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Dean Olsher LCAT

Online Therapy

Teletherapy: A How-To Guide

Part 1: Why earbuds make all the difference.

 Feliphe Schiarolli/Unsplash
Source: Feliphe Schiarolli/Unsplash

Now that we’re forced to keep a safe distance from others, psychotherapy is moving from office to online. It’s a major disruption, since therapeutic relationships are built on the nervous systems of therapist and client regulating together. We’re used to that happening in person. Paradoxically, there are ways in which technology makes a different kind of closeness possible.

There is no shortage of resistance to teletherapy, even among people young enough to be considered digital natives. This resistance is no doubt driven by fear. I remember taking part in a teleconference in which one participant, a fellow therapist in her 30s, insisted on sitting at the opposite end of the room from the computer. I pleaded with her: “Is there anything I can do to get you to move next to the microphone?”

Every day, therapists (and teachers) are asking online: “Do I have to buy an external microphone and headphones?” The answer is no, you can just use the mic and speakers built into your computer or phone, but the experience will be poor for everyone as a result. Successful teletherapy requires us to imagine things from someone else’s perspective.

First, if you don’t use headphones, there is a risk of audio feedback. But also—and this is just as important, perhaps even more so—when you talk into the microphone built into your computer or phone, you need to project your voice to be heard. In other words, there will be shouting, and shouting is probably not what you want as the starting point in a therapy session. Your voice will echo from the far end of the room. Social distancing is made even worse.

You don't need a fancy headset of the sort that online gamers use. With even a cheap external microphone, like the one connected to the earbuds you get free with your smartphone, you are able to speak softly into the ear of another person. Instead of shouting, you've come closer. One writer recently described this phenomenon as digital intimacy to explain how successful influencers master social media platforms such as Instagram.

If you have a smartphone, then teletherapy is just an extension of what you already do.

And when you use connected earbuds, it’s not only the sound that improves. You’re closer to the camera as well. In my next post, I’ll write about how to improve the visual experience.

In moments such as these, technology is a gift, and we are lucky that computers and phones have evolved to where they are now. For sure, social media seems to do more harm than good, especially with the spread of misinformation during a public health crisis. However, that doesn’t mean that technology itself is inherently bad. It can be a saving grace if we think about the best ways we can adapt it to our needs.


About the Author

Dean Olsher is a licensed creative arts psychotherapist in New York City.