Telehealth in a Pandemic: How One Therapist Moved Her Practice Online

Young woman participates in a virtual therapy session.

As the COVID-19 pandemic continues, and stay-at-home orders extend yet another week, there has been much focus on mental health. Social distancing may be necessary, but it also directly counters recommendations for treating many mental health challenges. In this time, more and more Americans are turning to telehealth options.

Strong, reliable connectivity across the country has helped make “virtual” therapy sessions a reality. As the internet can support an influx in Zoom calls and massive streaming growth, it also gives patients a way to care for their own mental wellbeing. However, considering the intensely personal nature of therapy, it took both technology and innovating thinking for many providers to move their practices online.

We spoke with Jennifer M. Benben, LMFT, to learn more about how she went digital to support her patients after she had to close her private therapy practice in Guilford, Connecticut – and overcame one of the biggest challenges in her 11 years of practice.

Navigating the Transition to Digital

The first week was a little rocky as Benben helped her clients adjust to the new normal. Clients, overwhelmed with new schedules and responsibilities, canceled appointments. However, that didn’t discourage Benben.

“I kept offering sessions because I wanted to offer consistency for my clients during this difficult time.” She says.

In the search for the best communication method to replace face-to-face sessions, Benben cycled through a number of different options, including phone calls and FaceTime. Eventually she settled on doxy.me: an online telemedicine solution allowing practitioners to open a virtual office complete with video, chat, a waiting room and check-in features. Most importantly, due to its security and encryption protocols, the site is compliant with the patient-protection requirements of the Health Insurance Portability and Accountability Act (HIPAA).

Overcoming Challenges

While helping clients adapt to the new system, Benben also had her own challenges to overcome. She found herself negotiating for office space in a home now shared all day long with her spouse and two children, with the additional task of having to remove photographs and other personal items to keep her home life private during video sessions. For clients, too, space has been an issue. “I have some clients that are sitting in their cars to do sessions now, or driving somewhere quiet to be alone,” she notes.

She’s also had to be conscious of establishing firm working hours. “It sometimes feels like I’m on-call because people know I’m home all the time,” Benben says. “So I’ve had to be good about setting boundaries, while understanding that my clients are dealing with difficult situations. While on the video call with them, I am scheduling their next appointment and then sending reminders prior to the next appointment.”

One critical component to making it all work is Benben’s broadband connection; fortunately, this is an area that has been relatively pain-free. “Thankfully, I haven’t had a real issue with the internet,” she says. “I also have my husband working from home and both of our kids working online on screens. Occasionally I’ve had a call get dropped, but mostly all four of us been able to get online and stream at the same time, daily.”

Finding Surprising Rewards

After the speedbumps of the first weeks were ironed out, the telehealth transition began to reveal a series of surprising rewards. Benben has noted greater openness from certain clients, for example, allowing them to share information they might not have before. “Some people feel more comfortable because they’re in their own environment and more relaxed,” she says. “They can hop on a call with me in their PJs and sweats.” A feature, she notes, that teenagers have particularly appreciated.

This openness has extended to other facets of the therapeutic relationship. The ability to peek into her clients’ real worlds, including home styles and family dynamics, has helped her glean additional insights. Clients have even shared talents such as art and music. “It’s very exciting to have them be able to share their self-expression,” she notes.

In addition to client-related benefits, the online format has also provided an unexpected form of insight into her own work. “Seeing my own face in the corner of the screen has given me feedback on my own cues that I wasn’t always aware of,” Benben says. “It’s a good reminder about what I’m bringing to the session. For example, whether I look tired or not.”

Moving to a Hybrid Method

What will life look like, post-coronavirus? For Benben, who had considered telehealth in the past but had not pursued it because of worries about quality of care, perhaps one of the most unexpected outcomes is that she now anticipates offering it as an ongoing service. “For my clients who prefer telehealth, I will keep online sessions going for them,” she says. And for healthcare or frontline workers and their families, online sessions will remain obligatory in order to keep Benben and her other clients safe. The hybrid method will allow Benben to continue to meet her clients’ needs in the way that suits them the best – something that would have been impossible without telehealth-enabling technology and strong broadband infrastructure.

Like Benben, millions of Americans are now working from home for the first time, sharing space and Wi-Fi with family members and roommates. For tips on how to improve your work-from-home experience, check out our related article