COVID 19 & Teletherapy
Seeing a therapist used to imply being in the same room with them, but not any longer. Teleconferencing has made it possible to see a mental health professional from a distance.
With recent requirements for social distancing, many therapists and clients have had to either pause their work or make other arrangements, including meeting by video conference.
I've been providing teletherapy services for a few years now. Here are some common questions and issues that come up when thinking about making the transition.
Will My Therapist Agree to Online Sessions?
Some therapists (myself included) are enthusiastic about using teletherapy, some won't use it at all, and a large number of therapists approach it with some reservations. I've been surprised how many therapists are now moving to it with the COVID-19 outbreak and resulting social distancing. Most therapists generally seem to find that it's a very beneficial approach.
Even among therapists I know who were skeptical about online sessions in the past, the majority have opened to the idea. They seem to recognize it as a good option to avoid an untimely break in the therapy relationship, and to provide continuity of care.
Will It Be Weird?
If you're generally comfortable with communicating through a screen (e.g., Skype, FaceTime), you'll probably be comfortable moving to online therapy. If you can't stand this form of communication, you'll likely have a harder time with it. Of the dozens of clients I've treated through teletherapy, most seem to find the transition to be smoother than they expected. Therapy tends to be intense, and quickly enough you're likely to forget about the medium and focus on the work.
That said, expect some differences with teletherapy. It's different when you're not in the same room with someone, and you're experiencing them in two spatial dimensions instead of three. It can also be harder to pick up on body language through a video. And while most of my clients seemed to be comfortable with making the switch, a few were not, or found the transition to be quite challenging. Occasional tech issues come up (like a delay in the audio and video), but typically can be handled with a little patience and humor.
Is It Effective?
Research suggests that therapy by video conference can be very effective, which has also been my clinical experience. It depends on you and your therapist, of course, but in general you should expect it to be helpful if you were finding in-person therapy helpful.
Personally, some of the most powerful clinical experiences I've witnessed have occurred through teletherapy. In my own practice, I've seen it work for people dealing with things like depression, anxiety, obsessive-compulsive disorder, insomnia, relationship issues, grief, and trauma.
Will Insurance Reimburse Me?
A growing number of insurance providers seem to be willing to cover online therapy sessions. They'll probably require the standard things for reimbursement: your identifying information, the provider's license and so forth, a diagnostic code, and a session (CPT) code. Check with your insurance provider before starting your sessions if you'll depend on reimbursement to cover the sessions.
How Does It Work?
You and your therapist will agree on a platform to use (or in some cases may decide to forego video and simply speak by phone). Some rely on Skype or FaceTime, although those options are not HIPAA compliant. More secure platforms include VSee, Zoom, and Doxy, among others. There may be a fee for your therapist to use the technology depending on the service, but it should be free for you (aside from your therapist's session fee, of course).
How Should I Prepare for My Sessions?
Some important and finer points about the logistics of teletherapy:
Do a test of the software beforehand for your own peace of mind and to be sure it will work, and verify that you have your therapist's contact information (e.g., VSee username).
Find a place in your home where you'll have as much privacy as possible. This could be a challenge if kids are out of school or other family members are always home (or work from home).
Along those lines, I recommend ear buds for privacy and also better sound quality. That way your therapist's voice won't feed back into your microphone and out their speakers.
Make sure you're sitting somewhere you'll be comfortable for the length of your session.
Have your screen on a stable surface, since excessive movement can create a feeling of seasickness for your therapist. If they're new to teletherapy and their screen is bouncing around, ask them to do the same.
A finer point: try to have the top of your head near the top of your video screen, rather than in the bottom half of the screen. That way when they're looking at your face they'll be looking more or less into their camera (assuming it's at the top of their computer), so it will feel like they're looking at you.
Be sure to close email and turn off notifications that could be distracting and dilute the experience for you. You'll want to have your full attention focused on your session.
Also close programs that could slow down your computer's processing ability and interfere with the quality of the video.
You may also need to work out payment arrangements with your therapist if you generally pay in person. Some therapists will keep a credit card on file for you; others will ask that you mail a check. Find out what they prefer.
Are There Other Advantages to Online Therapy?
One plus of online therapy you'll notice right away is that there's no travel time involved, so your sessions will probably take up much less of your day. With that in mind, you may want to build in some transition time into and out of therapy, since travel time often provides a buffer before and after your session. It might be challenging, for example, to return directly to childcare after an emotional session. Even a 10-minute break to process and digest the session can make a big difference.
You'll also never have to cancel for weather (assuming you have electricity and Internet), and there are no concerns about whether you could pass along a sickness to your therapist (or vice versa) if you're well enough to meet but possibly contagious. It's also possible to see your therapist when you're traveling, just as I've been able to see clients when I've been on the road.
What If My Therapist Won't Do Online Sessions?
