everyone as certain clients prefer to have their sessions in person for many reasons. Some clients do not think they have the privacy they need for a session at home, others look forward to taking out that one hour for themselves and physically leaving their existing surroundings, and then there are those who are unable to feel the connection and intimacy through a virtual screen. Perhaps there are more distractions at home, more responsibilities, and more obligations.

However, as a humanistic integrative therapist I have realised our core goal remains the same. To connect with the client and to provide a safe space for them. I have even enjoyed using resources that may be available to them in their own household that perhaps could not be available otherwise. Whether that is sharing an image with them or psycho educating them further with the entire internet at your disposal or helping them build their bag of self care and resources from their own surroundings.

You also get a chance to see the client in their personal space which opens up room for a more intimate relationship. Many clients have felt safer and comfortable by being in their room and speaking about issues as opposed to a clinical space.

It also provides both the client and the therapist more flexibility in terms of scheduling, which again has its pros and cons. Some clients may not prefer this flexibility and would feel rather threatened or unsafe by the changes of schedule and others may adapt to this change more readily.

The mediums that I have most often used are Skype and Zoom but since we live in a country where power outages and troubled internet connections are the norm, there have been times I have had to revert to WhatsApp calls and regular voice calls. Even though virtual or online therapy may not be the same as sharing the frustrations, excitement, disappointment and trauma in person, it still boils down to the relationship between the client and the therapist.

I would like to add however that just because therapy sessions have shifted online, the ethical considerations and policies have not changed. That is, if a session is 50 minutes or an hour long in person, it shall remain so, even if online. If therapy is to be done in a safe and confidential space, privacy is essential if not imperative for both the client and the therapist with as little disturbances as possible.

All in all, in the midst of a second wave of Covid-19, it looks like online therapy is here to stay and may just be the new norm for counseling, with some clients preferring to continue with this method once we are all out of these unfortunate circumstances. At the end of the day, in my opinion, if the purpose of therapy is being met, then online therapy is better no therapy.