What to keep in mind as you transition to video sessions

As more therapists and clients transition from in-office appointments to teletherapy, or psychotherapy through video, it’s important to remember that there’s more to the change than a new venue and technology. As a therapy client, some of the things you can do to get the most from therapy are particularly important when it comes to teletherapy.

1) Ask questions

Therapists are responsible for getting your informed consent to participate in teletherapy, so you’ve probably already received information on what to expect from the process. Still, you may have questions about privacy, how to use videoconferencing software, the risks and potential benefits of teletherapy, or what to do in an emergency, so it’s a good idea to check in with your therapist to make sure you’re both on the same page as you move forward.

2) Choose a focus area or two

Without a clear direction, therapy sessions can go by quickly and be unproductive, so write down before the session what would be important for you and your therapist to address in the time you have together. If you have trouble coming up with ideas, consider a setback from the previous week, an ongoing problem, or an upcoming challenge that you’d like your therapist to consider with you.

3) Give some thought to what you hope to achieve

Are you ambivalent or conflicted about an issue and unsure how to resolve it? Do you hope to come to a conclusion about how to understand yourself, a relationship, or a future challenge? Have you noticed a behavioral problem—too much of one behavior or not enough of another—and you want to figure out how to change it? Is it difficult to take care of personal responsibilities? Are you having a tough time at work, school, or in a relationship? Are you overwhelmed by an emotion and can’t figure out where it comes from, what it means, or how to respond to it? Is there something you’d like to achieve before the next session, and you want help to know how to make that happen?

The more specific you can be about your concerns and what you’d like to happen by the end of the appointment, the better. If you express these ideas at the beginning of the session, you and your therapist can move quickly to clarify focus areas and goals, and then spend the bulk of the time on being productive in your work together.

4) Take notes

There can be a great deal of information shared over the course of a therapy session. You don’t need to remember every detail, but if you have a meaningful insight or your therapist makes a great point, give yourself the opportunity to benefit in the future from these key ideas by writing them down.

As you go through the session, keep a notebook by your computer and jot down the information. If you’ve ever had the experience in therapy where you thought, “I need to remember that” but couldn’t recall the idea the next day, you’ll be glad you took a moment to record it in your notebook. If you can leave a session with 3-5 key ideas in writing, you’ll get much more from the process than you would if you rely solely on your memory.

5) Make a plan for homework

Much of what’s beneficial about therapy happens through the work you do after the session. You and your therapist should give some thought to what would be good for you to work on before your next appointment. If you’re going to therapy to address anxiety-related concerns, you might already be doing exposure tasks for therapy homework to reinforce the benefits of in-office exposures done with your therapist. As you transition to teletherapy, you may not be able to do some exposures in video sessions, so it’s good to collaborate with your therapist to determine how you’ll do this work on your own.

Even if you’re not in therapy for anxiety, it’s valuable to prepare for homework in between sessions. If you’re struggling with depression, you and your therapist might plan creative ways to increase activity that leads to pleasure and a sense of accomplishment. If you often have trouble expressing your needs to your partner, you might prepare yourself to be more assertive in your communication. If you get overwhelmed by your inner experience, your homework might involve mindfulness practice, worry journaling, or responding to thinking traps with more realistic and useful thoughts.

And if you’re not used to doing out-of-office therapy homework, start with simple ideas. Collaborate with your therapist to find the smallest change you’d still consider to be meaningful, and then make a commitment to engage in the homework practice as close to daily as possible.


Thanks to Psychology Today and clinical psychologist Joel Minden, Ph.D., who is the author of Show Your Anxiety Who’s Boss and a well-respected lecturer in the Department of Psychology at California State University, Chico.


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