If your current therapist isn't open to doing teletherapy, you might consider speaking with a new therapist who does offer online sessions. Obviously it's not ideal to have to start over with someone new, especially if you've been seeing your therapist for a while. But it may be your only option if you're committed to continuing therapy with as little interruption as possible.
If you don't want to start with a new person, consider other resources during the hiatus from seeing your therapist (and work with them on the plan, if possible). For example, there may be books, brief online courses, or other resources that will help you to continue the work. Your therapist might be open to having brief phone check-ins during this time.
Seek out additional support from loved ones, as well, and be sure to take care of your basic needs like sleep, nutrition, and movement to keep your body and mind healthy. You might find journaling to be helpful during this time, as it's been shown to be an effective way to process thoughts and emotions.
Keep in mind that there could be unexpected benefits to taking a therapy vacation. While it may not be ideal, an unplanned break from therapy can lead to surprising growth, as the work you've done settles in and takes hold.
The Bottom Line
If you're considering teletherapy, talk it over with your therapist and see if it's worth giving a try. You don't have to know in advance if it's the right decision for you—you can always plan to do a limited number of sessions to see how it goes. If it works well, it could be a convenient and time-saving way to continue the important work of therapy.
Find the fill article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
Relationship Pitfalls to be Aware Of
I think it’s safe to say, everyone loves love, whether you’re all about commitment or prefer to fly solo. The initial stages of a relationship can have you feeling like you’re on cloud 9 - the excitement, the butterflies, the attention, you know the feeling! However, once the “honeymoon" phase” has worn off and some time has passed, reality kicks in and certain relationship pitfalls can land you in hot water if you don’t know how to navigate them.
Making a relationship last for the long haul can be incredibly difficult! People naturally evolve and change and, unfortunately, sometimes, they aren’t able to do it together. That said, relationships are a choice and, while severing ties can be healthy in many instances, if you’re both in it to win it, playing for keeps can still be done.
Here are some relationship landmines to steer clear of on the path to forever.
Living in Absolute Certainty
Certainty is the end of a good relationship in most cases. Certainty leads to taking people for granted and that leads to increased friction and, ultimately, a break may occur.
Acknowledging and accepting change is important (even if it leads to the end of a relationship). It will help you appreciate your significant other more and see them as someone to continue to fight for.
Pointing Fingers
The secret to a healthy and long-lasting love is actually somewhat simple, but it requires each party to being fully accountable for their role. When it comes to conflict, couples often focus on how their significant other has wronged or hurt them. The sooner people learn that the only thing they can change is themselves, the better off they’ll be.
Without work from both sides it is almost impossible to fix a relationship. Getting couples to see the problem as something they both created, and not just making it about the other person, is one of the first aspects of relationship I attempt to change.
Ignoring Love Languages
Knowing the little things that your partner responds to - touch, words of affirmation, quality time, thoughtful acts, etc. — is pretty crucial in keeping things healthy and happy over time.
The language you most respond to is also the vehicle in which you express your love. If you don’t know what the other person responds to, you give what you want. In doing so, however, you slowly lose understanding of your partner, which can lead to a disconnect.
Attacking Each Other Instead of the Problem
If you continuously attack each other, you’re slowly stripping your partner of their dignity. Put your issues on the table and keep your focus on that. If you just throw a bandage on top of a dirty wound, it’s not going to heal correctly or fully. It’s when you pour the antiseptic solution on the wound that it’s purified and can heal well.
For instance, lack of communication is a popular pitfall in long-term relationships. It’s not about ‘We don’t know how to communicate’; What they should be asking is, ‘What did we lose in the communication process?’ and ‘When did I stop feeling safe?’ It gets deeper and what is actually lost is safety.
At the end of the day, relationships — no matter how healthy or peaceful — are work. You have to be game to put your all in if you’re running toward the finish line.
Relationships are not 50/50, they should be 100 percent. Always bring 100 percent of yourself.
If you live in the Los Angeles/Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Contact me now to see if we might be a good fit to work together! Or book your appointment now!
Unpacking Emotional Baggage
When dealing with emotional baggage, you are constantly struggling under the weight of baggage, bad filters, and triggers. In any situation, nothing that is said is evaluated objectively. Everything is going through a filter that distorts the original message. It stops being about the content of the message, and instead becomes about our perceptions of the sender, and more importantly, about us. We have let ourselves get to the point where we're not really hearing anymore, we're just judging. If you've reached this point with someone, it's time to unpack your baggage.
Here are a few things that contribute to the problem and understanding them is important tp changing the situation:
Your brain processes most information using primitive filters looking only for the most basic information about threats that should be attended to.
Attention errors make it likely that you'll pay more attention and give weight to information that confirms your original point of view.
You don’t get to hear the intent of people’s messages; you only to get hear how their words come out and to feel how the message impacts you. The disconnect between intent and impact is at the heart of many strained relationships.
