There was a time, many years ago, when my ex-supervisor balked at my Skype sessions with my clients that had left town, or left the country, or even, were too anxious to leave the house. I think of her now, forced to do something she thought was anathema to the fundamentals of psychotherapy. Of course therapy in a consulting room isn’t the same as it is online – two human bodies regulate each other in extraordinary (and now less mysterious) ways, and therapists rely upon whole body cues to feeling states that might not be verbalised.

Having said all that, online therapy is effective – and time will tell how much and how it compares – and it also has some advantages (at the very least, the advantage of existing over no support). I hope the following to be of use for anyone giving it a go – with more or anyone else.

  • Make sure your connection is as good as possible. If you can work ‘off wifi’ then do – ie with an ethernet cable connected to your device, use that. Switch off other wifi using devices, and ask fellow users in the home if it’s possible to stream or game when you finish/before you start.
  • Headphones may well help you be heard (and if noise-cancelling, to help you hear)
  • Let others in your home know that you are talking privately for 50 minutes and that you need no interruptions.
  • Agree a back-up option – so if Zoom fails, VSee (my preferred option) or FaceTime or phone. There are advantages to phone therapy and many colleagues choose that way above video conferencing for the focus and ‘voice intimacy’ it brings. I have had some powerful sessions by phone.
  • Discuss cancellation/payment of fees due to Covid-19 illness (or indeed other illness).
  • Do let your therapist know if you can’t see or hear them – or if you are distracted by something.
  • Bear in mind that people can’t look into each other’s eyes – we can only look into the camera to convey that.
  • Remove other distractions, such as notifications that alert your device (messaging or otherwise) or unfinished work documents that are open and obvious, or even piles of washing needing to be sorted beside you. Ensure you can prioritise having a focussed conversation that is for you.
  • Make sure you are comfortable – sessions are 50 minutes long and your back will need proper support, and you will want to be warm or cool enough, and not hungry or thirsty.Therapy works best for you if you can concentrate on your head and heart.
  • There could be some advantages of meeting a therapist from your own space or home to consider – maybe you can show your therapist important photographs or possessions, or works of art that mean something to you. There may even be words that are too tricky to say out loud but can be written down and shown, or messaged through.