As a psychotherapist / counsellor I do get at least couple of enquiries every day for in-person sessions. Personally, I have not seen clients in-person since March 2020 when the pandemic started.  Though I have been offering online counselling / online therapy sessions since 10 years, for clients from other cities/countries, it is in the recent past that I have shifted to online therapy sessions to all clients exclusively over video calls.

Given the current scenario I think it is important to understand the rationale as well as the pros and cons of both modes of therapy in the background of the pandemic.

Talking about in-person therapy / counselling sessions here are my thoughts.

1. In person meetings aids the therapeutic relationship:

There is a significantly higher degree of comfort between the client and the therapist when they are sitting face to face in the same room in a safe setting. The therapeutic relationship is strengthened by the fact of being in the presence of the other. Nuances like body language, body positioning, shifts in energy, movement, gestures etc can communicate so much more to the therapist, than just the face on a video call.

2. Lack of a private space to attend sessions from:

It is a struggle for many clients to find a private space where they can feel safe to have open conversations online with the therapist. Some other clients may not want their families to know that they are attending therapy sessions. Many a times I have seen clients attend sessions from their terrace or from their cars. Clients also express concerns regarding the privacy and security wrt online platforms for communication.

3. Zoom fatigue makes it difficult to really connect online:

Recent research shows that prolonged use of video chats and video conferencing leads to a feeling commonly called zoom fatigue, tiring you out and makes it difficult to really be fully present online. When you are already on video calls most of the time for your work or school or interacting with your peers/friends/family, it becomes a drag to see your therapist also on a video call.

4. No Network or internet issues

In person meetings offer more comfort with respect to problems like technical glitches, poor network or internet connectivity issues, issues in audio or video quality etc.

Talking about online therapy / counselling sessions.

1. Offers Safety for both client and the therapist:

Attending and offering therapy from in our own comfort and safe zones, ensures safety from COVID. When meeting in person, different clients may end up occupying the same space one after the other. And even if one client is unsafe, it might impact all other clients who meet the same therapist at the same space and would be at risk.

2. Confidentiality constraints:

With respect to the control of the pandemic, contact tracing was one of the key mechanisms adopted by the Government. As a therapist I am obligated to maintain confidentiality of my clients, and at the same time contact tracing would be a legal and social necessity which would be at loggerheads with confidentiality. This would be ethical dilemma to be navigated.   

3.  Comfort of your own space:

When you attend counselling sessions online from your own space of comfort, you save time with respect to travel, avoid navigating traffic, skip braving the weather conditions etc.

There are both advantages and disadvantages for online therapy vis-a-vis in person therapy in the background of the pandemic. Here I would like to highlight one of the key ethical guidelines for counselling/psychotherapy – nonmaleficence.

The principles of non-maleficence and beneficence are moral principles for the counselling profession, (American Counseling Association [ACA], 2014).

The nonmaleficence principle means not causing harm to others and avoiding practices that have potential harm. The principle of beneficence is to do good towards the welfare of the client.

As a therapist, though personally I may feel that certain interventions may be more potent in person than over a video call, I also have practically seen clients make significant progress towards their identified goals through online therapy.  Given that many are vaccinated today, and the risk is lower compared to when we didn’t have a vaccine, the risk still lingers.  Do the benefits of in person therapy outweigh the potential for harm?

What are your thoughts?  Do share in the comments section.

References:

https://news.stanford.edu/2021/02/23/four-causes-zoom-fatigue-solutions

https://www.counseling.org/docs/default-source/vistas/article_3452fd25f16116603abcacff0000bee5e7.pdf?sfvrsn=cceb452c_4

About the Author:

Kala Balasubramanian is a certified Counselling Psychologist and Psychotherapist with a Masters in Counselling and Psychotherapy, Diplomas in Counselling and has further certifications specializing in couple/marriage/relationship counselling and family counselling. As a trained therapist, she provides professional and confidential counselling services including Individual counselling and Couples counselling / Marriage counselling.

Currently with the COVID-19 situation, all counselling services are offered online over video calls. Reach us at +91 9632146316 or write to us at counselor@innerdawn.in.

The post Online therapy vs in-person therapy in the pandemic backdrop first appeared on Inner Dawn Counselling.

Currently, in the COVID-19-related quarantine times, we are talking about a new normal, which, per se, is stressful for everybody. Everyone is attempting to cope with the new, modified situations and challenges that come along with it. Given that change itself is stressful, under this stress, pre-existing issues become more visible and highly intense, leading to more conflicts spiralling out of control and lowered relationship satisfaction, above and beyond the new problems that have cropped up, with the quarantine.

Managing children at home with online classes, children unable to move out, everyone cooped at home, no external help available for domestic chores, anxiety around the disease, precautions, taking care of the elderly and family members who are at risk etc are the new challenges with quarantine.  Uncertainty regarding, what will happen and how will things be etc is the current reality.