Start with a Positive Assumption
The next time you react to something someone else says, turn the situation on its head. Start with a positive assumption, rather than a negative one. Instead of assuming that a person is attacking you, start by assuming they are adding value.
Instead of having your normal reaction to what is said, really think about it. Repeat what they said in your head before responding. Think about the words, without reading between the lines or thinking about the back story. Hear the words coming out of someone else’s mouth—how do you interpret them now?
Pay attention to the positive, rather than the negative components of the message. Did the person start with a compliment and then share some constructive feedback? Focus on the compliment for a moment. Let it soak in.
Think about the possible positive intentions they might have had. How might the person have been trying to help? What were they trying to get at? What value are their comments adding?
If you start with a negative assumption, you waste all the value that others could be providing. A positive assumption is the only thing that gives you a chance.
If you live in the Los Angeles/Westlake Village area and are interested in understanding your emotional baggage and unpacking them, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Contact me now to see if we might be a good fit to work together! Or book your appointment now!
Made The Brave Decision To Go To Therapy...Now What?
I’ve made the brave decision to go to therapy…now what?
We’ve all been there - feeling overwhelmed, confused, thinking we could benefit from seeing a therapist. But only some of us make it through the door and get the help we need. Why is that? Looking for a therapist can be a grueling process.
Searching for a therapist can feel extremely impersonal, leading you from profile to profile on the web only to find yourself lost. The whole process can feel like a massive load - that’s why breaking it down into smaller manageable parts can be a great way to maximize your search. Here are a few tips to consider:
Check in with yourself. I always ask my new clients what they’re looking for out of therapy - what are your goals? What do you want to work on? Is there a specific type of therapy you want to try: individuals, couples, family, etc.? Are there certain qualities you want your therapist to have?
Pro Tip: I suggest taking time to imagine the kind of therapist you want to work with. Write down the traits that feel important to you, and traits that are deal breakers. Ideally what you are looking for is finding a therapist that puts you at ease.
Consider your therapy budget: Therapy is expensive. While I believe it is one of the best investments we can make in our self, there are real financial barriers that can make it hard to do so. Depending on the community you live in, therapy can range from $80-$200 per session.
One option is to consider using your insurance for therapy; it is important to first find out what type of reimbursement, if any, your insurance company offers. If it is a requirement to see someone “in network,” ask for a list of providers and begin looking them up online. Some insurance companies will provide reimbursement for therapy that is '‘out of network'‘ and your therapist can provide you with a “superbill” each month to submit to your insurance.
Pro Tip: Look at your overall spending and see where you can make adjustments. Saving could be as simple as bringing lunches to work and making coffee at home. It is a choice, like everything else, and you must weigh the financial commitment you are willing to make.
Ask people you trust for recommendations: Asking people you trust for recommendations is a great place to start. This could be a friend, family member, colleague or other health professional.
Pro Tip: If you have a friend or family member who is a therapist, they would also be a good person to ask as well. Therapists tend to have reputable colleagues who they can refer you too.
Use the web: The Internet is a great resource for reading about and finding local therapists. Psychology Today and Good Therapy have a comprehensive listing of therapists and allows you to search based on several different factors. All therapists listed in those databases must prove that they have an advanced degree and an up-to-date professional license. You can read profiles or click through to individual therapist websites. Yelp is another great way to search for local therapists.
Interview therapists: Once you narrowed down your list of potentials, it’s time to start making calls. I offer all new clients a free 20 minute consultation to see if we might be a good fit to work together. Pay attention to how you feel on the phone. Do you feel comfortable talking with him or her? Do they sound clear and confident while answering your questions? Is their style of communication relatable? If yes, go ahead and book an intake session at the end of your phone call. Feel free to do this with more than one therapist if you like the idea of “shopping around.”
Pro Tip: Have a few questions prepared before calling, such as:
How would you describe your style of therapy?
What do you charge per session?
What insurance plans do you take?
Do you provide a sliding pay scale?
How often will we meet?
How does therapy work?
Found the right person…now what? Your first session with your therapist will cover a lot of material. You will be asked to share what brought you into therapy, parts of your personal and family history, and the current symptoms you are experiencing. Your therapist will ask you personal questions and, depending on your relationship to vulnerability, this may feel challenging. This is normal and to be expected. Your therapist should never rush your process. Your pace and comfort level must be respected.
“A person’s relationship with their therapist frequently mirrors their relationships outside the therapy office. We often unconsciously recreate dynamics from other relationships with our therapist giving us the opportunity to process negative feelings and work through maladaptive patterns in a safe space. A good therapeutic relationship can be a corrective experience: We are accepted for who we are, encouraged to look inward and connect with our true natures, and supported in growing into our real selves.”
If you live in the Westlake Village Area and are interested in individual or couples therapy I invite you to contact me via email at: tanyasamuelianmft@yahoo.com
major credit to The Every Girl for the guideline to this very important post!