Teletherapy

Benefits of Online Therapy

The benefits of online counseling compared to in-person psychotherapy include:

• Community Health: During the Coronavirus outbreak, you can get the mental health support that you need without exposing yourself to the virus.
• Convenience: Online therapy can take less time away from your life at work or at home. Plus you don’t need to worry about traffic, or travel miles to meet with your counselor. The session can happen wherever you are comfortable.
• Comfort: It can be more comfortable to use the video conference than talking to someone in person, especially when revealing personal or private information.
• Privacy: You may need additional privacy because you are high profile in the community and are concerned about running into others in the waiting room.
• Access: You live in a remote or rural area with limited access to therapists. Your chronic illness, disability, or mental health concerns (agoraphobia or social anxiety) may prevent you from leaving your home. You reside in a country where there is no access to an English-speaking mental health provider. You have already been in therapy with me and you’ve moved somewhere else in Oregon or abroad and would like to continue sessions.

Therapeutic Relationship in Teletherapy

You may wonder if it is possible to build rapport with your counselor online. It turns out that most people project more authentic versions of themselves from the comfort of their own homes. The integrity of the therapeutic relationship is not diluted in teletherapy. It is entirely possible to accurately track shifting facial expressions, emotions, and even body language in a video call.

Limitations of Online Counseling

The most notable disadvantage of teletherapy is a technological glitch due to inconsistency in Internet connection strength or issues with the video chat platform. Dropped calls, frozen screens, echoing, or low-resolution video feeds can interfere with the therapeutic experience.

Despite these limitations, online therapy can be effective for many people (non-suicidal individuals or those not in the midst of a major crisis requiring more intense intervention). I will be assessing your needs during our initial consultation and/or during intake. If the services that you require are more complex than what I can provide in my practice, I will do my best to offer referrals.

How Does Teletherapy Work?

You will need:

• A comfortable, quiet and private space,
• A fast and reliable Internet connection,
• A smart phone, tablet, laptop or personal computer, and
• Access to a microphone, webcam, and speakers.

You must be located at the time of our session in a state where I am licensed. If we have not met in person, I will ask you to verify your identity and location with a state ID, a driver’s license, or a passport.

After we’ve talked in a 20-minute free consultation and determined that online therapy is an appropriate fit, electronic paperwork will be provided to you.

On the day and time of your appointment, you will be able to connect to my HIPAA-compliant and confidential video platform.

Fees for Online Counseling

The rates for online counseling sessions are the same as for in-person counseling sessions.

Payment for US clients is done through Ivy Pay. Payment for international clients is done through Square invoicing. Both are secure, HIPAA-compliant credit card processors.

Preparing for the Video Therapy Session

Prior to our virtual therapy session, here are some steps you can take to improve the experience:

1. Pick a quiet and private place (it could be inside the car, if necessary) that allows you to have the same level of concentration and openness you show in our in-person sessions.
2. Make sure there are no pets in your space during our session. Pets are very good at picking up their owner’s emotions. I’ve seen many cases where the client is finally doing deep healing work in session, after many months of preparation, and in the critical moment, their pet jumps into their lap to “help”. The client loses the special healing opportunity we worked so hard for, and we are back to the beginning… While I know very well how much comfort you get from your special pet, a key point of therapy for individuals and for couples is to learn how to notice, respond to, and hold our own emotions in a safe space, without the help of a pet.
3. Ensure quality Internet access either on your smartphone, tablet, laptop, or a desktop
4. Ensure quality lighting behind the monitor – so that we can see each other clearly.
5. Have a box of tissues nearby – since the ones in my physical office won’t be accessible.
6. Have a Post-It note nearby – I use one to cover my own face on my screen to reduce the distraction of seeing myself talk, and I recommend the same for you. This is probably the most annoying part of teletherapy – seeing yourself talk and express emotions. People are automatically drawn to studying and judging their own images critically. When we are in session face-to-face, we don’t see ourselves in the mirror every few seconds, and it’s not therapeutic. Sticky notes really help manage this issue.
7. Set your device (laptop/smartphone/tablet) in such a way that the camera is at your eye level (I use a raised stand for my laptop) – so that it feels like we are interacting face-to-face.
8. In order to make eye-contact, do not stare into the camera – it won’t look like eye contact and you may lose important facial and body cues. Instead, take your chat window out of full-view view and reduce the browser size so that it takes up to 2/3 of your screen. Then, center the window under your camera. This way, when we look at each other, it will feel like we are looking in each other’s eyes.
9. Headphones might be helpful for your privacy – you can either use them to listen to the music (if we are doing Brainspotting) or to me.
10. It might help to sit at a table, so that you don’t have to hold all these things in your lap.
11. Discuss, or create, a “Privacy Agreement” with your family members (or people living in your home who are privy to services) to adhere to, regarding respecting the time as therapy time, not barging in or interrupting a session, and not listening in by the door, etc., when the session is taking place.
12. Consider downloading a white-noise app and having that play by your door, while your are in session. A standing fan by the door is another option for your privacy.
13. During our session, please avoid eating or drinking substances that alter your brain state.

Brainspotting in Teletherapy

If we are doing Brainspotting together in video sessions, here is how you can prepare ahead of time:

• Have stickers nearby to mark your Brainspots.
• Download Brainspotting music to a separate device and set it to a very low volume. You can find Brainspotting or Bilateral music on YouTube or iTunes. Please contact me for more options.
• Have something pointer-like nearby – it could be a long pencil, a cat toy with a long handle, a knitting needle, a grill implement, or any kitchen gadget with a long handle. You can also purchase your own pointer – I use a telescopic handheld flagpole.
• Prepare a large wide-mouth jar or a vase with similar characteristics and fill it about half-way with pebbles or beans. A stable pencil holder can also work. You can use it to hold your pointer, so that you don’t have to hold it for yourself.
• For one-eye goggles, you can use a dark face mask, a pirate patch, an eye mask for sleeping, a bandana, or an old pair of glasses with tape or a folded index card covering one eye.

What to Expect at the Start of Each Online Session

At the beginning of each video therapy session, I will confirm your physical location (this is part of teletherapy ethics) and ask you who else is in the house. I may ask you to take me for a “spin”. This is where you can rotate the camera to show me around your entire room. I will also briefly assess if you are “appropriate” for teletherapy from a safety and mental health perspective. We will always have a back-up plan in place to connect by phone if there is a technology glitch. So please keep your phone nearby.

Curious about Teletherapy?

Contact me to book your free 20-minute teletherapy consultation to discuss how I can be of help.