Do you find yourself and your partner experiencing frayed nerves, being irritable, frustrated, snapping at each other, getting annoyed and angry, about each other and the situation?  Well, you are not alone.  That doesn’t make it any easy to navigate the situation any better.

8 ways to navigate your relationship issues in quarantine times.

1. Acknowledge that this is the new normal.

It is important that the both of you need to understand, acknowledge and accept that this is a new normal for now.  That it is stressful to the both of you and to your family. You need to find new and better ways of working together and living together.   Your usual activities of going to office, going out partying, spending time with friends, playing badminton or favourite sport, gym workouts, going to a movie, shopping in a mall, travel/trips etc have all been put on an indefinite pause. It is the current reality and you both need to acknowledge it.

2. Negotiate new rules / work arounds.

One of the major causes of frustration and annoyance is a realization of the stark contrast of the sharing of household domestic responsibilities. When one partner is going all around the house engaged in cleaning / cooking / other activities and the other partner is plonked in front of the TV or on the mobile or laptop all the time without a thought of helping, it’s a sign of brewing troubles to come. If this is the case in your family in the current situation this can lead to the risk of major discontent and burnout of one partner. Both of you can together renegotiate the sharing of household responsibilities and to have a fairly equitable share.

3. Be more sensitive to each other’s needs.

Being sensitive to each other needs will go a long way in creating that supportive bond in your relationship. If you have a child to take care of, offer to take care of the child when your partner is on important meeting or call. If there are elderly members in the family who do not agree your new sharing of responsibilities, it is important that the both of you sit with them and explain the need to do things in a better manner that works for everybody involved. Try not to take out your frustration or anger on each other. Remember – you are not each other’s punching bags. This is the time to be more sensitive and supportive of each other.  Agree on specific time lines and log out from work at that time.  If there is a need to extend work time, talk about it and inform your partner.

4. Delay major decisions.

It is possible that when some of these conflicts escalate you may feel compelled towards taking some drastic decisions. Any major decision is always better taken when you are in a calm state of mind, when your cognitive abilities as well as decision making capabilities are intact and effective. Major decisions need to be taken taking into account all the possible consequences and how prepared you are to deal/cope with them. It is preferable to postpone major decisions in the current situation, so that you don’t regret them later.

5. Take Timeouts.

When emotions are overflowing and you are not in a balanced frame of mind you may end up saying or doing things, which may be hurtful to each other. It is not practically possible to have a reasonable or rational conversation or to listen when you are agitated and your emotions are running pretty high. It is a good strategy to take a timeout to calm yourself down. You might choose to go to different room, have a glass of water, meditate, listen to music etc whatever works for you till the time you calm down. A timeout also has an indicated time after which you come back and resume the conversation in a calm manner. When one partner asks for a timeout the other partner needs to allow it and not go on and on with the conflict. Resuming the conversation, would ensure that the conflict doesn’t just get swept under the carpet.

6. Be connected but also give space.

This is especially a difficult time for everybody including you and your partner. It is a very important time for you both to be supportive of each other and stay connected with each other. At the same time it is important to realise that you are spending time in the same confines of your home 24/7 which can also be difficult.  Both of you will need your own space and time as well.  Agree and arrange for both of your needs to have some space for each of you. Talk about sex with each other and understand each other’s needs.  Lack of privacy and being at home all the time might increase or decrease your sexual desire.  Being open and talking about it with your partner, will make it easier to manage the difference if any in your needs and manage hurdles like privacy etc.

7. Old relationship issues re-surfacing.

Any pre-existing issues in your relationship could get aggravated in the current quarantine situation. These issues could be related to communication, responsibilities, parenting, finances, extended family – in laws, sharing house hold chores, other friendships and so on and can escalate as well. If these issues were not resolved till now, it is very unlikely that you can resolve this effectively now in the stressful environment. It would be good for the both of you to have a conversation that this is an existing problem and if it can be kept aside for now and look at possible alternatives temporarily that can work as of now.  You can also seek professional help with a relationship counselor or therapist to work with you.

8. Have other healthy coping strategies.

It is important for the both of you to identify other healthy coping strategies for yourself individually or together to deal with the stressful situation.  You may think of some new hobbies or revive some old hobbies that are feasible in the current situation.  Or take up some online courses in meditation or yoga to help yourself relax and also build your resilience. Eat healthy food and have adequate sleep to keep your immunity in a good place, apart from the recommended health and safety related practices.

