Getting the most from online therapy - 12 tips for clients

There are two main ways in which online therapy differs from traditional in-person therapy. Understanding these differences, and why they matter, can help you prepare more effectively for your online therapy sessions.

Key differences between online and in-person therapy

Key difference 1: Privacy

Therapists generally belong to one (or more) of the main regulatory bodies such as the UKCP, BACP or BPS. These regulatory bodies have codes of ethics to which all therapists are expected to adhere, and the need to respect and protect the client’s right to confidentiality is a fundamental principle.

When meeting your therapist in person, they would take responsibility for safeguarding your privacy during your session while you are in their space.

When opting for online therapy, however, your therapist can only ensure their own setting is private. You will need to prepare your space yourself.

Key difference 2: Quality of connection 

With traditional in-person therapy, it is likely you would only ever visit your therapist’s room for sessions. Your therapist’s room would therefore be a unique space cultivated expressly for the purpose of therapy, and within which you (hopefully) feel safe to explore whatever is troubling you. It is unlikely you would experience much in the way of interruptions or distractions and, when you leave the room, there would be a clear transition back to everyday life.

When meeting your therapist online, however, it is likely you would be meeting your therapist from a familiar space - one with which you are likely to have many other associations including other types of video calls, for example, social and/or work-related ones.

Being in a space that also ‘contains’ other aspects of your life can lead to an unintentional (often unconscious) blurring of the boundaries between therapy calls and other types of calls. This can risk online therapy encounters lacking the relational depth of traditional in-person sessions.

What actions can I take to address these differences? 

With the above points in mind, I have put together the following tips to help you create a therapy-friendly space for yourself. By taking these few simple steps, you are more likely to be fully present with your therapist when you meet which, in turn, means you are more likely to benefit from your sessions.

1. Check your internet speed 

The faster your internet speed, the higher the quality of your video call will be. The higher the quality of your call, the easier it will be for you to focus on the content of your sessions rather than the technical quality of your connection.

The broadband regulator, Ofcom, offers a user-friendly guide to internet speeds which includes suggestions for boosting speed and solving any problems you might have. 

It’s a good idea to check the quality of your internet connection in the space you plan to use, and at roughly the same time of day when you plan to have your therapy.  This is because internet quality can vary from room to room and can fluctuate depending on how much demand there is on the service at any point in time.

2. Guard against being overheard

If you share your living space (or wherever you plan to have your therapy) with others, try to book your therapy sessions at a time when you know the others will be out.  

If this isn’t possible, you could consider buying a white noise machine to position outside the room you are using. The white noise it emits should muffle the sounds coming from behind your door.

Another idea could be to use headphones with a built-in mic so that you can speak quietly and still be heard by your therapist.

Or, if you have access to a car, could you drive to a private space with your laptop (or whichever device you are using) and use data to get online?

Many therapists offer the option of phone calls instead of video calls so if it would be easier for you to control your privacy over the phone, you could ask your therapist about this option. 

3. Familiarise yourself with your therapist's video call platform 

When beginning with a new online therapist, check which video conferencing platform they use. If the platform is new to you, you could ask your therapist if they’d be happy to send you a link to their platform a few days in advance of your first session. This would give you time to familiarise yourself with the logging-in process and the settings.

Taking the time to do this upfront means valuable time with your therapist is less likely to be taken up with troubleshooting.   

4. Minimis in-vision distractions

In the run-up to your session, close any windows or browsers on your device other than the platform you are using for your session, and switch off any alarms or reminders that may interrupt your session.

It’s unlikely you would be checking your device for messages if you were in the same room as your therapist, so treat your online session in the same way. The fewer the distractions, the more fully present you will be with your therapist and the more likely you are to benefit from the session.

5. Turn off listening devices 

This is important for the protection of your privacy as well as for minimising the potential for disruptions to your session.

Many homes these days contain listening devices, so check the space you will be in for your session and turn off any devices that are primed to listen for voice cues. This can include items such as games consoles and other smart gadgets alongside the more obvious ones like Siri and Alexa.  

6. Think about what you're wearing 

Is it appropriate for a therapy session? If you had to get up for a glass of water or a comfort break would you be comfortable with what your therapist may see? The less you have to worry about what is on view, the more engaged you will be with your therapist.

7. Ensure your device has enough power for your session

Either keep your device plugged in during your session or, if that’s not possible, take steps to ensure it has enough charge to last the duration of your session.

Some people find it helpful to set a reminder for themselves ahead of their therapy start time to check the power status of their device and charge it up ahead of time, if necessary.

8. Log on a few minutes early

If possible, log on a few minutes before your session is due to start.  This will give you time to address any last-minute technical issues, and to frame yourself in vision so that you’re ready to begin as soon as your therapist appears.

9. Prepare mentally for your session 

Most online clients are in their homes for their therapy sessions, which means the traditional journey to and from the therapy space doesn’t take place.

Travel time to therapy can actually be a valuable part of the therapy experience as it’s a time when you would be anticipating your session, noticing how you’re feeling as it approaches, thinking about what you want to talk about, etc.

So that you don’t miss out on this valuable preparation time, think about how you might recreate this ‘journey’ for yourself before your online session.

Ideas include taking a short walk, having a cup of tea, or doing some deep breathing.  Think about your own situation and what might work best for you.

10. Tissues and clocks 

Cornerstones of any therapy space!

Whether or not you think you may cry, it’s a good idea to have tissues to hand so that, if you do, you’re not interrupting the flow of the session to fetch some.  

Whether or not you have a clock (or other timekeeping device) to hand is worth thinking about, too. When meeting in person, some therapists like to ensure clients can always see a clock so that their clients can play an active role in managing what they want to say, and when, within the session time.

Other therapists prefer to take sole responsibility for timings as they believe it encourages the client to relax into the session, knowing the therapist will take care of bringing it to a timely close.

Think about your preference and, if you would like to keep an eye on the time, make sure you have a timekeeping device easily in view. 

11. Decompression time 

In the same way that creating space to anticipate your session is important, so is allowing time, afterwards, for your session to ‘land’.

If you were seeing your therapist in person, this process would be taking place as you leave the room and begin the journey to your next destination. During this time, you would likely be reflecting on what took place in the session. This ‘sorting through’ is a valuable part of the process of being in therapy because it’s when your neural networks are processing the content of your session and new pathways are being formed.

Think about how you might create this important space for yourself after your online session before you transition back to everyday life.

12. Closing your session 

There are two considerations to bear in mind when bringing your online session to a close.

Firstly, on a practical level, it’s a good idea to close your browser afterwards as this helps to protect your privacy by minimising the chances of anybody who may see, or use, your device afterwards, from tracking your activity.

Secondly, on a therapeutic level, ending your session with the press of a button is rather more ‘sudden’ than the in-person ritual of standing up, saying goodbye and leaving the room. You may like to discuss with your therapist how you will end each session, for example, who will press the ‘leave’ button first and how will you know when that's going to happen?  

Finally, remember that you can always talk to your therapist about any aspect of working online that may be troubling you, or that you’re unsure about. Most concerns are easy to iron out and your therapist will want to support you in feeling as comfortable as possible.  

You are, after all, a team!