Remote Therapy Is Not So Remote After All

​The change from doing most of therapy in person to doing all of therapy remotely has been a big shock for both clients and clinicians.  Many clinicians have never had to do video sessions, and have had to step out of their comfort zone and figure it out so they can be there for their clients during this time of need.  Clients had to transition from the comfort of their therapists' office to doing therapy in sometimes not so comfortable places (e.g. home, car).  Fortunately, doing therapy remotely also has its upsides.

1) Flexibility
Doing therapy remotely has created a great deal of flexibility for clients who no longer have to drive to the office and juggle multiple work, child, and family obligations to carve out time to focus on their own self improvement.  Although it can be a little harder with kids at home or having others in the house, the tradeoff of being able to see therapists during a lunch break or in the morning has made it easier for clients to get the help they've been needing.

2) Opportunity
Let's consider the things that often hold people back from committing to therapy: the therapists office is too far away, they don't want to take time off of work, the social stigma of talking to their manager about taking time off of work to go, family commitments, etc. Now with the ability to do virtual sessions people may find themselves more open to the idea of taking time out of their lives to better themselves.  Thanks to the flexibility of virtual sessions, clients are able to streamline getting help. Clients are able to begin the process of meeting therapists in a more efficient way, without having to leave their homes or find a day with no soccer practice to bring their child into therapy .  Working remotely also allows them to manage some of the anxiety about talking to a stranger about the problems they've been struggling with.  Lastly, for better or for worse, many problems that individuals, families, and couples have been dealing with have come to a head now that they are stuck at home.  It was much easier to avoid the problems, but now many of those problems have been exacerbated, creating a crisis, and an opportunity to do something about it. 

3) Connection via Screens
Many therapists, as well as clients prefer to meet in person, feeling as though meeting remotely doesn't give the same human connection.  It's true, you can feel the emotion in the room, and the connection when your therapist is really getting you, not just on an intellectual level, but what we feel inside.  I've been doing therapy remotely for over 10 years, although they are usually one off sessions if a client is traveling, sick, etc. and it has been very effective.  I was wary about starting with new individuals, families, and couples that I had never met in person, but I found that we were able to make a strong connection just as if we had met in person.  While in-person sessions may be ideal, being able to connect with my clients through a screen while making them feel seen, heard, and attuned to has not been an issue. Whether I'm working with a couple in crisis, a teenager frustrated with their parents, a family and their anxious child, or an adult struggling with depression and ADHD, we're able to connect just the same as if we were working in person.  

4) Move Forwards or Backwards
We can either move forwards or backwards, but usually cannot stay stationary.  Life continues to move on, and as they say in drug and alcohol counseling, "we are either moving towards our recovery or our relapse".  This is a time to move towards your recovery, rather than letting problems snowball. Many families I have worked with who have struggled to develop structure with their children are now forced into a scenario where they have to figure it out.  To work, do homeschooling, and keep children entertained day in and day out is hard, and its created the need to stop procrastinating and find a system that works.  Many couples I've worked with were able to go through the motions, avoid each other in the time between getting home from work and going to bed. However, being stuck at home has forced them to turn to each other, to fight and resolve arguments, and find a resource in one another that they were able to survive without before.  Several of the couples I work with have had to depend more on their relationship during this time, and have jumped into creating a more satisfying relationship for both partners.  Many adults I work with have begun to address the issues they may have been avoiding such as connecting with friends and family, finally facing their anxieties about their finances, starting to exercise, and setting goals that work with family.  This time of shelter in place and social distancing for many is creating a context where we can no longer avoid, and so choose to move forward, rather than backwards.  

5) Accessing Expertise
Finally, one of the biggest shifts of working remotely has been clients beginning to realize that distance doesn't matter, and they can get the expertise they've been needing. By removing the psychological barrier of needing to meet in person, clients are beginning to reach out from areas far away and finally work with someone who is trained to treat their specific problem.  Whether it be exposure and response prevention for OCD, EMDR for PTSD, family therapy for oppositional defiance disorder, Cognitive Behavioral Therapy for adult ADHD, or Emotionally Focused Couples Therapy for relationship and sex problems, clients are finally getting specialized assistance, rather than transitioning from therapist to therapist who has a generalist approach.  When working with an expert they're no longer talking about how their week was and just giving updates, but specifically addressing the problems they're dealing with and learning the tools to overcome their difficulties to create lasting change.  

There are many out there who are struggling, and many where things have gotten worse with their drinking or conflict at home, or loneliness becoming overwhelming, but with the help of a good therapist, this time in life can become an opportunity to move forward, rather than move backwards.  The majority of therapists I speak with have been experiencing great success in their work with clients, and are often surprised at how the difference between working in person and remotely is not as great as they had thought.  It's allowed people who have not been making progress in therapy to get the expertise they needed to create lasting change, and to everyone's surprise, a remote connection is still a strong and deep connection.  I applaud the therapists who are becoming flexible and creative to provide what their clients need during this time of shelter in place, and encourage clients to reach out and take this opportunity to make the change they've been knowing they've been needing to make!

 

W. Keith Sutton, Psy.D. is the director of the Institute for the Advancement of Psychotherapy (www.sfiap.com) in San Francisco where he provides effective, evidence based treatments such as Structural-Strategic Family Therapy, Cognitive Behavioral Therapy (CBT), Emotionally Focused Couples Therapy (EFT), and Eye Movement Desensitization Reprocessing (EMDR).  Dr. Sutton has expertise in children, adolescents, families, couples, and individual adults.  He treats issues such as ADHD, OCD, depression, PTSD, panic attacks, anxiety, substance abuse/addiction, oppositional defiance disorder, relationship problems, and self harm.  He also provides training through his Institute to licensed and prelicensed clinicians, and is the director of the nonprofit, Bay Area Community Counseling (www.sf-bacc.org), where he trains and supervises interns learning effective therapies and seeing clients in financial need.   Dr. Sutton is the past president of the Association of Family Therapists of Northern California (www.aftnc.org) and the founder of Bay Area Therapists Specializing in Adolescents (www.batsa.net).

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