If you’ve considered moving to online therapy (or you’re already offering it), you might wonder how to adapt tools and exercises to the online setting.
Online therapy has become a widespread phenomenon, offering many advantages to both the client and the mental health professional – as you likely know if you’ve come across this blog post!
Working online with clients allows you much more flexibility in where, when, how, and with whom you work and frees you from being tied to an office.
But if you’re new to online therapy – whether you’re looking to transition from an in-person setting or just qualified and starting out on your career – you might be a little unsure about how to adapt tools and exercises from a face-to-face setting for use in online sessions.
Adapting Offline Tools to Online Therapy – and Finding New Tools!
While online therapy has many advantages, it can also have some challenges. For example, you may find that some of the tools and exercises you use in person don’t work so well online. But with a little creativity, mental health professionals can adapt these exercises and tweak them to suit the online setting.
You may even discover new tools that are better suited to online therapy that could provide you with more options for how you work with your clients.
We had a business meetup in the LIT Community on this topic, and it was so interesting to share ideas and see what works for our colleagues in their online sessions with clients. So we put together this blog post to share some of these tips and suggestions with you!
If you’ve been wondering how to transition from in-person therapy or simply want some new ideas to freshen up your online sessions, read on!
The Differences Between In-Person and Online Therapy
You might think that online therapy differs a lot from meeting clients face-to-face. And while there are some notable differences which we’ll explore below, many of our members have found very little difficulty in adapting to work with clients online.
One thing some of our LIT Community members noted was that being face-to-face with clients can provoke a more emotional response from the mental health professional, especially when discussing intense situations.
In contrast, it can be easier to remain more detached online when you have a physical distance between you and the client. And in turn, that allows you to keep your emotions under control while responding in a compassionate manner to your clients.
When you’re working online with clients, it can take longer to explain certain exercises and convey what you’d like them to do in the session. At the same time, it’s easy to fall into a pattern of relying on the same exercises all the time as you know that they work well online. And that can prevent you from experimenting with new tools or exercises that could benefit your client.
How to Adapt Tools and Exercises to Online Therapy: Tips & Ideas
Here are some suggestions, ideas, and exercises that work well in the online setting. If you’ve been wondering how to adapt tools and exercises to online therapy, why not try starting with one of these ideas?
You can also find inspiration for adapting your own tools and exercises for your online therapy sessions.
One thing to keep in mind is that you should also consider how you prefer to work with clients and what kind of therapy you use with them.
There are many factors to consider beyond just the virtual vs. in-person setting, so not all of these ideas will work for everyone. But they will give you some ideas and tips to get you on the right track – and you can adapt them to your preferred method of working with your clients.
How to Be More Present in a Virtual Therapy Session: Using Physical Items
Using physical items is a great way for both your client and yourself to feel more present and engaged in a virtual therapy session. Not only can props or items help you to explain theories or illustrate a point, but they can also make your client feel more involved and focused.
For example, you could use a mini garbage can to represent your client’s worries. You can ask your client to imagine putting all their stress and worries into the bin and then closing the lid, symbolically letting them go.
Another idea is to have a plastic cup with holes punched in it to represent self-esteem issues. Each hole represents one of the ways the client’s self-esteem is being drained. Then, you could explore how to address these issues, who is draining their self-esteem, and how they could take action to address the situation or bolster their self-esteem so it doesn’t all get sapped away. A simple plastic cup is another great prop to use when you’re talking about self-care and not being able to pour from an empty cup.
Using Small Figures & Manipulatives
You could also use some small figures that you can manipulate to represent certain situations or feelings. It might be helpful to display them on a small shelf or raised area in front of your laptop, so they are easy for your client to see.
Or, if possible, you could ask your client to bring along some little manipulatives to move them around and interact with them during the session. This can be a powerful way to connect with and understand your client, and it works particularly well for people who express themselves better through movement and action rather than words.
How to Adapt Tools and Exercises to Online Therapy: Writing & Drawing
You could also integrate drawing or writing exercises into your online therapy sessions.
For example, when working with a client with anxiety or low self-esteem, you can create a powerful moment by asking them to write down any persistent negative thoughts or worries on a piece of paper. Then, they can scrunch, rip, or tear up the paper to release these thoughts and visualise moving on from them.
Another idea that some therapists use really effectively is to draw quick doodles to represent a situation or show emotions or a reaction. You could keep a flip chart handy and use it throughout the session when it makes sense, or suggest your client bring a notebook to draw how they feel.
These are just a few ideas for how you could bring physical items into your virtual therapy sessions. You can take these suggestions or use them for inspiration to create your own physical props that you can integrate into your online therapy.
Moving Around and Using the Physical Space in an Online Therapy Session
Another advantage of online therapy is that the client is likely to be at home, in a private space where they hopefully feel safe and comfortable.
So, you could think about incorporating exercises that make use of the physical space around them.
That could be as simple as asking them to sit or lie down with their eyes closed while you talk them through a guided meditation. Or you could put on some music for a quick movement break or invite them to physically shake away some emotions and release stress from their bodies.
