Struggling to Find any Positives?!
As a therapist, I spend many hours a week talking with people who are struggling to find any positives during this time, or at all. My role is to make space for my client’s experiences during this unprecedented time.
Acknowledging Your Anxiety
I’ve been talking with my clients a lot recently about how to manage anxiety and stress. We’re all experiencing probably a higher level of anxiety than what we’re used to. Some people have a lot of skills for managing that and some of us don’t
Creating Social Connections through Quarantine
Our need for human connection is so powerful that it is essential to our physical and mental well-being.
How to Transition From In-Person to Online Therapy During Coronavirus
How to Transition From In-Person to Online Therapy During Coronavirus
To help prevent the spread of the coronavirus, the Centers for Disease Control and Prevention (CDC) recommends social distancing. This means that individuals are encouraged to limit unnecessary social contact.
In response, many people are changing the way they conduct business—including therapists. Meeting with a therapist might place both you and the therapist at a higher risk of catching (and spreading) the virus. In addition, any other staff members or patients you come in contact with in the waiting room may also increase the risk that the virus will be spread.
To reduce in-person contact, some therapists are starting to offer online treatment. Whether meeting via video or phone, virtual therapy appointments aren’t the same as meeting face-to-face, so it’s important to educate yourself about what to expect and how it may impact your treatment.
Differences Between In-Person and Online Treatment
There are some big differences between online therapy and face-to-face therapy. And while online treatment can be convenient for some people—especially during the coronavirus pandemic—it does have some potential drawbacks.
Keeping the Same Therapist
If you’re already attending therapy, you may want to ask your therapist about any virtual treatment options if you’re concerned about social distancing. Your therapist, of course, may bring it up first as well.
But before agreeing to do it, it’s important to consider how your treatment may change if you aren’t meeting face-to-face.
Ask how your therapist will be providing treatment. Will you speak over the phone? Can you communicate via video chat? Can you send emails or messages?
Have a conversation about any concerns you may have. Discuss what you’ll do if you run into any obstacles while trying to conduct online therapy. You may encounter practical problems, like technical glitches, or you may discover that either your progress slows or your appointments don’t seem to be as effective.
Having a candid discussion about the obstacles you might encounter as well as how you can address issues if they arise can be very helpful. When you have a plan in place, you’ll feel more confident about your ability to make the best of online therapy.
Remember, there’s always a chance you might even like online or phone therapy better than face-to-face therapy.
After all, you’ll spend less time commuting to appointments. Your therapist may also offer more flexible hours. And you may even find that it’s easier to be more forthcoming with information when not in the same room as your therapist.
Body Language
Another factor to consider if you’re going to meet online is your body language. During face-to-face treatment, you and your therapist can read one another’s body language.
This is much tougher to do during video chats, and it’s impossible to do if you’re talking over the phone. You might find it’s difficult to know how your therapist is responding if you can’t see their body language or facial gestures.
On the flipside, your therapist won’t be able to read your body language either. When you say that you’re doing “fine,” do you really mean fine? Perhaps your body language says something different. Without being in the same room, your therapist may be more likely to miss vital visual clues about your emotional state.
Not all Types of Therapy Work Well Online
Many forms of talk therapy can work over the phone, via email, or video chat. But some types of treatment just aren’t made for virtual sessions.
Sand tray therapy and EMDR, for example, may be challenging to do virtually. So you’ll want to talk to your therapist about the type of treatment you’re receiving and whether it will still work online or over the phone.
Getting a New Therapist
Not all therapists are equipped to offer virtual appointments. Some of them may be uncomfortable conducting phone therapy. Others may not have the means to provide secure, confidential email or video chat services.
If your therapist isn’t able to provide virtual treatment, you might decide to seek treatment with a new therapist. It can be helpful to talk to your in-person therapist about this.
Ask your therapist if they think you’re a good candidate for online therapy. Individuals with serious mental illnesses or people with suicidal ideation, for example, are typically not good candidates for online therapy.
Your therapist can help you decide if virtual treatment is right for you. Discuss any mental health diagnoses or pertinent information that you’d want to share in online therapy. And review how you can continue to make progress with a new therapist while using a new form of treatment.
Do a little research to learn about the different online therapy options. Consider what type of communication you might want to use—video chats, text messaging, or phone calls. Explore prices and various online options so you can make an informed decision about which online service you think will best meet your needs.
Questions to Ask Your Therapist Before Beginning Treatment
Before you transition to online therapy, it’s important to ask questions about your treatment. Here are some things you may want to address:
- How will I sign the paperwork? Does your therapist have a way for you to electronically sign forms, like treatment plans or consent forms?
- How is my information kept confidential? Any video chat service or email messaging service you use must meet specific regulations to ensure that your information is kept safe and confidential.
- Does my insurance cover this? Most insurance companies do not cover online treatment. So you’ll want to ask your therapist whether they accept insurance. You may also want to contact your insurance company to learn about your options.
- How much will it cost? Online therapy typically costs less than in-person treatment. But if you’re transitioning to online therapy with a therapist you’ve been seeing, the price may not necessarily change.
