• Ashton Rose

How Therapists Struggle With Online Treatment


When the Covid-19 pandemic hit, our world was changed in many ways. And one of the biggest changes we saw was the transition from in-person therapy services to online therapy, or teletherapy.


Teletherapy is by no means a new thing. But before the pandemic, it was still just growing in popularity— roughly 63% of providers didn’t use telehealth services at all. But now, after the pandemic hit, only 2% of providers don’t use teletherapy, and more than 80% of providers use it most of the time.


This change was certainly necessary to allow us to get the treatment we need in a safe manner. And it has its benefits: it allows people to see therapists wherever they are, it cuts out the cost of transportation, and it makes it easier to fit therapy into a busy schedule. But there have definitely been downsides as well.


Some therapists, such as our own Rebecca Letterman, had been doing teletherapy even before the pandemic hit. But for those who were new to the subject, there have been a lot of challenges that they’ve had to face. Even therapists who are used to teletherapy may have struggles that come with it.


This article is not meant to act as a guide— we are not here to tell therapists how to fix these problems. Instead, we want to help spread awareness of these issues, especially for patients who go to therapy. This will help you understand what your therapist is dealing with, so you can be more understanding if they have difficulties. So without further ado, let’s look at some of the struggles with teletherapy that therapists face.


Separating work from home


Anyone who works from home, like myself, knows the difficulty of this. Without that separation, you won’t get the space you need, and you might not be able to focus as well on work. And since many therapists no longer work in their office space, this has become an issue for them.


This can be a problem in many ways. For one, it makes it more difficult to get in the mental space for working. If you conduct therapy from your bedroom, a place where you are used to resting and relaxing, it may be hard to get in the right mindset to do therapy.


And of course, if you have family, there is always the threat of noise and interruptions. In an office, you will likely only get interrupted if there’s an emergency. But at home, family members— especially small children and pets— may barge in for a variety of reasons, disrupting a session. These things make it really hard for a therapist to set up a good space for them to work in while at home.


Staring contests


When meeting in person, therapists and clients don’t tend to stare at each other all the time. They may look around the room, or even out the window. But when doing therapy online, many therapists might feel a constant pressure to maintain eye contact with the screen.


This pressure can result in therapists constantly staring at their camera, which is uncomfortable for them and awkward for everyone. So if you notice your therapist constantly doing this, know that they’re not trying to have a staring contest, and maybe even let them know that you don’t care if they maintain eye contact. They might not even know they’re doing it.


Reading body language


Many therapists often seem to know how you’re feeling in a specific moment, and the right way to guide the conversation. And this isn’t just based off of your words— they can also pick up on body language to tell when a patient is uncomfortable, excited, or wants to move away from a certain topic.


Through the frame of a computer screen, though, body language is a lot harder to read. Often therapists can only see a person’s head, and camera quality may make it hard to see small movements. So you may find yourself having to say out loud things that were previously said silently— and that is ok.


Creating comfort


Most people feel comfortable in their therapist’s office. That’s what helps therapy work. But a big struggle with teletherapy for providers is creating that same comfort without an office space.


For one, they don’t control the client’s environment, so they can’t make it a safe space. And common gestures of comfort, such as handing someone a cup of water or some tissues, can’t be done. So it’s a lot harder right now for therapists to make their clients feel as comfortable during therapy.


Sharing resources


In the office, many therapists may want to share resources with their clients, such as diagrams, flowcharts, or lists of terms. These resources can help patients understand certain issues better, and increase the quality of their care.


However, without face-to-face interaction, it can be much harder to share these resources. Any sort of sharing now requires at least some understanding of technology from both parties, and some people may struggle with that. And for resources that therapists may only have on paper, it means needing to know how to scan and send them— and that’s if you’re even able to get into the office to find them first.


Lack of movement


Being a therapist isn’t known for being one of the most physically demanding jobs. However, one of the struggles with teletherapy is that even smaller amounts of movement have been cut out. Walking to get resources, getting clients from the waiting room, and other small acts are no longer necessary. Which means that a lot of therapists doing telehealth could be suffering from moving around less.


Less movement can cause a lot of issues, but the most common ones are tension and stress on the body. Your neck may be tense, due to lack of movement. Your legs could cramp up, and even your back could ache from not sitting well. So not only are therapists struggling to maintain the same quality of care, but they’re doing it while dealing with minor physical ailments too.


Too much screen time


Anyone who is working virtually now, and wasn’t before, could be facing similar issues: a massive boost in the amount of time spent in front of a screen. And while some people are used to this— I, as a writer and gamer, spend most of my time in front of screens— many people aren’t, and it can be tough on them.


So much screen time can strain your eyes, and if you’re lucky, that’s the worst. But many people will suffer headaches because of it. Plus, such an increase in screen time can have detrimental effects on sleep and mood. It may be necessary for us all to spend so much time looking at screens, but until we adjust to that, it will be difficult for many people.


Therapists are people too


Everything said in this article boils down to one solid point: your therapist is a person too. These are all struggles that your therapist may face, so it’s important for you to be aware of them. Hopefully, it allows you to get better care without putting too much pressure on your therapists.


After all, who knows what the future holds. Telehealth as such a large part of the mental health services industry might be here to stay, even long after Covid-19 has begun to fade from our daily lives. And if we all work together, we can make sure that if that’s the case, we all benefit from it without too much stress.



Have you just learned new things about what your therapist may be struggling with? Are you a therapist who has other struggles? We’d love to know! Let us know by leaving a comment below or sharing on social media and tagging us (@llctherapeutic on Twitter and @therapeutichealingjourney on Instagram).


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