If things become difficult, unmanageable or go out of hand, you can seek professional help, get counselling / therapy online over video calls either individually or as a couple. Reach us at +919632146316 or write to us at counselor@innerdawn.in.  We provide online counselling over video calls for individuals and couples

About the Author:

Kala Balasubramanian is a certified Counselling Psychologist and Psychotherapist with a Masters in Counselling and Psychotherapy, Diplomas in Counselling and has further certifications specializing in couple/marriage/relationship counselling and family counselling. She takes an eclectic approach with different therapeutic modalities like CBT, Gestalt, TA in her work. As a trained therapist, she provides professional and confidential Counselling and Therapy, including Individual counselling and Couples counselling / Marriage counselling.

The post Is Quarantine making your relationship worse first appeared on Inner Dawn Counselling.

Online counselling was earlier sought mainly by people who are not able to access in-person counselling or therapy services in their location. But today, when we are all not able to move out of our homes in the current situation, many people opt for online counselling. It is possible to seek professional support, especially in the current uncertain times, without stepping out.

Lock downs, forced to stay at home, comes with its own set of challenges. It also aggravates any existing problems and challenges as well. It need not stop you from seeking professional support that you want to seek.

Today a variety of counselling services are provided through online channels.  Some of the channels/media are face to face video calls, telephone counselling, counselling over email, over chat etc.

As a therapist among all these online options I personally prefer, the video call based counselling, as second best to in-person sessions where the client and therapist are in the same location. 

A video call provides face to face interaction between the client and therapist, and it becomes possible for the therapist to take a notice of many nonverbal signals like facial expressions, posture, eye contact etc.

But there are many providers who do use the other media like email or phone counselling based upon the requirements of their specific clients. 

In this article, I am going to talk about what you can do to make the best out of online counselling over a video call. 

1. Get your queries clarified upfront

When you first reach out to the counsellor to get an appointment for a session, get all your queries clarified with the counsellor. Though your counsellor may give you most of the information that you may need it is good to know what is important for you to be aware. Ask about the counsellor’s qualifications and experience. Check what modes/medium are available for counselling, and specify what you are comfortable with. Counsellor also will give you clarity in terms of what they are comfortable with.  It is important that both you and your counsellor need to be comfortable and have the facility needed for the medium of counselling. Ask about payment modes, online wallets or bank transfer etc and ensure that you are comfortable with the same.

2. Plan for your Privacy

Counselling is a safe space for you where you can express yourself without any hesitation or fear. Hence ensure that you have a private space for yourself to be able to speak openly and without any hesitation or fear. If you are taking the call from a room, it is preferable that you close the door and lock it. Ensure that you stay undisturbed during the call and that no one else can hear the conversation.  I usually do not recommend clients taking the calls from open spaces like a park or a coffee shop etc, but there have been times when clients have taken the session from their parked car to have better privacy.

3. Take the Online Counselling session seriously

Even if the session is going to be over a video call, the process is the same as an in-person session. It is important that you login on time and keep the counsellor informed if you are going to be a few minutes late. Turn up for the online session as though you are there in person.  Wear appropriate clothing and groom to be presentable. Ensure that your mobiles are on silent.

4. Set up your logistics upfront

Ensure that you have proper Lighting and ventilation and a good internet connection.  Use a computer/mobile with a reasonably good camera. Close other applications and other windows on your system. Get yourself a pair of good quality headphones with a mike. If you are going to use a Video call application, install it prior and check its functioning and get comfortable with it upfront.

5. Be prepared for technical issues

Be prepared and expect that there might be some technical issues like network issues, loss of internet connectivity, power cuts etc that might happen during your session.  Have patience and plan for alternative arrangements, in case that happens. It is good to talk to you about any possible technical issues and plan for an alternative arrangement to continue and complete the session.  It is not advisable to stop a session abruptly unless it is a major emergency.

6. Be aware of the limitations of online platforms

Understand that there might be certain limitations for therapy on online platforms like a video call. Very intensive deep therapeutic work may not be indicated on online platform depending on the challenges that you bring into therapy. Check about possibilities of meeting the counsellor in-person subsequently to continue in therapy or to have intermittent in-person meetings. As a therapist I recommend this option, to clients for whom this is possible. Also the recent incidents of privacy breaches on a popular online platform, means that you and your therapist need to explore and choose a platform that is secure and confidential.

Online counselling on video calls can be utilized for adult-individual counselling, couple counselling, adolescent counselling as well. I don’t consider it a good choice for very young children.

 About the Author:

Kala Balasubramanian is a certified Counselling Psychologist and Psychotherapist with a Masters in Counselling and Psychotherapy, Diplomas in Counselling and has further certifications specializing in couple/marriage/relationship counselling and family counselling. She takes an eclectic approach with different therapeutic modalities like CBT, Gestalt, TA in her work. As a trained therapist, she provides professional and confidential Counselling and Therapy, including Individual counselling and Couples counselling / Marriage counselling.

Reach us at +919632146316 or write to us at counselor@innerdawn.in.  We provide online counselling over video calls for individuals and couples

The post 6 points to make the best out of Online Counselling first appeared on Inner Dawn Counselling.