Guidance for online therapy

Guidance for online Psychotherapy Sessions 

While psychotherapy is usually conducted face to face, a variety of modalities is actually possible. I see most clients in person, but also provide regular remote sessions where distance is an issue and of course, I occasionally complement face to face sessions with remote sessions where health or travel issues arise. Keep in mind though that video sessions may not work for everyone; you need a device that meets the technical requirements and you must be able to access a private space for the 50- minute session. Telephone sessions are also available for people whose devices do not support the video platforms I use. 

What follows is information that may help you prepare for a remote psychotherapy session. 

Preparing for Remote Psychotherapy Sessions 

So that we can have a session that feels maximally natural, please prepare the following setup in advance. 

  • I prefer to use Skype, so have a bit of a play around with it ahead of time to ensure that it works on your chosen device. Adjust audio and video settings to fit with the inputs/outputs you are using. 
    If for whatever reason Skype is not technologically compatible with your device, we can use Zoom, WhatsApp or FaceTime instead. Please add me ahead of your session: my username is Prof. Martin Milton
  • Decide where you will sit for the session. Treat this as you would any psychotherapy session, arranging not to be disturbed during the session if you can. I will be doing the same! Let family, housemates or work colleagues know that you have a private meeting and cannot be disturbed.
  • Disturbances also include digital disturbances – pings and interruptions from messages and emails, for example. Please disable these and close down other windows and applications/notifications so that these will stay out of your environment. Put any other devices you are not using for the video call (i.e., phones) away. 
  • Ensure that your device will have power through the entire 50-minute session. Ideally, you should be connected to power. 
  • It can be helpful to be hard-wired for video calls so that the problems of Wi-Fi can be limited, (pixilation, lags or other digital disturbances due to weak signal). When it’s bad, it can be very distracting. Do whatever you can to ensure good connection on your end. 
  • Whatever device you are using, laptop or tablet/phone, ensure that it is properly situated so that I can see you well – not the ceiling, or a wall, or half your face. I’ll feed back to you if the frame needs adjustment. I organise my space so that when I am doing a video session, people see me sitting in my home-clinic chair, pretty much as they would see me in person. Try not to be backlit by a window or roof light, as I can’t then easily see your face. 
  • Please don’t walk around with the phone or hold it in your hand. From my vantage point it looks like you’re bouncing around, and you won’t be optimally focused on the session. Ensure that your device is on a surface in front of you, stable and supported, so it doesn’t keep falling over. For a natural connection between us, it works better if you’re facing it straight on – not from above or below. 
  • Managing Risk 
    These are unusual circumstances and unlikely to occur, but it is important to let you know what steps I take to try and ensure your safety when I am conducting remote sessions and not right there with you.
  • If you terminate the connection during the session, and if this happens when you are severely agitated or upset or after you have made statements indicating compromised safety, I will first attempt to re-contact you online. 
  • If reconnecting with you online is unsuccessful, I will try you by phone. 
  • If I am unable to reach you by phone, and if the broken contact occurred after you had made statements indicating that your safety or the safety of others might be compromised – or if you were so severely agitated or emotional that I felt significantly concerned for your safety or the safety of others – I will attempt to contact your emergency contact and/or your GP, using information as provided on your Client Information Sheet. If this is unsuccessful and I am significantly concerned, I may need to contact emergency services. 

If you have further questions about remote psychotherapy, please contact me. I am happy to discuss.

Thanks to Dr Elaine Kasket for the template used above.