A Therapist’s Reflections on the Pandemic

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Let’s start by saying there is A LOT I could tell you about what it has been like to provide therapy during a pandemic. Many articles worth of content, for sure. I would like to share the lessons I’ve learned and some things that I’ll be taking away from the experience.

The most prominent question in my mind is:

“Why hadn’t therapists embraced telehealth as a norm before we had to?”

Some answers I’ve arrived at include:

  1. Ableism

  2. Need for power and control

  3. What our supervisors and educators taught us (often decades ago)

  4. A healthy frame for therapy (confidentiality, a separate and safe space)

  5. Technology barriers for both client and therapist

  6. Fear of doing something different from one’s peers

  7. Biases about certain types of communication (this is part of ableism too)

  8. Lack of training about its benefits

  9. Perceived difficulty in providing certain interventions this way

  10. Disenfranchisement of the therapists already doing telehealth in years prior

  11. Personality of the therapist

  12. Prioritizing our needs as therapists over accessibility for clients

We all carry bias and this has been a large wake-up call for me to address what preconceived notions formed my therapeutic norms. While I am planning on going back to offering in-person services one day, I will absolutely always keep telehealth as an option for clients. Some people likely miss me in person, others are pleased as punch to use video. Who am I to decide what is best!?

This year created an opportunity for me to tap back into the creative learner that I was in grad school and during my first clinical internships. At the start of the pandemic, part of me felt like a total imposter and part felt really inspired to figure out how to serve my clients the best way I could given our professional standard of care to meet virtually. Since I hadn’t worked this way before, I got lots (and I mean LOTS) of training on therapy via video. I am greatly indebted to those telehealth savvy clinicians who paved the way for me and mobilized our profession to meet our challenges. I am so sad that we had potentially not seen them as performing ‘real’ therapy in the past since it was not in person.

I remember an article we read in grad school titled “They Don’t Come In,” which basically reminded social workers that we should be empathic to the real needs of our clients and see the world through their eyes instead of judging them for what looks like cancelling or ghosting. If a client does not bring their body into an office for an appointment and we get cranky that says more about us than them. How lovely for a client facing (insert any barrier) to be able to say “Hey, can we do a virtual session today?” and to be heard and appreciated within an authentic relationship. It didn’t take a pandemic for me to know this, but it has certainly highlighted where therapists can do a better job of listening to those we work with.

I’ve heard the phrase ‘back to normal’ about a thousand times at this point and it feels problematic to say the least. The before times weren’t normal or good, even in the therapy world. This experience has shown that real therapeutic relationships can be built via telehealth and clients can experience the same clinical benefits as those from in-person services. I’m here to enthusiastically support people through the modality that is most accessible and meaningful for them.