5 Tips for Teletherapy or Online Counseling

Many therapists in the United States and probably across the globe have switched to some or all virtual sessions. It all shifted so quickly that I’m amazed the Internet didn’t collapse! Between everyone streaming movies, shows, games, and exercise classes, I’ve been pleasantly surprised at how well my online sessions with clients have gone and how well my clients adapted to this new medium.

I’ve been doing online therapy, or teletherapy, with a few clients for about a year, so I’m familiar with the platform.  A lot of free training is available to help therapists  get online and feel more comfortable, but I haven’t seen much to help our clients feel more at ease with this “new normal.”

Sitting in the client’s seat

I experienced the discomfort first-hand as I got ready to meet my therapist online for the first time this week. I’ve been advocating for the switch with my clients, but when it was my turn, I found I wasn’t as enthusiastic at all! Some of the thoughts that went through my head were:

• “Maybe I don’t need a session this week.”

• “It can’t possibly be as meaningful as in person.”

• “I wish I’d just cancelled my session.”

I like going to my therapist’s office, and I was a little frustrated that I had to do this “new thing at home.” We talked and I laughed about my own discomfort as we met through our screens. Guess what? My session went really well! I got so much out of the session.

Experiencing virtual therapy myself gave me a lot of perspective and I felt so much compassion for my clients who have to do this “new thing.”

So, I thought it might be helpful to share some things that might help you if you’re going through a something similar, or if you’re considering therapy for the first time and your sessions will be online.

Here are a few tips for client of online therapy:

1.    You’re probably going to feel a little nervous about seeing your therapist online if you’ve never done it that way before. Your therapist will probably be nervous, too, especially if it’s new for them too.

Meeting a therapist in a new space in a new way feels different, and that can make us feels uncomfortable and anxious. That’s totally normal! Talking to your therapist about your feelings can help you feel comfortable as you get more familiar this new platform.

2.     If possible, find a place in your home where you feel at ease and have a comfy place to sit.  As a therapist, I go to great lengths to make my office feel like a sanctuary. A place you come to and say, “Ahhhh…”

We will talk about difficult issues in session and we want you to feel supported even in your discomfort. So, do your best to find a place where you can relax when meeting virtually with your therapist.

3.     Privacy is very important. When you go to your therapist’s office, there’s good chance you’ve come across a white noise machine. That’s because we want our conversation in the therapy room to be private. Now, you don’t necessarily need a white noise machine, but you do want to find a place in your home where you can talk freely.

If you have to monitor your voice level or are worried about someone listening to your conversation, address this with your therapist.  Maybe you can find an alternative solution, like calling or meeting virtually in your car, or another private place.

Using headphones or earbuds can help, too. That way, you are the only one hearing your therapist’s voice.

4.     There will be glitches! Technology is rarely seamless. Screens will freeze, voices will sound disjointed of clipped, or you might not be able to connect at all online. Those issues can be very frustrating. The amazing thing is that, most of the time, it works really well. So, try not to get too discouraged if a video session isn’t perfect.

I’ve opted to call clients by phone when the online technology is working against us. Your therapist might not be able to provide this option if your insurance won’t allow phone calls, but your therapist might be able to suggest other options.

5.     If you’ve always met your therapist in their office, know that we are in this new space together. You will get used to it. The discomfort will fade, and therapy will continue to be a source of support, learning, comfort, acceptance and growth.

As we move forward in this new world where entire countries can be affected by health concerns, I’m grateful for the virtual spaces where we can feel connected to our families, friends, colleagues and our therapists!

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If you enjoyed this blog post and would like more insights into living with anxiety, tune into the Woman Worriers podcast. In each weekly 30-minute episode, host Elizabeth Cush, LCPC, and her guests explore living with anxiety, relationships, parenting, surviving trauma and other topics and offer insights into mindfulness, meditation and other helpful resources.

Elizabeth Cush, LCPC is a therapist, blogger,  creator and host of the Woman Worriers podcast, and the owner of Progression Counseling in Annapolis, Md and she’s been featured in these major publications. Elizabeth helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose. If you'd like to know more about how individual, online and group therapy can help ease anxiety and stress, contact me!

Seeing And Being Seen: My Story Of Survival And Healing

Me as a young girl

Earlier this year I decided to write what I thought would be a “how therapy helped me become a better therapist” story. Over the years, I’ve been in and out of therapy to help me manage my anxiety and depression. I created what I thought was a vulnerable, open piece that shared how my own therapy helped me learn to cope with trauma and how each of the therapists I’d worked with led me to insights that help me be a better therapist today.

I submitted the piece to colleagues who have a contributor’s blog on their website, The Practice of Being Seen. Although I felt I’d been open, honest and vulnerable, I was told that the piece didn’t go deep enough into my story. I think one of the comments they had was, “We want to know about you, not your therapists.”

