Reflection · Practice
Therapy by video: what is actually lost, and what is not
Online work is no longer an emergency measure. Several years in, I have a clearer sense of what the screen takes away and what it quietly makes possible.
I qualified to work online and by telephone, and a good proportion of my practice now happens that way. It is genuinely different work, and pretending otherwise does clients no favours.
What the screen costs
The peripheral information goes: how someone arrives, what they do with their hands, the shift in a room when something difficult is said. Silences are harder to hold, because a pause and a frozen connection look the same. I say more about silence out loud than I would in person.
What it makes possible
Some people speak more freely with a little distance. Clients who would otherwise have stopped — through illness, travel, caring responsibilities, or simply a hard winter — can keep the work going. Continuity matters more than setting more often than I expected.
Practical things that help
A private space at both ends, a full session rather than a shortened one, and an agreement about what we do if the connection drops. Small frames, but they carry the same function as the door of the consulting room.