LIT co-founder Sonia Jaeger also likes to use the Hands and Thoughts exercise with her clients, a tool from Acceptance and Commitment Therapy. This simple exercise involves moving the hands and takes less than five minutes, allowing clients to create distance from their thoughts and emotions instead of feeling guilty about them.
One of our LIT Community members has experimented with asking clients to lie down and close their eyes, similar to a traditional therapy setup. Sometimes, that has helped her clients to feel more relaxed and focused on the session, as they aren’t worried about what they look like on the screen or watching the therapist’s reaction. You could think about where you want your client to sit and whether you want them to look at the screen or not.
Interacting with Technology During an Online Therapy Session
And that brings us to another important point – what role should technology play in online therapy?
From the basics of where you position your laptop so your client feels like you are looking at them – even if they can’t make real eye contact – to more advanced ideas such as using new digital tools and technology.
Here are some tips on getting the most out of technology during your online sessions.
Interacting with the Screen
Your client will pick up on where you’re looking during a video call, so we recommend placing your laptop or webcam somewhere you can look directly into the camera.
On your screen, position the client near your camera so you can make eye contact and don’t have to keep looking in a different direction when they’re talking to you. That will make it more personal and show your client that you’re listening to them. If you have two screens, explain that to your client so they know why you’re looking away from them.
At the same time, it can be helpful to encourage your client to hide their own video, so they can only see you. Seeing themself on the screen can be distracting, especially when discussing emotional topics or difficult things. You don’t want your client to feel more self-conscious or worry about how they look, so hiding their video is a simple solution.
Video Call Etiquette
You could also let your client know that they don’t need to look at the screen the whole time during the session. If you were meeting face to face, you wouldn’t maintain eye contact for the entire duration.
But on a video call, it can be tricky to know the correct etiquette – so make it clear to your clients. They are welcome to look around, focus elsewhere, or do anything else that might help them to relax during the session. Or simply have them turn the chair slightly so they aren’t directly facing the screen but at more of a natural angle, which can feel less intense.
Related to this, you should also think about what you are comfortable with during a session. Are you happy if a client is sitting in bed, or would you prefer them to be upright at a table or desk? Make sure to communicate these things early on and discuss what is suitable and what isn’t during a virtual therapy session. You could also include these details in your onboarding documents.
Using Digital Tools During the Virtual Therapy Session
There are lots of helpful digital tools that you could work into your therapy sessions. For example, that could be as simple as watching a relevant YouTube video together. You could find something that helps illustrate an idea you’ve been working on with a client. It could be a fresh and interesting way to showcase a technique or convey a message to your client.
We’ve already mentioned drawing on a physical flip chart or notebook, but you could make it more interactive by using the whiteboard feature in Zoom. Some digital drawing tools may require your client to have a tablet and digital stylus, but a lot can be done just with a computer mouse. So, explore these different options and consider how you could incorporate them into your online therapy. It could allow you to bring in new tools and exercises to explore with your clients.
Or you could ask your client to create a mood board using a free digital tool like Canva. Using visuals can help you to better understand your client than simply relying on words.
Multiple Cameras, VR, & the Future of Technology & Online Therapy
There is the potential to go even further by using technology to support you in your online therapy sessions, especially in specific situations.
For example, if your client is moving around a lot during a session, it could be helpful if they have a separate camera set up so you can see them clearly and notice how they’re moving. Or for exposure and response therapy with clients who have OCD, a second camera could allow you to see what they’re seeing and better support them throughout the session.
New tools and technologies are being developed all the time, and they may offer new techniques for online therapy. Consider, for example, how VR tools could be incorporated into therapy as they become more mainstream. You might not need to use any of these advanced tools at all, but it’s good to be open to any new developments and consider whether they could be useful tools for your online therapy practice.
However, don’t feel like you have to use new digital tools or come up with different exercises every time you meet with a client. Importantly, they shouldn’t be a distraction from the work you’re doing with your clients.
But by being open to fresh ideas, you could discover new methods that integrate well into your online therapy sessions.
How To Adapt Tools and Exercises to Online Therapy – A Conclusion
So there you have lots of ideas for how to adapt tools and exercises to online therapy. In many cases, a few small tweaks or adaptations will allow you to use your favourite face-to-face exercises in an online session. But you could also experiment with new techniques that are particularly well suited to the online setting, too.
You can see which of these ideas appeal to you and suit your therapy style – whether that’s through using physical items, making use of space and movement, or incorporating new technologies into your virtual therapy session.
We’d love to know what other ideas or techniques you’ve used in your online therapy practice. What has worked well (or not so well) for you? Share with us in the comments below!
And if you enjoy discussing all things related to online therapy, you’ll love the LIT Community. It’s our thriving community of mental health professionals around the world. We come together for business meetups, peer supervision sessions, virtual coworking, hot seat coaching, goal-setting sessions, and more. When you join, you get access to our program of events, 24/7 discussion board, a network of international colleagues, tons of resources for growing your business, and all our event replays too.
So, if you’re looking for support, community, accountability and inspiration on your LIT journey, join us inside the community! Our doors are closed now, but sign up for our waitlist here to be the first to hear when we’ll next open them.