I went back to the computer and started again. After multiple edits and rewrites, it turns out that the story I needed to tell was a much different, much more personal story — the story of being the survivor of childhood sexual abuse. You might wonder, “Why anyone would want to share that story? Isn’t that too much to share with the world?” That’s precisely why I needed to tell it.

I recently had the honor and pleasure of attending a talk by author, speaker, researcher, social worker extraordinaire Brené Brown who said, “When we deny our stories, they define us. When we write our own stories, we write the ending.” I knew then it was time for me to write my own ending.

When we hold our stories so close that they rarely see the light of day, the story remains the same. For me, avoiding the story created a negative feedback loop. For years I felt damaged by the abuse, because all I could feel was the shame of what happened. Avoiding what happened, and the feelings associated with it left me feeling disconnected from me and those around me. I needed to retell my story from a place of strength.

Writing my story, A Story of Survival and Healing: A Therapists Journey Into Seeing and Being Seen, has been a difficult, raw and extremely empowering experience. As Anne Lamott writes, “It's good to do uncomfortable things. It's weight training for life.”

Let me know your thoughts and if you’re ready, start writing your own story.

My Struggle With Anxiety

This blog post was featured in the November editions of the Severna Park Voice.

Dealing with mental health issues can be hard. You often feel alone, isolated — like no one understands what you’re going through. The reality is, a lot of people struggle. The National Institute of Mental Health reports that in 2014, 18.1 percent of all adults in the United States suffered from some type of mental illness. I thought that I’d share my own experience with anxiety to let you know that you are not alone.

I’ve struggled with anxiety for most of my life. Up until my late 40s, I didn’t call it anxiety. I called it stress, or I’d say I was overwhelmed. So what if the same things got me stressed and overwhelmed, over and over again? Later, as I learned more about anxiety, I understood that those things that made me anxious were called triggers.

Some of my triggers included:

• Holidays
• Traveling to unknown places
• Staying somewhere that wasn’t home
• When things didn’t go the way I expected
• When I felt like I was failing, or couldn’t figure something out
• Unplanned events, like being asked to go somewhere at the last minute
• Being with a group of people I didn’t know very well
• Making phone calls

I could probably think of more examples, but you get the idea. When I wasn’t in control, when things weren’t “perfect,” I got anxious. Anxiety presented itself in ways I thought were just a part of my personality. I got really cranky leading up to things that made me anxious, like those listed above. I snapped at my family. I became obsessed with the details — everything had to be “just so” to make me feel somewhat at ease. I avoided situations and events that felt threatening. I’m pretty sure I lost some friends when my kids were little, because I was happier being at home where I could handle any emergency than I was hanging out with them. Later, when the kids were older, I felt uneasy when they weren’t at home. I’d also make my husband call for pizza or answer the phone.

I realize now that anxiety had a greater impact on my life than I was willing to recognize. If someone had asked me examine how anxiety or stress was affecting my day-to-day experiences, I might have gotten help sooner!

Managing Anxiety Day-To-Day

I’ve worked with counselors on and off throughout my life, and it’s been very helpful. (Yes, lots of counselors also get counseling.) These days, my anxiety usually pops up when I have significant transitions in my life. Counseling helped me identify my triggers, so I can start paying attention and begin to relax my body before the anxiety kicks into full gear. In addition to counseling, I also read a lot and learned about anxiety — what causes it, how it presents itself both physically and emotionally, and how to manage it better.

Here are some strategies that have helped me manage my anxiety:

• Using grounding techniques to refocus myself when situations make me anxious
• Practicing mindful meditations
• Taking care of myself and recognizing my needs
• Being more present in the moment instead of worrying about the past or future
• Practicing self-compassion

My struggle with anxiety pushed me to learn about more about it — the causes, how it shows up in my clients’ lives, and how to help those who grapple with anxiety manage it more effectively. Providing a calm, non-judgmental space for my clients to share their story is the first step.

Managing Anxiety Is An Ongoing Process

Anxiety is a normal response to threats, so it doesn’t just disappear. Different situations will continue to trigger my anxiety, so I have to keep working at managing it. The good news is, I’m more aware of the impact of anxiety when I let it take control, and I recognize what is happening. Now, anxiety no longer rules my life. It’s taken a backseat, where it belongs.

If you’d like help managing your anxiety or stress, call me at 410-339-1979 for a free 15-minute phone consultation.

Photos by Mike Wilson and Averie Woodard from Unsplash.com.

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Elizabeth Cush, LCPC is a therapist and the owner of Progression Counseling in Annapolis, Md. She helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose. If you'd like to know more about how individual and group therapy can help ease anxiety and stress call me 410-339-1979.