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A Quick ‘Transition’ in the Age of Telehealth Psychotherapy

Occasionally, it becomes clear that a client is having some trouble decompressing or transitioning after distance psychotherapy sessions. The fact that telehealth can occur anywhere that is secure and private, means that sometimes it gets squeezed right into a tight schedule–a schedule that then demands for time to sprint on, like nothing just happened. Or, sometimes the session takes place at home or in another place that is not normally meant for psychotherapy processes to take place, and then there is an unceremonious jolt right back into a tangible, demanding, rushing life.

In this age, we have lost a natural gateway or bridging process before and after therapy sessions

For example, the several to many minutes it might take to drive to the therapist’s office, sit in a waiting area, and have a session in a completely different setting than usual–a therapy office space that is ‘transitional’ or ‘in-between’ in many important, useful ways. That old way was not always easy. It was not always convenient. But I think it perhaps had quite a bit to recommend it.

The physical therapy office space is real and includes two real people, but psychologically it is protected, open, imaginative, and accepting in ways that are not often the case in the raw world. We have also lost the several to many minutes to drive back to work or home, digesting what we have just experienced and learned and preparing for the return of that raw world. (Lately, when dealing with psychotherapeutic and counseling matters, I’ve been calling the ‘real world’ the ‘raw world’ for accuracy and a new take on the concept).

Develop a ritual or activity to mentally and emotionally denote a boundary, and a journey back over it.

This can be helpful before, but especially after, distance / telehealth therapy sessions. ItĀ could be as simple as:

  • Giving oneself a few minutes of quiet contemplation before opening the bedroom, closet (!), or home office door.
  • If there is little mercy in the daily schedule, it could be stopping the session with five minutes to spare so that contemplation happens then.
  • We could arrange the session so that immediately after it, the client / patient goes on an errand in the car or can manage to take a brief walk alone.
  • Perhaps the last five minutes (or a bit more) of the session could be for narrating to oneself, silently or out loud (with therapist silently listening), what a drive home would be like or a fictional walk through pleasing and comforting areas and through an imaginary gate.
  • If there is truly no respite, then perhaps exiting the session and: praying, smelling a special perfume, listening to a particular song, making oneself a special tea before dealing with anything else, etc. The possibilities are numerous and can be tailored.

Obviously, such rituals can be helpful in the home / work mashup that so many people are managing

I have been hearing anecdotally that people with young families or who are more private are having more difficulty managing work-at-home, work-at-home-plus-school, or no-work-plus-handling-school-at-home, while single persons are enjoying the blending of work into easy, more convenient, and familiar spaces. Those are, of course, generalizations, but are apparent trends.

When trying to get the most benefit and absorption from your psychotherapy / counseling sessions, let’s not push the new flexibility and bleed-overs too far. It can be quite beneficial to have a few moments to prepare for your telehealth psychotherapy session and then, after, to process it. Re-entering the raw world too rapidly can sometimes be a letdown, too stark a contrast, or prevent final digestion of the session content and processes. Find your simple post-session ritual–and a pre-session one, if you can.

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