Teletherapy
Instant Message (IM) therapy or teletherapy has been around for years through platforms like BetterHelp and TalkSpace. As a student in the early 2010s, I was pretty skeptical of anything outside of in person therapy. I wondered how you could get a true therapeutic experience at a distance. Teletherapy, however, has been shown to be effective and is able to provide access to healthcare to folks who may not have many options. Here’s some other reading you can do on the subject: “14 Benefits of Teletherapy for Clients” “Does Online Therapy Actually Work?“.
Effective communication is effective communication, regardless of the setting
– Keith Grafman
If you thought teletherapy is just something reserved for a younger crowd, I want to share some of what I have learned offering these sessions through BetterHelp.
You get insight into someone’s brain..with their consent!
With BetterHelp, the client has the option to toggle on or off “live text”. This allows them to show what they type as they go. Think about all those times you write something and go back and delete before you send it or save it. Imagine the usefulness of seeing someone’s train of thought in action while doing that? Seeing this is a therapeutic jackpot that can help with processing what’s “left unsaid”. I give a disclaimer ahead of sessions to let people know of this capability. Not doing so would be very intrusive if formal consent is not given.
There is time for thoughtful replies.
Like with email, you have more time to allow yourself to write a thoughtful reply than phone or video sessions. This allows for more time choosing language, direction, and flow of therapy. As a client, you can also get into your therapist’s head when you see them typing as well. Yes, it works both ways! I know this feature has made me feel more humble in my communications as my clients see me wrestling with words, train of thought, and typos.
Therapeutic pacing feels easier to manage.
As with any texting, it is easier to see both parties are participating and how much. As a therapist, this helps with gauging how much “coaching,” you are engaging in, or psychoeducation. We can more intentionally choose to balance our stage time with this overt awareness, and perhaps illicit more client interaction with Socratic questions for our client’s to explore.
Emojis can help clarify tone and emotion, and even add to the therapeutic process.
Emojis definitely help out with trying to express the emotional content of what is communicated. I also find them necessary so that both parties can feel like they are on the same emotional wavelength. I was actually quite surprised with how much personality and humor can come through on this platform. Because I like using a lot of metaphors and analogies in my work, emojis have been great to use as symbols throughout sessions. I have found using emojis in some instances help communicate a point better than verbal or nonverbal communication could. For example, maybe a turtle emoji (🐢) symbolizes a client’s frequent Automatic Negative Thought. It serves as a representation of themself as being slow. Using that emoji in future sessions can be rewarding and shed humor and light onto their internal world.
Privacy
IM sessions probably provide the most privacy during these pandemic times where we are most on top of each other in our homes. The discretion of the IM platform is a huge perk. It is quiet, looks like a texting window, and is easy to engage in while multitasking.
Less pressure
There is definitely something to be said about the “informality” of IM therapy. I have noticed that it tends to take some of the unhelpful pressure that both parties may place on themselves going into sessions to reach a breakthrough or perform in a certain way. This allows for an easier way to build trust and rapport as both parties feel like they can be more themselves. Having said that, this does not mean this is “therapy lite,” or a way to slack off on therapeutic work. My final point brings the accountability portion of this therapy modality into light.
Extra effort needs to be put in to attune to one another
The additional need to ensure we are in lockstep with our clients, due to missing nonverbal communications, gives us enough fuel to lock in,and make sure our communications are heard in the way we intended them. I have noticed this phenomena from the client end too. I have greatly appreciated how there is more back and forth about what is said to make sure that we are hearing each other correctly. In some ways, I feel like my IM sessions have had the most reliability with how both parties are interpreting each other’s communication for this reason.
IM therapy does have limitations that shouldn’t be discredited. This is definitely not a platform that fits everyone, but I would caution letting the concept of it undermine its legitimacy.
Having said that, I have been pleasantly surprised that I have been able to engage clients in experiential practices, and behavioral practices that I once thought would be a very limited process through chat. If you have been contemplating trying Teletherapy or the IM function, go on give it a try. Accessibility and healing await you.
