Lianne Perry, MA, MSc., RCC
I’ll admit, I was a rather reluctant participant in the online/video platform for counselling. I worried about losing the connection of in-person sessions. Would certain things, like reading subtle body language nuance, be challenging? Would the technology work? How would I find a video platform that complies with all of the Canadian privacy laws? For an EMDR therapist who mostly uses little vibrating pulsars in each hand for the bilateral stimulation, how would I be able to replicate that through a computer screen? What about couples? When you’re used to handing couples a laminated card that describes an intervention exercise, how do you do that over the computer? How do you make sure they can hear you if you want to interject when emotions run high?
HOW WILL THIS WORK??
Turns out, surprisingly well.
One of the effects of this COVID time in which we’re living is that most of us have become, to varying degrees, more comfortable with functioning in the online world. Being forced to talk to friends, family, even doctors over video platforms like Zoom have normalized what was once thought to be an impersonal way of communicating. Done right, it can be just as personal and effective as meeting in person, and for things like appointments and counselling sessions, it actually has a lot of benefits.
For one thing, you’re not exposing yourself to any outside health risks if you’re not leaving your house for a session. Our clinic has taken extraordinary precautions around cleanliness and sanitization, however, anytime you venture out, you increase your risk.
Also, let’s be honest, it’s super convenient and comfortable. You don’t have travel time to and from the session. A 50-minute appointment really is a 50-minute appointment with no driving to and from the clinic. You can wear your pyjamas, if you want, and sip your favourite cup of tea or coffee while we work. If your cat or dog is a comfort to you, sit him or her in your lap or have them lay at your feet. You don't even need to live in Victoria, where I live. You live in Vancouver? No problem. Prince George? Also, no problem. The video platform ensures we can live anywhere in different cities and still connect.
As a therapist, the concerns I had were quickly eased once I took the plunge and started working with clients online. First, it surprised me that I didn’t feel any measurable difference in terms of how “personal” online counselling felt. Probably because we can see each other, I still feel connected and in-tune with my client, and feedback from my clients indicates that they feel the same way.
Second, the technology has worked very well. I use a company called Jane for my client e-files and online booking. It’s a Canadian company based in Vancouver, and is used by many health care professionals like doctors, massage therapists, and counsellors. When the pandemic hit, they fast-tracked a telehealth/video platform that they had been working on in order to make it available to us much quicker than they had planned. It’s fully PIPEDA and HIPAA compliant and follows all Canadian privacy law requirements. It’s also really reliable and easy to use. You get a reminder an hour before the session with a “begin your online appointment now” button attached, or you can log into your Jane profile with me and see the same option there. You click on it and presto! You’re in. It’s that simple.
With respect to EMDR, there are many options available to facilitate bilateral stimulation online. I settled on something called RemotEMDR. In the Jane video screen, I provide a link to a RemotEMDR session in the chat window. You click on the link and are taken to a screen that looks like this:
When it’s time for reprocessing, you simply follow the little balls, shown here in green, with your eyes as they go back and forth across your computer screen. The research does indicate that eye movement is the fastest and most effective way to reprocess, but the RemotEMDR method can feel easier on the eyes than the more traditional way of following the therapist’s fingers moving back and forth in the air in front of you.
For couples, all of the logistics of how the session will be managed are worked out in the first session. I have scanned all of the Gottman materials into my computer and when it comes time to use them, I simply screen share them instead of physically handing them to the couple. This has also worked really well.
If you decide to try online counselling, pay attention to where in your house you set yourself up for a session. For example, try and find a fairly “neutral” spot and keep areas like your bedroom as a safe, session-free area. Allow yourself some time after a session to ground yourself and “switch gears”. Remember that you don’t have the benefit of the time it would take to drive or take transit home to decompress after a session so this time at home needs to be set aside with purpose. Finally, make sure the time you’ve booked will allow you to have the safety and privacy needed for confidentiality purposes.
Video sessions can be booked online by clicking the “book now” button on my website.
Hope to see you online soon. As Dr. Henry says, remember to be kind; Be calm; Be safe.
