Effective Remote Counseling

Particular best practices are needed to use telebehavioral health effectively which include setting up your equipment to ensure privacy and confidence. 

Pro tips on setting up on your video workspace and environment:

Privacy (Actual & Perceived) 

As a counselor, you already know the importance of a private and confidential place to conduct sessions. This may have gotten complicated with the entire family now at home because of school closings and teleworking mandates. Be sure that not only is your space private, but that from the viewpoint of your camera it looks and feels that way to your client. It may be unsettling for a client to see an open door in your background or see you in an open air setting, While there may be no one home or you may be in a private back yard, the perception of privacy is as important as the reality. If there is anything in your environment that might be off-putting to a client bring it up and address it before the client asks about it.

The Client’s Privacy Setting

Your clients might also be at home with others present. In this time of uncertainty all around them, it’s nice to work with a counselor who knows how to help set clients up for success. Set the expectation with them to find a time and a place in their home that they can focus only on their session. You may need to help your clients come up with ways to keep family members engaged for the length of the session It might also require sessions to be shortened to accommodate the new dynamics of many families. 

Internet Speed and Bandwidth

Do an internet speed test of your home internet. Consider limiting the number of devices connected to your internet during session times. Again, this might require changes to your schedule to allow for other people in your home to have the access to the internet they need.  

Video Position

Using the video platforms on your laptop is best because it is stable. If you are using a smartphone or tablet consider getting a tripod to keep it steady. You can prop it up but it may slide down during the session, getting awkward angels of you and distracting from session work. Be sure your video angle is head on, not up your nose or at a distorting angle. As tempting as it can be, don’t pick the device up and walk around with it while in session. It can cause motion sickness for the person on the other end of the video. 

Structure

There is an element of always being available, always being at work when you work from home. Maintain a schedule of start and end times, don’t book sessions outside of those times. Make your home office, whether it’s makeshift or a permanent space, a place you enjoy being. It’s important to feel comfortable in your space, especially if you’re feeling uncomfortable with a new workflow and technologies. Also be aware that clients will be getting a peek inside your private life. They’ll see a sliver of your home, they might see a pet who is serving as your personal assistant, if your kids, spouse, housemates are unaware that you’re in session and come into the room. Think through what you’re comfortable sharing and what needs to remain private and separate from work.

Presence

Your clients are looking to you for stability, comfort, and confidence that everything is going to be OK. Be sure that you are managing your anxiety and uncertainty in a healthy manner.

Pro Tips

• Put a sign on the door of where you’re conducting sessions to alert anyone else in the house that you are in session and not to disturb. (Good luck if you have toddlers!)
• Make sure you have anything you need before the session starts – avoid getting up for a coffee refill or materials for session during the session
• Telebehavioral health sessions can sometimes feel more intimate because of the camera frame is close up. Keep that in mind if you need to cough or sneeze, mute the audio and video if you have time.
• Lighting is key to maintaining the non-verbal read that you get from your client and that your client gets from you. Make sure that you are lit directly from the front. You can position yourself in front of a window, strategically place a lamp in front of your face, or if you’re really getting into this whole telebehavioral health thing consider investing in a circle light for sessions at dusk or later. They start at $15 on Amazon (so you don’t even have to leave your house to get one.)
• If you’re concerned about someone in your home hearing any session content use headphones during session.

REMEMBER:  Know the physical location of each client, as well as local community resources which may need to be contacted in the event of an emergency, or circumstances that may require a mandated report.  Remember that 911 is a national number and will route you to the authorities closest to you, where the call originates from, not to the location of your client. Be sure you know where your client is located during the session and that you have the contact information for emergency services in their area. Keep that information in their client chart.

It is important to be trained in telebehavioral health and ensure that one’s clients are comfortable with this modality as well. ACA offers training in this area.