Counselling during the coronavirus pandemic: Alternatives to in-person sessions

In my last article, I discussed strategies you can use to cope with your anxiety as a result of the coronavirus pandemic. Unfortunately, at a time when it is especially helpful to meet with a psychologist to help you learn and practice these strategies, recommended and in some cases mandatory social distancing practices preclude the usual option of having sessions at your psychologist’s office.

Fortunately, there are ways to having counselling sessions other than by meeting your psychologist at their office. These alternatives will allow you to learn and practice strategies to manage your anxiety regarding the pandemic along with helping you to address any other issues which need attention until social distancing is no longer required.

In the following sections, I will discuss and evaluate these options which will allow you to access counselling while adhering to social distancing best practices.

Effects of the pandemic on counselling: Alternatives to in-person sessions

Although many businesses have unfortunately ground to a screeching halt as a result of the pandemic, counselling has continued. That is fortunate because I have rarely seen a single event which has led to so many people needing counselling as this one.

So counselling has kept going in the midst of this crisis and will continue to be offered as long as the pandemic lasts and after that. However, the setting in which sessions normally take place–the client meeting with their psychologist at their office–does not fit with the social distancing practices which are necessary to limit the spread of the virus.

Therefore, alternative means of conducting counselling sessions are being used. As you will read in the following sections, certain of these other options allow clients to benefit as much as if sessions were conducted in the conventional face-to-face setting while others are less effective in this regard.

The best alternative: Video counselling

There are many potential alternatives to having counselling sessions at your psychologist’s office. I will start with what I believe is the best alternative. This entails having sessions by live video using one of the many platforms such as FaceTime, Skype and Zoom. I consider this the best alternative because it most closely simulates the conditions of an in-person session with your psychologist.

That is, you and your psychologist can see each other as well as talk with and listen to each other in real time. Given that this is what happens when you meet in person, it is not surprising that I and the clients with whom I have had video sessions consider them to be as effective as in-person sessions.

Despite it being the preferred alternative to in-person sessions, there are some challenges and glitches which can arise in video counselling. For example, sometimes the connection is temporarily lost or the video and sound quality is not optimal. In addition, if there is printed material I would normally show a client in the office I have to make it a point to email it to them in advance so that we can discuss it at their session.

However, these are minor challenges which rarely detract significantly from the benefits clients receive from video counselling. Fortunately, in our high-technology age every client to whom I have offered the video counselling alternative has been able to take advantage of it.

Less preferred alternatives

Because non-video alternatives simulate in-person sessions to a lesser extent than video counselling, clients in my experience do not benefit as much from counselling using these other options. As a result, I have not conducted sessions using these options nearly as often as I have held video sessions. The infrequent occasions on which I used these options typically occurred when the client either did not have the video option available or preferred not to exercise it.

Non-video alternatives typically are missing one or more forms of communication which in-person and video sessions have which contribute to the effectiveness of the latter types of sessions. For example, I have conducted some counselling sessions by telephone and have found that, although these sessions generally have been helpful to the client, conducting them is more of a challenge compared with in-person and video sessions. The reason is that the lack of visual communication deprives me and my client of nonverbal cues (such as facial expressions and body language) which are important in being able to convey points and to understand each other.

I also think the missing visual mode makes it more difficult to develop a warm and close therapeutic relationship which is fundamental to clients benefiting from counselling. So although telephone sessions were my go-to alternative to face-to-face meetings several years ago when video platforms were not yet in use, these days I would only have sessions by telephone if they were requested by the client or if video sessions were not possible.

As for other options, they have the same drawback as telephone sessions in not simulating in-person sessions in terms of the modes of communication used. Having said that, at least telephone sessions allow the psychologist and client to speak to and listen to each other. And, as many radio talk-show hosts will tell you, communicating solely by voice can still be very effective and arguably create more feelings of closeness than is the case when video is added to the audio. Options beyond telephone sessions simulate in-person sessions even less well and therefore are even less likely to be as effective.

As a caveat, I must admit that I have not conducted sessions by means other than face-to-face, video and telephone primarily because of never having had to do so. So my comments on the effectiveness of other forms of counselling are admittedly speculative. Having said that, I do not see myself conducting sessions by means such as text, email or live computer chat in the near future. However, I would consider doing so if circumstances necessitated it or if the client requested it. For example, I may encounter some clients who feel too intimidated to speak with and/or see a psychologist but who would be open to having sessions conducted in written form.

For the time being, I will recommend that people continue to access counselling at this stressful time even though they may not be able to meet with their psychologist in person. As I stated, I recommend video sessions but—as with the various counselling skills and techniques I offer my clients—I am open to the alternatives.

May you keep your counselling going at this much-needed time,

Dr. Pat