Online therapy is a challenge, and certainly not what most of us trained for. It is more tiring for both the therapist and the client. It is hard work trying to understand what is going on for the client with less information than we normally have, because it is harder to observe body posture and other nuances. Often, Internet connections are shaky and we’re even having to fill in a few gaps in their words as it cuts in and out or freezes temporarily. Similarly, the client is receiving fewer forms of feedback from us, and having to risk describing feelings that are hard to put into words whilst in a context that might not always be supportive (or in some cases, even properly soundproof).
As a result, I often worry that my sessions might become more superficial. It’s no problem to check in with my clients, but it is a challenge to really push therapy to a deeper level via teletherapy. Which is why I try to slow down to speed up.
In the movies, you often see paramedics and first responders running to an emergency. However, in real life, paramedics never run to a scene; instead, they always walk. This allows them to be alert for hazards and reduces the chance that they will injure themselves on the way.
This is my rule for therapy, too. When a client is describing something, slow them down. Rather than have them tell you about what happened, have them evoke it. Ask them to describe it as if it is happening right now. Ask what happened before the incident. What happened immediately afterward? What could they see and hear as it happened? What thoughts and feelings were they having? What was happening in their body? What is happening in their body right now as they describe it? What do they here now, want to say to them there then? And so on. Keep asking questions until you feel that you can vividly imagine the incident they are describing. If they are rushing through details, ask them to take a breath and describe it more slowly or even just repeat things they said at a slower pace.
The first sentence or two that they’re telling you are things they already know. By slowing down their description, you’re enabling the client to learn more from their own experience. This is especially useful during teletherapy, when it is more tiring and there is more temptation to stay superficial.
Slow down, stay curious, and keep safe.
Ben Sedley, PhD is a clinical psychologist and acceptance and commitment therapy (ACT) practitioner with over fifteen years of experience working with adolescents and families facing mental health difficulties. Sedley’s research and practice has focused on examining children and young people’s understanding of mental health, which has helped guide him on the best ways to explain mental health concepts and ACT to young people.
Part 2: What to Do When a Client Is Participating in Self-Judgment?