How to Get the Most Out of Online Therapy - Justin Lioi, LCSW - Brooklyn, NY

While many therapists were providing online therapy for the past several years, the Coronavirus pandemic has suddenly made it the major—and in many cases the only—way to continue one’s self-work and treatment.

It’s a scary idea for many, but I’ve found that it takes only one session—and sometimes not even a whole session—for my client to settle into this way of receiving support.

While research has shown that it is just as effective as in-office therapy, this doesn’t mean that it’s not different and comes with its own set of challenges.

I talk about some of the benefits of online therapy here, but several people have been asking about how to get the most from this brave new world of online therapy.

1. Recreate Your Space

The first thing for you to take a look at is where you’re going to physically be for your session. As you’re figuring that out, think of your time in your therapist’s office and what can you use to recreate in your space. Believe it or not, we take a lot of time designing this space and the foremost thought is privacy. This might mean letting others in your home know that you are not to be interrupted during your therapy time—including them not being near the room where you will be. Close (and lock if you like) the door to your space. Therapists generally use a white noise machine on the outside or inside of the therapy room for an added level of security and this is available for free as an app on your phone or tablet. Find somewhere comfortable to sit or lie down without too many distractions around—you may need to turn off notifications if texts or emails pop up on whatever device you’re using. Lastly, keep some tissues handy!

2. Prepare for Tech

I like to say that technology is great…until it isn’t. But anything you can do to avoid unnecessary technical glitches is helpful. We can only cover the tech on our side of the equation so see what you can do. I find it helpful to not use WiFi, but to plug in my ethernet from my router. Not everyone can do this, and it may take a special adapter, but it’s one way to decrease the inevitable WiFi instability—especially if a bunch of people in your home are using the WiFi at the same time as your session. This also helps for privacy. Check out your lighting—it’s best to have the light source be in front of you. If it comes from behind you’ll only be seen as a black dot. Try out headphones or ear buds. This helps with sound as well as confidentiality.

3. Ensure Some Time Before and After Your Session

One of the parts of in-office therapy that people find helpful is the ritual and process of getting to the therapy and leaving. Being able to sit in a waiting room for a few minutes to collect your thoughts, connect with your feelings, do some mindfulness is great. If this is something you’ve found helpful, give yourself some time on the front end of your session to get into the therapy mindset. As you know, the session itself can stir up feelings and ideas that you had been carrying around, but have not actively explored. Since you don’t have the walk to the subway or to your car post session, find some way to ground yourself as you leave your session and transition back to your family and your home life. If that sounds daunting—don’t be shy about asking your therapist how best to do this. I’m sure they’ll have some tips!

4. Let Go of Perfection

Any use of tech I find to be a great teacher for myself in allowing for uncertainty and pushing against any perfectionist parts of me. There will be inevitable issues. I saw this circling around social media: “We are not working from home, we are trying to get our work down while at home during a crisis.” This applies to therapy too.

  • The kids may knock.
  • The rain may make the service spotty.
  • A loud noise will be coming from outside.
  • Something unexpected will happen

5. Ask Questions of Your Therapist

Anything here that you’re unsure of or that you want to confirm, please don’t hesitate in asking your therapist about. Questions about security and risk, why they chose this platform or that platform? Ask. Wondering how you can still continue your work and progress that you’ve made up until now? Talk to your therapist about it. Worried about your therapist and how they’re doing—you are allowed to ask! The therapist will want to focus on you, but if you need to know that your therapist is OK and taking care of themselves in order for you to talk about your own stuff, you’re allowed to ask.

Online therapy may not be your mode of choice, but it is what we have available during this crisis. It may not be what you want. You may want the ritual of going to and from your therapist’s office for the boundary setting. You may have endowed the office as the space for you to talk about your trauma, your worries, your family and relationship issues, but we are an adaptable species.

My last request is that you don’t discount online therapy before giving it a try. Most of my clients who were initially resistant to it found that they were able to adapt within the first session—often surprising themselves.

Please contact me if you have any questions about online therapy or if you’re interested in trying it out for the first time.

Justin Lioi, LCSW is a men’s mental health and relationship expert based in Brooklyn, NY (and online throughout New York State and internationally.) He received his degree from New York University and has been working in family and men’s counseling for over 10 years. Justin is on the Board of the National Association of Social Workers and writes a weekly column for the Good Men Project called Unmasking Masculinity. He can be found on local and national podcasts talking about assertiveness, anger, self-compassion, all with the goal of becoming the man you want to be.