When the world is stressed, people think of therapy. But what do you do if a therapist’s waiting room makes it impossible to maintain social distance or the office has closed?

Anxiety is understandable. The nation and the world are in self-isolation. We are lonely, apprehensive about our health, and worried about the well-being of our families. Don’t be ashamed of being scared amid this new but temporary situation.

The idea of psychotherapy intimidates many people even when coughs and sneezes aren’t more dangerous than usual. The only safe therapeutic option is now online. Not only is this a change for the vast majority of current patients, but daunting to contemplate for many coming to counseling for the first time.

Welcome to membership in the largest club ever, the unusual human condition of the day. To the good, the therapist wants you to tell him of any hesitations or worries about this unfamiliar, remote method of care. He will try to calm you and work within your limits. 

Even before you seek counseling, the following often helps:

Ask yourself what other challenges you’ve had in your life. Make a list. Remember the qualities inside of you that enabled you to endure and triumph. They are still present.

Here is information to consider if you are seeking live video treatment:

• While telepsychology or teletherapy can include phone calls, this introduction is limited to simultaneous videoconferencing in real-time.
• Imagine yourself sitting in front of your computer in a well-lit space. The therapist sees you above the waist, and you can see only as much of him. He hears you and vice versa.
• Although there is a bit of a time-delay in the discussion, this is an as-it-happens experience, just as in a doctor’s office. Thus, appropriate dress is required. No pajamas! 
• Some therapists are adept at providing counseling this way. Others are new to it due to our Coronavirus emergency moment. Ask the counselor about his experience with this medium when you reach out for an appointment.
• The provider will talk about several more things before booking your first session. Among those topics are the following:

1. 1. You will need a computer that includes a webcam and audio for both talking and listening. He may ask for a few more details of your setup. A phone nearby is essential; headphones are helpful. This person will try to use words you understand if you aren’t computer savvy.
   2. He needs to be acquainted with your reason for calling him. A clinical psychologist considers whether he possesses the skills to treat you for the condition you describe.
   3. Questions related to your physical and emotional history should be anticipated, as well.

Further steps follow once an appointment is made:

1. 1. The therapist will send you a Telehealth Informed Consent Form and go over it with you. This will include potential benefits and risks of treatment.
   2. Payment arrangements will be made. Be assured that Medicare has agreed to pay for telehealth sessions during this emergency.
   3. If you are not covered by Medicare, check with your own insurance company to determine reimbursement for such services and what portion of the fee is your responsibility.
   4. The counselor will ask you to sign a release/permission allowing him to speak with an individual designated by you in an emergency.

The professional who treats you needs the competence to provide teletherapy. Technical expertise is necessary to address an unexpected failure of the audio or video connection. Ask about this.

FaceTime and Skype are not secure platforms for the delivery of videotherapy, meaning your protected health information in a session might be compromised and your confidentiality breached. Nonetheless, during the Coronavirus emergency, HHS (the US Department of Health and Human Services) is permitting the use of insecure platforms to meet the demand for psychological assistance.

The doctor will discuss potential privacy concerns within your residence. Will anyone try to hear what you are talking about? Might another person enter the room? Will a pet or child show up?

White noise machines may reduce the chance someone else will overhear you. You will be encouraged to minimize distractions to the extent possible.

Your telephone is used as a backup in case of temporary loss of video or audio, not as the primary source of communication.

Visual cues such as your facial expressions, tears in your eyes, or tremulousness in your movements are indications of your emotional state. He must know that you are not engaging in harmful activities within his sight, etc. None of these indicators are knowable if he speaks with you on the phone.

Research suggests that teletherapy patients are about as satisfied as those who participate in traditional office visits. Most dissatisfactions come from technical problems in the course of the sessions.

Consider this an introduction to the treatment closest to an in-person office visit. You can expect other matters to be brought up, too.

Do not take what you have read here as a complete overview of the field. As the virus peril continues, federal and state laws may well change rules to adapt to changing circumstances. These might impact the delivery of psychological assistance.

Know that help is available to respond to the heightened stress of our situation. Talented psychologists, psychiatric social workers, psychiatrists, and other license counselors will continue to render the comfort they provide every day.

All these health professionals work with you, not on you. If you embrace the idea of partnership, both of you will work to create a bridge to a better time for everyone.

—–

The photos above come courtesy of Laura Hedien, a gifted and generous photographer. They are Crossing Chicago River at Michigan Avenue on March 21, 2020, and Crazy Luminescence. Much more of her work can be found at: https://laura-hedien.pixels.com/