With our kids and grandkids returning to school Monday, this round of on-line virtual learning is over—we hope permanently! But I must confess that cancelling face-to-face relationships in many other professional situations offered a few advantages. My recent consultations with medical specialists have been via phone calls, saving me trips to Owen Sound and Kitchener/Waterloo. I also appreciated not being stuck in crowded waiting rooms.
Early in the pandemic, counsellors and psychotherapists were mandated by the Ministry of Health to replace many office visits with phone or video contacts with clients. But did this switch mean these professionals would still be able to provide the same high quality of help? Although I am long-retired from the field, my curiosity led me to ask a friend who is a practicing psychotherapist. His answer both surprised and reassured me that it is possible. And not only is it possible—there are recognized advantages described by women or men who have sought remote assistance with mental health or relationship struggles.
I admitted to being initially skeptical. When I taught college-level counselling courses, we spent hours focused on the importance of recognizing “body language,” those physical movements or facial expressions which convey unspoken happiness, relief, confusion, anxiety, sadness, fear, anger or other emotions. Through videotaped role play, students learned to direct their interviews toward helping a client put words to those feelings and explore their significance to the problem being shared. Conversely, the ability to read body language could direct the interview away from a focus which was evidently too difficult for the client to share. In my counselling text book, I wrote:
When there is a conflict in meaning between the words and the non-verbal body language, one can usually believe the (unspoken) body language to be more accurate. (A Time to Listen, 1996)
Consider your own meaningful and deep personal conversations. How often has the other person noticed and picked up on your body language? And are you easily attuned to this unspoken communication from a friend or family member? It has now become a well-accepted cliché that at least 70% of interpersonal communication is expressed through these non-verbal signals. That is one reason why emails often include emojis to add an emotional dimension to any statement which on its own, might be misinterpreted.
Accepting the fact that therapy from a distance can have some obvious limitations, I came back to my basic question: when client and therapist likely have never met, can virtual
psychotherapy hold any advantage over the office interview—even in non-covid times?
Four key words come to mind:
CONVENIENCE: As with my medical consultations, there is no need to drive many miles for a weekly counselling session. A commitment of 3-4 hours can be reduced to a more manageable one hour. (Yet one can argue that being willing to commit to those 3-4 hours per week is a more positive indicator of commitment.)
COMFORT: When we have deep issues to talk about, is not each of us more relaxed in our own kitchen than sitting in the waiting room or office of a stranger? We typically unwind easier on home turf.
CONCENTRATION: Without the potential distraction of observing one another or the office set-up, client and therapist can focus more intensely on a mutual “listening ear.” (My office clock was never visible to a client, but only to me in order to keep track of time. For me to be seen checking my watch every few minutes would obviously constitute negative body language.)
CONFIDENTIALITY: Here is the biggest advantage. In Peterborough, when I began my practice, our counselling offices were right on the main street of the city, on the second floor above a busy drug store. Then as now, there remains some unfortunate stigma about seeking this kind of professional help. I often imagined my clients walking down George Street, taking a fast look over their shoulder, then quickly ducking into the building. When I eventually became Director, I worked with the Board to move our offices to a much quieter, less visible location in town. Engaging in a counselling process from home reduces any such feeling of embarrassment.
If you were considering entering into a professional therapeutic relationship, would it make a difference whether that dialogue happened at home or in a more formal office setting? I would stress that seeking help is not a sign of weakness but rather a sign of strength. It takes strength of character to admit that there are areas of your life or relationships that need some attention. It takes courage to initiate that first step into the unknown. If you are being robbed of fullness of life through situations which are fixable or struggling to cope better with a painful reality which is your unchangeable lot in life, I encourage you to reach out—at home or in an office when covid protocols permit.
At some point I will need to trade my medical phone consultations for face-to-face meetings. Post-pandemic, the practice of medicine will see a growing return to office visits as will psychotherapy. But I do hope that serving our communities through providing the option of some virtual connectedness will not be abandoned.
