5 Things Therapists Wish You Didn’t Do During Video Sessions

How everyone can avoid a little awkwardness and embarrassment.

Posted Sep 15, 2020

When the pandemic began, psychotherapy sessions moved from in-person sessions in an office to virtual ones online. The upside of teletherapy (sessions via video platforms such as Doxy and Zoom) is that it has made therapy available to many, including some for whom such services were previously inaccessible. Many people lived too far from their local clinics or providers to make in-person sessions practical or were unable to get reimbursement for teletherapy services (which are now reimbursed by medical insurance carriers).

I’ve spoken to many psychotherapists over the past months, and most agree that working with patients via video has provided an interesting peek into their lives (and perhaps into ours). My colleagues also agree that some "peeks" can be a bit distracting. Here are the do’s and don’ts of five situations my fellow therapists and I have encountered that we (A) never had to deal with during face-to-face sessions in the office, and (B) wouldn't mind not encountering again.  

1. Car therapy: Doing the session from your car? No problem. Doing the session while you’re driving in your car—problem. Yes, you might be only five minutes from home but please either pull over or just mute the video. Seeing cars whiz by outside your window while you keep glancing down at the phone is going to give me a heart attack.

2. Toilet therapy: If the bathroom is the only place in which you have privacy for the session, sitting on the toilet is fine. Flushing is not. And saying, “I was crying so it’s just tissues,” does not make it less awkward. Just don’t flush.

3. That sinking feeling: Tablets and phones can slip if you just prop them up. For a therapist, being able to see you from the chest/shoulders up—great. Seeing you slowly sink in the frame until all I see is your forehead and ceiling—not so great. Please make sure your handheld device is in a stable position.

4. Intrusions. If you live with other people and there’s a door behind you, kids or another adult might come in during the session. If the person quickly leaves—it’s fine. If they glance at the screen, see me, and say, “Is that your psychologist? Does he know we haven't had sex in three months?" less so.

5. Pet anatomy: Dog on your lap during the session—fine. Cat on your laptop keyboard—not fine. As a therapist, it’s important for me to see your face. I’d rather not have to look past your cat’s rectum to do it.

That said, being invited into my patients’ homes via video sessions is a privilege I do not take for granted and one for which I am truly appreciative. Being able to continue my work, especially during a global pandemic and economic crisis in which so many have lost their jobs, is an opportunity for which I feel grateful every day.

Stay healthy.

Copyright 2020 by Guy Winch

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