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  • Nicole L. Bickham

Getting the Most Out of Telehealth Sessions

I’ve been offering sessions exclusively via telehealth for nine months now, and during this time, there are a few things I’ve observed that seem to result in a better experience for both me and my client:

  1. Both of us wearing headphones. By now my clients are quite used to seeing me don my headset. It allows me to hear and be heard more clearly, reduces background noise, increases privacy, and reduces feedback from the computer speakers. I have observed that sound quality is better when the client wears earbuds or a headset (whether for video or phone sessions) as well, for all of these reasons. Even a simple, $10-15 pair of corded earbuds from the drugstore is usually an improvement. (Noise cancellation is not a necessary feature for our purposes.)

  2. Closing background applications. Any applications running in the background will slow down the video connection. Email is one of the major culprits. Having other devices on the same internet connection also makes a big difference. Of course sometimes this can’t be avoided, but if you have a phone or other device not in use, temporarily turning off its use of WiFi could help.

  3. Using video at least once in a while. Sometimes video sessions are impossible because one’s internet connection just can’t support it. I also have clients who prefer phone sessions because they don’t have privacy at home but can take a phone call somewhere else. Some clients say they just have more ease when they can’t be seen. Some like to have sessions while walking outside. I have been surprised at how well phone sessions work, and most insurance companies have loosened (temporarily) their restrictions on telehealth by permitting phone sessions. However, I have noticed that when my phone-based clients can occasionally arrange for a video session, our work seems to land more deeply. This makes sense, because humans are relational beings who evolved to use visual cues, especially the faces of others, to make sense of our environment. If you have been using phone exclusively, here are some considerations for an occasional video session: (a) Simple Practice, the HIPAA secure system I use, offers a free phone app that works quite well as long as you have sufficient bandwidth (whether via WiFi or cellular data); (b) a white noise machine (or device running a white noise app) placed just outside the room in which you will have a session can do wonders to enhance privacy; (c) if you prefer not to be on camera, or if bandwidth is an issue, we can connect using video, but turn our cameras off most of the time; having the option to turn the camera on, even if just for a few moments during or at the end of a session, can be helpful.

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