Despite lockdowns lifting in many parts of the world, social distancing isn't going away anytime soon. And while nonessential medical treatments and appointments are starting back up again, traditional mental health therapy involves getting in the same room with another person at least once a week, which is uncomfortable or impossible for many at the moment. Luckily, the majority of therapists who once saw patients IRL have decided to keep their practices virtual for the time being — and many say they plan to continue offering virtual appointments forever.
But virtual therapy sessions present their own unique challenges. For instance, Busy Philipps recently shared her therapy spot of choice: her car. “One reason I've been doing car therapy in this Quar time is because I get to drive to places I would go almost every day and hang out there in my car for a while and pretend it's all normal,” Philipps wrote. “Like I'm just gonna hop out and grab a celery juice and my shampoo and conditioner that I'm out of.”
Unfortunately, things still aren’t quite normal, and they won’t be for a while. But because the fallout from the COVID-19 pandemic and the trauma associated with systemic racism and police brutality are on the forefront of many minds, therapy is more important than ever.
“Anxiety is particularly high right now,” says Amy Cirbus, PhD, LMHC, LPC, director of clinical content at Talkspace. “Times are not normal, stress is high, and taking care of our mental health needs to be a priority.”
But because online therapy is a bit different from the in-person experience, it can help to keep some specific strategies in mind to ensure you’re reaping the full benefits. Ahead, mental health pros share their tips to ease in, whether you're transitioning from IRL to virtual therapy or trying therapy for the very first time.
Accept that it’s different from the “real” thing.
Whether you choose to do a video, phone, or message-based session, body language is limited or potentially completely absent from the equation, points out Tonika Dew Evans, LPC, a licensed professional counselor who is currently working with clients online. “Body language is important and helps both client and therapist convey and receive messages,” she adds. So you’ll need to try to “connect” with your therapist in other ways — which requires your full attention. Because of this, finding a quiet place to do your session and avoiding multitasking (i.e. texting or online shopping during your session) are key.
Also, if you’ve tried in-person therapy before, it’s best to avoid comparing your online sessions to your past experiences. “Although online sessions are different from in-person connection, the sessions can be very beneficial,” says Carla Manly, Ph.D., a licensed clinical psychologist. “If your brain is comparing the ‘old way’ to the ‘new way,’ you’re less likely to be fully in the present for your session.” In other words, it’s important to embrace the new experience.
Consider the payment logistics beforehand so you can focus on your session.
There are a lot of options out there for online therapy. You can work directly with a private therapist, get set up with one through a larger practice network, or even find one through a therapy app. These options are all slightly different, so it’s worth considering what you’re most comfortable with before you dive in.
One of the main differentiators between therapy apps and working with an individual therapist is cost. Apps tend to be less expensive, though they may offer shorter sessions or just voice and text messaging. Apps are also not usually covered by insurance.
If you opt to work with a therapist directly, ask about their payment policy before scheduling an appointment, says Lequita Brooks, LCSW, a therapist and founder of TherapyTopia. Find out whether your sessions will be covered by your insurance, or if you’ll be required to pay out-of-pocket for the therapy session. Some therapists offer a discount for those who aren’t going through insurance, so you can ask about their self-pay fees as well. Having this information ahead of time ensures you’re not left with a surprisingly hefty bill, which could add to stress and anxiety.
Another important point to consider: If you use insurance coverage to pay for your sessions, your therapist will need to provide a diagnosis, such as depression, general anxiety disorder, or bipolar disorder. “If you prefer not to receive a mental health diagnosis, you may want to consider self-pay,” Brooks says. (Some people may prefer to avoid being diagnosed if it has implications for their future insurance coverage.)
Like Philipps, people who are interacting with their therapist in real-time and have other family members (or roommates) around often have to get a little creative to find a place to do their appointments.
“The purpose of therapy is to have a safe, uninterrupted, confidential space that you can vent, be human, learn coping strategies, and let it all out without judgment,” Brooks says. “I would encourage my patients to use their closet, garage, car, or any place that will allow them a space to have a meaningful online therapy experience.”
Brooks recommends giving other household members a heads up that you won’t be available during your session. And if that’s not possible or feels too awkward: “Leave the house, park in the parking lot at a park or somewhere that resembles tranquility, and let the members of your household know you’ll be unavailable for the next two hours,” Brooks adds. (FYI, taking a little time after therapy to decompress is just as important as the session itself.)
Setting boundaries around online sessions might also prompt conversations with people in your household about why you’re seeking therapy in the first place — ones that might not come up if you were just stepping out of the office at lunch for an in-person session. If this makes you uncomfortable, talk about it with your therapist, Dew Evans suggests. They’re likely to have ideas and strategies for how to address it.
Lastly, it’s important to ensure your data privacy is protected during your sessions. FaceTime, Zoom, Skype, and other similar platforms are not HIPAA compliant, meaning they don’t follow the specific set rules for securing your sensitive health information. “Confirm your therapist uses a HIPAA compliant platform,” Brooks advises. (While you’re at it, it’s also a good idea to double-check the therapist is licensed to practice in your state. This information is usually listed in directories or on the practitioner’s website.)
Don’t be afraid to try out multiple therapists.
Fit is important, whether your therapy session is taking place online or IRL. Here’s how to ensure you end up with a therapist who meets your unique needs.
Get clear on where you need help. “Before scheduling an online session, identify what you would like to gain from the online therapy sessions,” Brooks recommends. Are you looking for a safe space to vent? Searching for coping strategies? “It’s okay to express your desired outcome with the therapist before scheduling an appointment to ensure they are the best fit,” Brooks adds.
Look for therapists who specialize in what you need help with. “Contact the therapist that you believe will understand your plight,” Brooks says. Most therapists list areas of specialization on their website. If you’re dealing with something sensitive and feel unsure if a therapist will understand what you’re going through, Brooks recommends asking about their specializations before informing them of your concerns.
Schedule short intro calls. “Many therapists are very amenable to having a no-charge phone discussion to answer a prospective client’s questions,” Manly says. Therapists want a good fit as much as you do, she adds.
During this call, be direct about what you’re looking for and ask questions, Cirbus suggests. “A therapist who is a good fit will answer them, be sensitive to what you’re asking rather than defensive, and offer up insight on how they can best help you and deliver on your needs.”
If you’re not sure where to start with looking for therapists, experts interviewed for this article recommend:
Psychology Today, which has an extensive directory for all types of mental health concerns based on your location
Therapy for Black Girls, an online space dedicated to encouraging the mental wellness of Black women and girls
TherapyTopia, a diverse group of licensed therapists that offer online virtual mental wellness sessions that include a fifty-minute online session through a HIPAA compliant platform
The Boris Lawrence Henson Foundation, which provides a directory of mental health providers serving the African-American community
Stay invested in the process.
Regardless of what anyone else may think, remember that there's absolutely no shame in carving out this time for your mental health. “Going to therapy is normal and it is a way of life,” Brooks says. “Look at your therapist as someone you can share your deepest, darkest secrets with, who will not tell anyone else your business.”
For her part, Manly recommends staying invested in the process. “This looks different for each person, but the general principle is to remember that therapy is essential self-care,” she says. “When you prioritize yourself and your needs, you’ll come to see that psychotherapy is not about ‘fixing’ a broken you; it’s all about maximizing your best self.”