The pandemic is over now but telehealth is still the predominant way of getting therapy. Not only do most therapists continue their practice via screen, you, as the consumer, are also continue opting for telehealth. The advantages are obvious and often out weigh the need for in person connection with your therapists .
As a therapist who has ‘seen it all’, I’m now noticing that many are bending the rules and taking advantage of something that has been working. So, let’s be mindful of the privilege of telehealth so that it can remain a good, practical option.
Please keep these simple suggestions in mind to make for a good telehealth experience for both you and your therapist:
1) Finding a Therapist
Referrals from your friends or doctor are always first choice. But if they don’t know (or if you prefer not to ask), there are excellent online platforms to choose from such as Alma, Headway, Better Help and more. Please keep in mind, these are not dating apps. It’s not about swiping left or right. We take time to write a thoughtful description about who we are and what we offer as therapists. See if the descriptions align to your needs. Contact us and do the consultations. When you make a decision, email everyone with your decision. If no one was right for you, then go pick out a few more people. But please remember that this is not an invitation to shop. We are professionals and this is our source of income. Be respectful of who we are and that our time is valuable.
2. Keeping Appointments
I get it. You have busy lives; juggling your career, kids and maybe school. Again, we are professional. Once your therapist assigns a time for you, do your best to keep the appointment. If you cancel saying that you scheduled a doctor or dentist appointment in your regular therapy time slot, be mindful how that appears. I know that it’s often hard to get into see your other professional, but therapy is a big priority too. Surely, there are other slots open for your other professionals and it does not have to occur the exact same time as your regular therapy time.
Same with having to meet a friend or going to an event. Take your mental health as seriously as you do other aspects of your life. Keep canceling or asking for another appointment to a minimum. Again, we’re not hair dressers or manicurists. We are professionally trained people who have chosen the difficult job of helping regulate your stressful lives. Be respectful by keeping your time slot as best a you can. You should schedule your life around your therapy appointment. Your mental health should be a top priority. It shouldn’t be that your therapist needs to rearrange her schedule around your life. And, by all means if you are traveling, or know in advance, you can’t make an appointment, contact your therapist as soon as you know. This is about being considerate to the person who is there for you.
3) No Multi-Tasking During an Appointment
I recently had a client who was having a dinner party and wanted to talk on the phone so she could continue to cook and clean. That's insulting and diminishes of the therapy process. Telehealth is a privilege and as such needs to be seen the same as an in-person therapy appointment. That means finding a quiet space in your home, making sure there will be no interruptions and giving the therapy appointment your full attention. This is the ONLY way your therapy can be successful. If it is your lunch hour, try to eat before or after the session. Therapy is not a lunch date with a friend. If you are tired, nap before your session so you are fresh. You will also need the energy to do the work in your session. If you have to be in your car, pull over. I have a hard rule about driving and talking. I won’t do it. It’s dangerous and I don’t want to hear you get into an accident. Therapy often brings out hidden past hurts or charged material. So, no therapy and driving.
4) Don’t Ghost Your Therapist
Sometimes your therapist will unintentionally say something that you disagree with, felt hurtful or felt distracted. Tell us! The therapeutic relationship is a relationship like any other. Sometimes it clicks right away and other times it takes time. If you don’t feel like it’s a good fit, that’s okay. Let us refer you to a colleague who might work better. Or maybe we can fix the problem. The point is, don’t just ghost us. On a personal level, that is beyond demeaning. It’s immature and rude. Just don’t do it. Be kind and considerate of another human being. Everyone has their good and bad days, so keep it in mind. Therapists are people too. We choose this profession because we want to help. Most of us have experienced our own life traumas and want to pay it forward. We are not here to be hurtful. Still, sometimes, we make mistakes, so tell us.
5) Collaborate with Your Therapist
You don’t know everything, even though you think you might. While I love that many of you enter therapy with the treatment you think you want, this is something that is something that you and your therapist decide together when setting up your treatment goals. Yes, I’m aware that there are so many modalities now: CBT, DBT, EFT, ERP, EMDR and others. We also know and are aware. While these modalities are good considerations when you choose your therapist, remember that other aspects are important. Like the therapeutic relationship and if you click with your provider. Ultimately, you should look forward to your therapy sessions and assess your progress together with your therapist.
6) The Therapeutic Relationship
When I was trained as a therapist many years ago, we were taught to be relational, attentive and let the client lead the way in therapy. When I say lead the way, we were taught to be present and go wherever the client led. We were taught to not take notes during a session and to keep as minimal notes as possible.
Today it’s a different world. Documentation is everything and notes are meant to be written according to diagnosis and treatment plan. We are also taught to avoid words like validation and support. Instead, we use more technical type of words like interventions, reframe, monitored and psycho-education.
7) Medical Necessity
If you are using insurance, you must have a diagnosis listed in the Diagnostic Statistical Manual. Insurance utilizes the medical model. When you visit a medical doctor or hospital, you are diagnosed, treated and discharged. It's the same now with therapy. Insurance wants you in and out. Plain and simple. They have the right to call us and ask how you are doing. They also have the right to ask to see progress notes.
When you are feeling better, the therapy needs to end. When you use insurance, you are not covered for self-growth or someone to talk with. I personally, find this model painful. I take insurance but wish I didn’t have to because of this lack of confidentiality and rigid rules. However, many people have no other choice but to use it while others simply don’t want to pay for therapy. So for these folks, insurance is their only option.
8) Remember, We Are Human
We have feelings too. If you have a problem or issue, by all means, bring it up. However, be mindful of how you present your opinion. Be kind and truthful. Don’t come on aggressively. Allow us speak too and refrain from being argumentative. Therapy is personal for all involved. Ideally, we are co-regulators with each other’s nervous system. The therapeutic relationship is not meant to work with everyone. I generally know within a session or two if we are a good fit. As I tell all my patients on the first day of therapy, we are not getting married. It’s okay to move on, but oftentimes the problem may be fixable.
In Summary
Be kind, present and attentive in your sessions. Remember to be considerate. We are here to help.
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