⚖️ What do we lose when therapy goes online?

Therapy has become an online-first profession in India.
Many of us who trained or began practicing during the pandemic may have never seen a client in person. While online sessions have greatly improved accessibility, this shift in setting has also transformed how therapy is conducted.
Over the next few weeks, I’ll be exploring the consequences of this change.

In online therapy we see only what fits inside a laptop screen, our picture of the client is inevitably cropped. If, like me, you have worked mostly online, you may not even notice what else is subsequently missing from the work. Therapists have shared some experiences:

• When sessions moved from in-person to online, a psychotherapist felt the absence of body language related cues of a particular client. To fill that gap, she would frequently ask them how they felt and what they experience bodily (Sayers, 2021).

• Another therapist described a client who would avoid eye contact and stare into a corner, out of fear that the therapist would judge them as harshly as their parents. The therapist went on to comment that the nature of online sessions would not have been conducive for the same to be expressed (Sayers, 2021).

• A therapist shared about the waiting room interactions of clients- some people would be late to avoid interacting with other patients, others wouldcome early to get a better sense of who are the other people the therapist works with or just gain a sense that they are ‘not the only ones’ (Kegerreis, 2022).

On video we miss the rest of the body, the way a client enters a room, and how they negotiate the space around them. A wealth of information is lost.

What can we do? I am still working that out. But acknowledging the gap is a start: that it can take longer in online work to get to know about certain aspects of a client’s world.

Until next week,
Suvrita

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