As a psychosexual and relationship therapist I work comfortably with couples online. Until recently this was scoffed at by many; how could I possibly? With eyebrows firmly in their hairline, therapists would fall between diminishing of my expertise to displaying outright rudeness at the sheer thought a therapeutic relationship could be built online with challenging and complex dynamics.
The same therapists have of course been doing the same over the last weeks and months. My eyebrows have also been shot into my ever-lengthening fringe as I notice there is even training out there on how to do the same. Whilst I do not doubt their expertise as professional therapists, I do wonder where their knowledge of online therapy comes from. Anyway, I digress. There are some questions out there in the therapeutic community on how to approach this.
Relate has offered remote therapy for couples for some years and have done it very well. Their training is in house so has a strong focus on ethics, privacy and adapting their relationship model to suit. As independent practitioners, we may not have access to the technical structures of a large organisation but we can adapt those that are available for relatively small fees and create our own ethical and safe model for therapy.
Covid-19 put paid to the couple workshop which was being developed and Online Training for Counsellors are not going to put together a hastily developed, half done programme. It will be back on our reminder list shortly and will be developed fully in line with robustness of training you have come to expect. For experienced couple therapists who are feeling a bit unsure about their practice, I have added some signposts below.
If you have not had specific training in couple therapy, I would respectfully suggest this blog post is not for you. Working with couples is not just an extra person “in the room”. It is complex and often challenging work and requires a different way of working than with individuals.
Work With Your Supervisor
If you haven’t approached an online supervisor now is the time to do so. Their experience and training will help you feel supported when things go wrong – and they will. I’m not saying it is time to retire your regular supervisor, just recognise that each of the professionals in your life has different levels of expertise.
Online therapy often requires therapists to carry out reviews often. The work can progress quickly and the couples’ focus can change often. When working at depth or some knotty issue you might lose track of time. You might consider using a reminder of some kind to ensure you don’t overrun. Your boundary stays the same, even if the space looks different.
Take some time to disguise your bedroom wallpaper and put a sign on the door to ensure you are not disturbed. Use a chair & not your bed and encourage your clients to do the same. You are both creating a safe space for the sharing of sometimes distressing detail. Your couple can be sitting in different rooms, on different devices or might be sitting together at the kitchen table. Either is fine but be prepared. If you don’t use a professional service for your webcam you may find you are cut off before the end of the appointment if they use different devices.
Webcam/Text or Emails?
All are useful ways of working online with relationships. When using video have some prearranged signals if a child wanders into the room or to put a halt to a period of online conflict. A raised hand is often enough for both. Psychosexual therapy seems to work particularly well via email, benefitting from both the disinhibition effect plus written instruction. If you haven’t had training in working via email, I would suggest it’s a particular skill within the online approach and perhaps some training would help.
Take a step back and consider whether your payment method has worked for you. With economic crisis approaching at an ever-increasing pace it’s important you feel able to talk about money, charge your fee and not take up a role of accidental debt collector. Your record keeping will likely need adapting a little so take a look at that in your quieter times but for now, ensure you have prepared invoices, bank details ready to share or take a subscription out on one of the many electronic appointment systems who take payment for you.
Consider removing your picture from the webcam when you join a room so your clients are sitting side by side on your screen. Remind the couple often you can’t see their bodies so pay close attention to what is happening in your own body. Checking out the transference is always useful. You might find yourself with only 1 person as the other tries to connect. Keep it light and talk about the weather. In that respect couple counselling is the same as in a room – we have to be aware of secrets and collusion.
To practise online, you need to be competent in the online approach – and that’s not about being technologically competent, although that is certainly helpful. If you are finding your proficiency isn’t quite what you thought it was for remote therapy now is the time to refer to a therapist who is online trained. It’s embedded in your code of ethics, no-matter which membership body you belong to. If it’s working out not too badly for you well done. There aren’t enough online couple therapists around so I for one am delighted.