- What type of technology do I need? Ask about whether you’ll need to download any apps or software. Also, find out if you can video chat from mobile devices or whether you’ll need a computer.
Coronavirus Related Issues You May Want to Address
If you’re meeting with a therapist online because you’re social distancing, you may have coronavirus-related issues to address.
Here are some examples:
- How can I manage my mental health when I’ve reduced my social contact?
- What can I do about my anxiety surrounding the coronavirus?
- Now that I’m spending more time at home, what steps do I need to take to stay as mentally healthy as possible?
- Are there specific exercises or strategies I can use to build mental strength?
- How should I talk to my kids about the coronavirus?
- What can I do about my financial stress during this time?
7 Tips to Make the Most of Online Therapy During the COVID-19 Outbreak
7 Tips to Make the Most of Online Therapy During the COVID-19 Outbreak
A couple of years ago — long before COVID-19 was an unfortunate glimmer in the CDC’s eye — I made the decision to switch from in-person therapy to telemedicine.
As someone who has historically struggled with opening up to therapists, my hope was that I would find it easier to be vulnerable if I could hide behind a screen. What I found was that I was able to disclose more, and as a result, it deepened the therapeutic relationship.
Not only did this transform my therapy experience — it also unwittingly prepared me for the huge shift to telehealth that’s now happening in light of the recent COVID-19 outbreak.
If you’re looking to start online therapy, or if your therapist has moved their practice to digital for the unforeseeable future, it can be a jarring transition.
While it can be a big adjustment, online therapy can be an amazing and worthwhile support system — particularly in a time of crisis.
So how do you make the most of it? Consider these 7 tips as you make your transition to teletherapy.
1. Carve out a safe space and intentional time for therapy
One of the most touted benefits of online therapy is the fact that you can do it any time, anywhere. That said, I don’t necessarily recommend that approach if you can avoid it.
For one, distractions are never ideal when you’re trying to work — and therapy is rigorous, difficult work sometimes!
The emotional nature of therapy makes it even more important to have some space and time set aside to engage with this process fully.
If you’re self-isolating with another person, you could also ask them to wear headphones or take a walk outside while you do therapy. You might also get creative and create a blanket fort with string lights for a more soothing, contained environment.
No matter what you decide, make sure you’re prioritizing therapy and doing it in an environment that feels safest for you.
2. Expect some awkwardness at first
No matter what platform your therapist is using and how tech-savvy they are, it’s still going to be a different experience from in-person — so don’t be alarmed if it doesn’t feel like you and your therapist are “in-sync” right away.
For example, when my therapist and I used messaging as our primary mode of communication, it took some time for me to get used to not being replied to right away.
It can be tempting to think that some discomfort or awkwardness is a sign that online therapy isn’t working for you, but if you can keep an open line of communication with your therapist, you might be surprised by your ability to adapt!
It’s also normal to “grieve” the loss of in-person support, especially if you and your therapist have worked together offline before.
It’s understandable that there could be frustration, fear, and sadness from the loss of this type of connection. These are all things that you can mention to your therapist as well.
3. Be flexible with the format of your therapy
Some therapy platforms use a combination of messaging, audio, and video, while others are a typical session over webcam. If you have options, it’s worth exploring what combination of text, audio, and video works best for you.
For example, if you’re self-isolated with your family, you may rely on messaging more frequently as not to be overheard by someone and have as much time as you need to write it. Or if you’re burnt out from working remotely and staring at a screen, recording an audio message may feel better for you.
One of the benefits of teletherapy is that you have a lot of different tools at your disposal. Be open to experimenting!
4. Lean into the unique parts of telemedicine
There are some things you can do with online therapy that you can’t necessarily do in-person.
For example, I can’t bring my cats to an in-person therapy session — but it’s been special to introduce my therapist to my furry companions over webcam.
Because online therapy is accessible in a different way, there are unique things you can do to integrate it into your daily life.
I like to send my therapist articles that have resonated with me for us to talk about later, set up small daily check-ins instead of just once weekly, and I’ve shared written gratitude lists over text during especially stressful times.
Getting creative with how you use the tools available to you can make online therapy feel a lot more engaging.
5. In the absence of bodily cues, practice naming your emotions more explicitly
If you’ve been in in-person therapy for a while, you may be used to your therapist observing your bodily cues and facial expressions, and sort of “intuiting” your emotional state.
Our therapists’ ability to read us is something we might take for granted as we pivot to telemedicine.
This is why it can be really beneficial to practice naming our emotions and reactions more explicitly.
For instance, if your therapist says something that strikes a nerve, it can be powerful to pause and say, “When you shared that with me, I found myself feeling frustrated.”
Similarly, learning to be more descriptive around our emotions can give our therapists useful information in the work that we do.
Rather than saying “I’m tired,” we might say “I’m drained/burnt out.” Instead of saying “I’m feeling down,” we might say, “I’m feeling a mix of anxiety and helplessness.”
These are useful skills in self-awareness regardless, but online therapy is a great excuse to start flexing those muscles in a safe environment.
6. Be willing to name what you need — even if it seems ‘silly’
With COVID-19 in particular, an active pandemic means that many of us — if not all — are struggling with getting some of our most fundamental human needs met.
