Adapting to Online Therapy, As a Therapist, During COVID-19

The colleagues I have talked to in the past few weeks appear divided between those who are working exclusively on line and others who are mixing things a little – seeing clients face-to-face as well as via video conferencing.

From the outset of the lockdown at the end of March, counsellors were considered “essential services” by the South African government, so I have slotted into the latter role.

I do have clients who live permanently abroad, and as a result, over the years have seen them via an online platform. And since Covid-19, some have been stuck, or stranded in a country other than their home during the lockdown, so have had no option to engage in online weekly sessions.

Several colleagues have complained to me of the added strain they’re taking because of online therapy. Simply put, they’re just not used to it. Sitting in front of a computer or laptop screen for several hours a day listening to clients and the issues they bring to the counselling session can indeed, under any circumstances, be tiring and draining.

Perhaps that’s why counsellors and therapists need to ensure that they take regular holidays and breaks from their work in order to restore their energies and re-charge their batteries.

The added difficulties during lockdown means that since in South Africa we are not permitted to travel from one province to another, it’s difficult, if not impossible to venture anywhere. And staying at home as we’ve all been used to doing since lockdown began, doesn’t exactly offer any new alternatives or enticements.

So taking a break or a vacation during lockdown has proved difficult if not impossible. I have come up, and I must admit, only recently, with my own solution in order to make sure I don’t run out of steam.

I have decided to stop work on a Friday at midday and not resume until mid-morning on a Monday. This means that one gets a complete break from clients and their problems. In other words, it’s a complete shutdown from work, and I make sure that I don’t even enter my consulting rooms or try to think about them during my so called “mini” break at weekends.

Most of my clients living and working in Johannesburg have opted for face-to-face counselling , preferring inter-personal reaction to on-line sessions.

I think the main difference is that on-line you are unable to judge or see a person’s body language, how they move on the sofa, change the position of their legs or their body movement.

On-line, on the other hand, means that you have a more direct and concentrated picture of the client’s face and their facial expressions. You are up close and much more personal and it’s difficult for them to hide true expressions.

You can’t stretch your legs during an on-line session … you don’t go to open the door when the clients arrive or get up to say goodbye at the end of the session. I’ve never quite figured out how to properly say goodbye at the end of an on-line session: do you simply wave (not exactly appropriate) or just say “I’m afraid we’ve come to time - see you next week” and disconnect your computer? Is this a gentle and kind ending of each weekly session I often wonder to myself.

I believe that there are many of these dilemmas that therapists were never taught about in our training. After all, who expected Covid-19 to be around in 2020 and still be with us as I write this?

Perhaps the weeks and months ahead will provide therapists with more answers than questions, and hopefully we’ll soon all be comfortable with the new “normal” – whatever that might look like.

Michael Kallenbach is a couples therapist with consulting rooms in Parkhurst, Johannesburg. He trained at the Tavistock Institute in London.