Visiting my psychologist pre-lockdown was a dependable routine. Hover in the uncomfortable waiting room, be ushered down a hallway, lower myself into the armchair next to the emotion wheel and unpack life’s many stresses in 50 minutes. The weekly-turned-monthly sessions became a place of safety and comfort.
Stay-at-home orders drastically changed our lifestyles, including therapy sessions. I remember my first Zoom psych call; I was sat in my bedroom in my family home, where the walls were thin and the floor plan small, whispering about said members of the family unit.
Therapy is hard enough. Throw in the hurdles of remote appointments and it can offer even more unique challenges, especially when many of us take these sessions while working from home. Psychologist Smruthy Nair from Unhyphen chats to Refinery29 Australia about the pain points and pros of online therapy and how people can optimise their own experience.
What are the benefits of online therapy?
“Accessibility is a huge factor. Timezone differences don't matter. If you're in another state it doesn't matter. It's cheaper, you don't have to travel, you don't have to leave home basically. Scheduling is also easier both for the therapist and client,” Nair says. “[There’s] the ability to use interpreters and things like the National Relay Service. For people who don't speak English or who use English as a second language, it is fantastic for them to be able to access therapy at the same level that everybody else does.”
Instead of being in an unfamiliar environment, clients have the option of being in a safe space, like their home. “Something that I've seen with clients is that they can be a bit more comfortable. They can access some emotions and hard things to talk about with a little more ease,” she says.
Is online therapy secure?
A big insecurity around online therapy is how safe or secure it is (a fear that’s understandable with Australia’s current Medibank data breach).
“In Australia, we have really good protections around [privacy]; we're only allowed to use secure platforms for Telehealth. There are rules and regulations that you have to comply with in terms of data storage as well,” Nair explains.
What are the cons of online therapy?
As someone who has struggled with poor internet connection on a therapy call, I know how frustrating it is to let technology get in the way of a personal conversation. “You need a stable internet connection and you need to be able to learn or know how to use something like Zoom as well,” agrees Nair, adding that for some communities like elderly people or young children, this can prove to be a struggle. Maintaining focus and interest also can be a challenge — Zoom fatigue is something we’re awfully familiar with.
“For some psychological assessments, you would need to be present in-person to do certain tasks, like for neuropsychological and cognitive assessments,” she adds. Telehealth appointments cannot always replace physical appointments and speaking directly with your psychologist or GP about what’s most beneficial to you is the best step forward.
How can you optimise your Zoom therapy sessions?
There’s a misconception that Zoom therapy cannot be as good as physical appointments. Nair disagrees and encourages asking your therapist questions to quell any anxieties you have around the medium.
“You can check if your therapist has specialised training in providing Telehealth. Trained therapists have specialist skills in areas of risk assessment and knowing what procedures to activate if the person sitting in front of them on the computer is having a crisis.”
Zoom sessions can broaden therapy too, there are digital tools that can be used that elevate an appointment, such as Zoom’s whiteboard and screen share functions.
“Another area for clients to think about is to remember that just because it's online, doesn't mean that they're not accountable for their own part in sessions. Showing up consistently is always important regardless of the modality. People can look at ways to extend the impact of the therapy session outside of the appointment time, so asking your therapist for activities to do after the session, even taking down notes during the session that you can use as reminders later [or] taking screenshots of things that your therapist has shared with you.”
What can you do to healthily switch your headspace between work and therapy?
Having therapy — whether that’s in person or online — in the middle of a workday can be disruptive. Switching from work mode, to therapy mode and then back to work mode, can be a head spin for your mental load and workload. Nair suggests several actions you can do to proactively make this transition smoother.
“Schedule your appointments [to] have some downtime right after so that you know if therapy is going to be really serious or you're talking about something really big and heavy, you have time to walk it off, debrief with somebody else or just gather your thoughts.”
To shift your mind into therapy mode, Nair recommends reading over notes from your previous session, looking over any homework tasks set or having a couple of dot points written down on what you’d like to focus on in the session. And in turn, she recommends ending your session in a similar way by summarising your thoughts and learning points in written form.
“[This will help] get some closure from that session and then you can move on with the day. Another thing to think about if you are at work and have a really busy day, you can actually tell your therapist or ask them for different goals. You can tell them, ‘let’s talk about something else, I can't talk about something heavy and traumatic because I actually need to be present and 100% cognitively aware of what's going on during my [work] day,’” says Nair.
How can you set boundaries around therapy at work?
Normalising mental health struggles at work can be an uncomfortable or unnatural experience for many. Implementing boundaries around this can help alleviate some of the stress.
Considering the time and location of your appointment is important here. “What I would suggest is seeing if you can schedule your appointment either at the beginning or at the end of your workday, or having your appointment adjacent to your lunch break… If you're at the office, make sure you have a room or space to attend that appointment from.”
“Your boss or manager doesn't have to know what you're actually doing in therapy, [you can just] say that it’s a psychologist or therapist appointment without feeling that shame or guilt about helping yourself [because] it is a serious appointment,” Nair says, adding that you can ask your therapist for a certificate of attendance to share with your work if need be.
“Don't try to explain what you're doing in therapy. Just keep it clear and concise. It's a time and spiritual boundary that you're allowed to set and then move on with your day.”