Online Therapy Is the New Normal—Here's How Therapists and Clients Make the Most of Virtual Sessions

Remember, your therapist is adjusting, too.

If you were in therapy before the pandemic, you were probably accustomed to a particular experience when you headed in for a session. This might have included a specific couch or chair you sat on, a window you looked out of when you were trying to gather your words, and so on. Now, you’re at home and everything feels out of whack. As strange as it is for you, it’s important to remember that your therapist is adapting, too. As New York City–based psychotherapist and author Jenny Maenpaa, LCSW, EDM explains, figuring out Zoom or other video conferencing was step one. Finding quiet areas to hold sessions was step two. And now, the unknown future is the third—and perhaps, most difficult—step of all. “We are now at home for an unknown amount of time, with little separation between our personal and professional lives, and reduced ability to use the many coping skills we had developed that involved engaging with the world around us,” she explains.

So if it feels a little weird, that’s OK. It’s odd for everyone, but together, you and your therapist can figure it out.

For first-timers, do your research.

Before COVID-19, Susan Jacob* had been thinking about returning to therapy for six months. However, it took four weeks at home for her to finally bite the bullet and book a virtual session. Though it took a lot of willpower not to postpone or cancel her first appointment, she’s now thankful for the ongoing sessions. If you’re a first-timer to therapy, Jacob recommends taking the time to do your homework: research where they graduated from, what they specialize in, and how they’re covered under your insurance. In light of the current pandemic, many insurance providers have extended their coverage for virtual counseling services, if they weren't covering them already. Don't hesitate to research online or call your insurance company to inquire about teletherapy coverage.

And if you start to feel bad over making quick judgments, keep in mind that not everyone is comfortable with the same type of people. As Jacob explains, she’s less at ease talking about her sex life with an older woman than she is with someone her age or younger. She also prefers a female therapist over a male. This may not be the case with you, but the same goes for finding an online therapist as it does for an in-person therapist: It’s worth exploring what therapy matches will benefit you the most.

Make it a priority.

Just like you schedule FaceTime sessions with friends and carve out meeting times to discuss projects with colleagues, in order for therapy to work, it has to be a priority. As New York City–based board-certified psychiatrist, Zlatin Ivanov, MD explains, online therapy consultations are very convenient in terms of scheduling. But they’re also easier to cancel since you can shoot off an email and avoid the appointment. “It’s imperative to carve out the time and place for it,” Dr. Ivanov says. “Make sure you are fully focused on your therapist and block off enough time.” After all, if they’re making time for you, you should return the favor.

Be even more prepared than usual.

Five weeks ago, Jennifer Weinstein* made the switch to online therapy with weekly bookings. With all things considered, she feels fully engaged and supported by her therapist. However, it takes two to tango, and she reaps the most reward from these hour-long chats when she comes prepared with topics to discuss. “While you can still feed off the therapist in a video, it can be a bit harder to focus when you’re not in the same room,” Weinstein says. “I try to be ready with what I’d like to talk about during the session, and if we trail off into other topics, that’s fine, but at least I have some sort of road map to guide me.”

Find a private, comfortable spot.

Amanda Smith* is thankful her therapist was able to pivot and offer online video appointments via Zoom. Surprisingly, she’s learned that rather than commuting to her therapist’s office, she enjoys the comfort of being at home. The keyword there, however, is comfort. Since therapy is meant to be a safe, private, and judgment-free zone, isolating space in your home where you can be candid with your words is a challenge. Smith has made it work after some trial and error and recommends encouraging the people you live with to be understanding and supportive. “Have your partner watch the kids, or maybe that’s the time you put a program on for the kids, so you know you’ll have as few interruptions as possible,” she suggests. “If you don't have a lot of space, perhaps that’s the time for a walk for the rest of the family, or you can take your call from your car. I think getting creative also helps in these times.”

Hide your front camera view.

Think about your therapist’s office: Is there a mirror in front of you? Likely not, so staring at your face on screen could distract during a virtual session. That’s why Maenpaa suggests turning off your video. This will help you focus on what’s important, rather than nitpicking your flaws. “If you’re constantly checking your lighting, posture, or T-zone, you won’t be able to engage with your therapist’s questions and observations,” she shares. “Intentional and thorough reflection is where you gain insight, which in turn is how you develop personal strategies and skills to help you cope with stress.”

Test all tech in advance.

Teletherapy sessions are timed like regular in-person appointments, and you’re charged for the full 45 minutes or hour. Do you really want to waste the first 10 minutes figuring out technology? Or become more stressed out than you already are by trying to fix a camera or microphone while your therapist stares at you? Probably not. Online clinical psychologist Sarah Schewitz, PsyD, says to begin your therapy with “calmness and composure, download all needed software ahead of time and conduct a practice run-through.”

Schedule strategically.

Is your partner a morning person, while you’re more of the snooze-button type? Make sure to strategize online therapy for when you can be really present, Maenpaa says. Say, for instance, you usually meet during lunch. But right now, you’re feeling like your therapy sessions are bringing up emotions that you’re having a hard time separating from to get back to working from home. That's OK! Maenpaa recommends switching to after-work sessions. That way you can really reflect on with your emotions without having to jump back into spreadsheets and video brainstorms.

Ask your therapist to hold you accountable.

Shauna Mehri* has been working on personal growth with a therapist for the past year and decided to take a pause earlier this year. After a few family members tested positive for COVID-19 and she started dating someone new right before quarantine began, she felt overwhelmed. So, she went back to therapy—and asked her therapist to hold her accountable. This looks different for everyone: homework assignments for some, notes emailed post-session for others. Test out a few approaches and see which one sticks for you.

And, if you can, Mehri recommends having a weekly or bi-weekly cadence. “For me, I’ve decided to commit to seeing my therapist every week because life is not normal and every day there’s some new challenge that pops up,” she continues. “Because we can’t escape and distract ourselves with travel, the gym, going to an office, hanging with friends, and so on, we tend to overthink, sit in our thoughts and let our emotions take over. Being able to talk to someone who isn’t in your inner circle helps put things into perspective.”

Pencil in time to process post-therapy.

After working through crippling anxiety or depressive thoughts with your therapist, it’s tricky—if not impossible—to snap right back into work mode and present a project. That’s why Schewitz recommends extending your calendar block by 20 minutes to journal your thoughts, lessons learned, and other information you want to remember. "With online therapy, it’s easy to book things right before and after your appointment but resist the urge to do so," she says. "If you schedule a work meeting right after an appointment, you'll be less likely to go to emotional places knowing you have to be composed right after your session."

*Name changed upon request.

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