I don’t think in-person therapy will ever become obsolete and I can hardly wait to get back to it. But I’ve been very surprised by the effectiveness and outcomes I’ve seen with video therapy as well as my own reaction to it. I’ve been trying to evaluate why it’s working so well, and have come up with a few ideas that may help people decide to seek help this way.
When I’m doing video therapy, the most important ingredient is still the therapeutic relationship, and this is not diluted through the screen. I think clients are encouraged to engage in an authentic, more intense and emotionally vulnerable way. I want them to feel as if their story and their experience is the only important thing in the world during that time and the video screen facilitates this process. Eye contact over video feels different to me – as if both of us are trying harder to have it stay constant. My guess is that this sustained eye contact and focus makes them feel more attuned, more deeply understood. I think I’ve become hyper-focused on observing my client’s emotional states from their voice, expressions, and the pace of their speech over video and my interpretations of this likely improve the therapy process.
I think video therapy enables clients to see their therapist in a new way so it changes the power dynamic and is less intimidating. Sometimes they can see my son’s electric guitar in the background, or they can hear the kids in the background during breaks in distance learning. It makes me seem more real – more approachable, and thus gives them more hope that they could be understood. Seeing me in my home reinforces the idea that in therapy, the therapist and the client are two mountain climbers (a metaphor developed by Hayes et al., 1999). We are each on our own mountain across from one another. I may be able to see the path up their mountain because I’m standing in a place where I can see things they can’t see because they are on the mountain. But I have my own mountain to climb, and my advantage is not being stronger or better, it’s about just having a perspective.
There are numerous other benefits for my clients, such as flexibility in scheduling, convenience, and not fearing bumping into people they know. People may feel more comfortable disclosing in a familiar setting, and are often doing therapy from their cars to ensure they have privacy. I’ve found that especially for clients who have some social anxiety, they find video therapy more appealing, and are likely to become more open and vulnerable with their emotions. They may feel like they are in a safer space to be their authentic self, and hopefully they will be able to carry this to other relationships.
I will always prefer being in the same room as my clients – but for now, having this option for both of us seems to be working very well. It is an exercise in joining together in the shared challenges of living.