So you’ve decided to take the plunge and meet with a counselor through HIPAA-compliant videoconference or “telehealth.” Congratulations! While telehealth may be an idea that the US medical system only began to embrace as a necessity during the pandemic of 2020, in many other countries it’s been improving and occasionally saving people’s lives for between two and three decades. And now that counselors and clients are both learning how effective it is, it can bring counseling to people who don’t have the time or resources to drive to an office. Telehealth is here to stay.

Are you worried that you won’t have the personal connection with your counselor that you need to make progress and meet your goals? Be sure to share those worries. While it is occasionally true that certain individuals will not be able to experience the benefits of their practitioner’s therapeutic presence through telehealth, most clients have just as rich a counseling experience provided their counselor is experienced and confident. If you are concerned about this, say so. Your counselor wants you to have the best experience possible.

Things that are required

First and foremost, you need the right equipment. Find out from your counselor specifically what is needed. Typically a smartphone is sufficient. Often a tablet or computer are just fine also. In fact, the larger screen size of a tablet or computer can really help you connect with your counselor and make the experience more real.

Your computer, if you’re using one, should be a recent model, or be updated for videoconferencing with internet capability, a user camera, microphone, and speakers or headphones. If you’re nervous about whether your system will work, ask if you can do a test run with your counselor’s office before your session. Also, if you plan to use a computer, find out from your counselor if there are any browsers that either cannot or must be used: often this is important. Generally tablets and smartphones will require an app download, although not always.

You will also need reliable internet with good upload and download speeds, at least 5 Mbps for download, 1 Mbps for upload. Higher speeds will make your experience better, and may even be needed in some cases. Test your internet speed before your session at a website like https://speedtest.net. 

If you are planning on using your cell phone’s metered internet connection, that’s fine, but there are some things to consider.  You may have a limited amount of internet gigabytes you can use per month through your cell service, or your speed could be severely reduced if you go over a certain amount (often the case with many bargain “unlimited” plans).  Keep in mind that a one hour session with video can consume around one gigabyte. Plan accordingly.

Next, you must have physical privacy. It is very important that you have auditory (sound) privacy for your sessions and will not be overheard by anyone. It’s best to have visual privacy too--so you won’t be observed or distracted by the movements of others. A private room is ideal. If you’ve decided to tuck yourself away in a corner and there’s no door, ask people not to come near until you’re done. Even if they aren’t paying direct attention to you, people moving in your visual sight can interfere with the counseling process.

Headphones can enhance your privacy because then no one but you will be able to hear what your counselor is saying to you. They are recommended if possible, as sometimes using a speaker can interfere with your microphone’s functioning. If you are concerned about your voice being overheard, placing a fan or a speaker playing music or other sounds at a low volume outside of the room you’re in will mask your speech and signal to others that you need privacy.

Things that are important

Counselors sometimes have their own requirements that are specific to their method. For example, I require my clients to have a stable place to prop their device that isn’t resting on a part of their body (no phone held up by your hand or computer in your lap). Satir Transformational Systems is experiential, and being “in process” involves being “in your body” or “in your feelings.” it can be disruptive to the client’s experience if some part of their body is involved in supporting their device. It may take a few extra minutes of planning, but most of the time people can find a shelf or table to prop their device on. With this small adjustment, the body tends to forget about the device entirely and telehealth counseling is more like an office experience. Surprising but true!

Also, keep in mind that in the US, counselors are licensed to practice by state, and may only deliver services to clients when those clients are physically present in a state in which that specific counselor is licensed. If you plan to travel, and wish to receive counseling services while traveling, inform your counselor in advance: it may be necessary to reschedule your appointment. Otherwise, your counselor trusts you to participate in your counseling session from the location you have agreed upon (often your residence or private office), so they can be in compliance with the law and be appropriately responsible for referring you to resources if you should have an emergency.

And finally, share your experience with your counselor! They want you to not only meet your goals, but to be comfortable with the process and grow in comfort with your own life. The counseling relationship exists to support you, and your counselor needs the information you provide in order to personalize your counseling experience.

Any questions? Don’t hesitate to reach out to your counselor. They want your telehealth experience to be as easy and satisfying as possible.