Whether that’s remembering to eat and drink water consistently, grappling with loneliness, or being fearful for yourself or loved ones, this is a difficult time to be a “grownup.”
Taking care of ourselves is going to be a challenge at times.
It can be tempting to invalidate our responses to COVID-19 as being an “overreaction,” which can make us reluctant to disclose or ask for help.
However, your therapist is working with clients every day who undoubtedly share your feelings and struggles. You aren’t alone.
What should I say?
Some things that might be helpful to bring to your therapist during this time:
- Can we brainstorm some ways to help me stay connected to other people?
- I keep forgetting to eat. Can I send a message at the beginning of the day with my meal plan for the day?
- I think I just had my first panic attack. Could you share some resources for how to cope?
- I can’t stop thinking about the coronavirus. What can I do to redirect my thoughts?
- Do you think my anxiety around this makes sense, or does it feel disproportionate?
- The person I’m quarantined with is impacting my mental health. How can I stay safe?
Remember that there’s no issue too big or too small to bring to your therapist. Anything that’s impacting you is worth talking about, even if it might seem trivial to someone else.
7. Don’t be afraid to give your therapist feedback
A lot of therapists who are making the shift to telemedicine are relatively new to it, which means there will almost certainly be hiccups along the way.
Online therapy itself is a more recent development in the field, and not all clinicians have proper training on how to translate their in-person work to a digital platform.
I don’t say this to undermine your faith in them — but rather, to remind and encourage you to be your own best advocate in this process.
So if a platform is cumbersome to use? Let them know! If you’re finding that their written messages aren’t helpful or that they feel too generic? Tell them that, too.
As you both experiment with online therapy, feedback is essential to figuring out what does and doesn’t work for you.
So if you can, keep communication open and transparent. You might even set aside dedicated time each session to discuss the transition, and what has and hasn’t felt supportive for you.
Online therapy can be a powerful tool for your mental health, especially during such an isolating, stressful time.
Don’t be afraid to try something different, vocalize what you need and expect, and be willing to meet your therapist halfway as you do this work together.
Now more than ever, we need to protect our mental health. And for me? I’ve found no greater ally in that work than my online therapist.
Weekly Intervention Ideas: March 30th Edition
Weekly Intervention Ideas: March 30th Edition
Kid strategy of the week:
- Video: Inside Out: Guess the Feelings
- Scavenger Hunt: have the child search around the house for these items and share them with you:
Couples strategy of the week:
- Help couples figure out similarities and differences in their attachment styles, and process how their attachment styles may play impact their relationship dynamics.
- Attachment Styles Assessment: https://dianepooleheller.com/attachment-test/
- Video: https://www.youtube.com/watch?v=2s9ACDMcpjA
Adult strategy of the week:
- Many people are experiencing high levels of stress right now. Sometimes, we are not even aware of the ways that our bodies and minds are reacting to stress. Use this worksheet to recognize signs of stress and discuss coping strategies for reducing stress and establishing healthy coping strategies
- https://www.therapistaid.com/worksheets/recognizing-stress.pdf
Five Secrets to Calming Yourself
Mindfulness/Meditation of the week:
● Loving Kindness Meditation
This loving kindness practice involves silently repeating phrases that offer good qualities to oneself and to others.
Let’s begin by settling into a comfortable position, whatever feels right for your body. Bring attention to your breath. Notice the still points between your breaths. Breathe in through the nose to the count of 4 and out to the count of 6. Focusing on the still place between breaths.
- Now shifting attention to our thoughts. Begin by taking delight in your own goodness—calling to mind things you have done out of good-heartedness, and rejoicing in those memories to celebrate the potential for goodness we all share.
- Silently recite a phrase that reflects what we wish most deeply for ourselves in an enduring way. Some examples are:
• May I live in safety.
• May I have mental peace
• May I have physical health
• May I live with ease. - Repeat a phrase with enough space and silence between breaths so they fall into a rhythm that is pleasing to you. Directing your attention to one phrase and breath at a time.
- Each time you notice your attention has wandered, be kind to yourself and let go of the distraction. Come back to repeating the phrase without judgment.
- (Few more breaths) … now, visualize yourself in the center of a circle composed of those who have been kind to you, or have inspired you because of their love. Perhaps you’ve met them, or read about them; perhaps they live now, or have existed historically or even mythically. That is the circle. As you visualize yourself in the center of it, experience yourself as the recipient of their love and attention. Keep gently repeating the phrase of loving kindness for yourself.
(few breaths) Slowly transitioning out of the visualization, and simply keep repeating the phrases for a few more breaths. Each time you do so, you are transforming your old relationship to yourself, and are moving forward, sustained by the force of kindness and compassion inward.
Mindfulness in the Midst of a Pandemic
As a therapist, people tend to look to me for answers. We ask the questions to gain understanding and help guide and walk with people on their journeys. In the midst of a pandemic, how does that work though?
Pandemic-Related Anxiety
Feelings of increased stress, anxiety, and depression are now a new “normal baseline” for a population finding themselves faced with fear and uncertainty.
