Every mental health provider had to reassess how they approached their therapy activities in 2020. Telehealth transitioned from being an option to a necessity as the world shut down and providers needed a way to keep seeing their clients and patients. For many mental health providers, telehealth has become the standard way to deliver services now and moving forward. While many therapeutic techniques, exercises, and activities are applied the same way, some have to be adjusted to the virtual world.
The Big Differences Between Telehealth and In-Person Therapy
Many of the characteristics of telehealth and in-person therapy are shared. For example, it is still a client talking to their mental health provider in the same way they would in an in-office visit. The major differences between the two that need to be considered include:
The same level of privacy may not exist for your clients in their homes the same way it does in your office. If they have thin walls or a lack of personal space, they might not get the same level of privacy they are used to or might need with their mental health services.
While verbal sharing is not interrupted in the virtual space, therapy activities that involve in-person interactions like drawing, crafting, writing, and more are more difficult to accomplish. You are not able to give your client the supplies they need to complete these kinds of tasks.
A positive difference between therapy activities completed via telehealth versus in-person generally offers some kinds of comfort to the client. Rather than be in an office that is unfamiliar to them, they get to be in the comfort of their own space. This might not be true for all clients as not everyone finds comfort in their living situation.
Therapy Activities for Telehealth
Therapists should do their best to only utilize therapy activities in telehealth that complement the virtual environment and the reality of the client’s living situation. Some of the best examples of therapy activities and exercises that are great choices for the telehealth setting include:
For clients that deal with anxiety, PTSD, dissociation, flashback, and other similar experiences might benefit from grounding exercises. Grounding techniques are easy to apply in a virtual setting for clients that might find themselves in an episode or need help navigating the ones they might have in the future.
Grounding therapy techniques utilize a client’s senses (sound, touch, smell, taste, and sight) to connect them to the present moment rather than to where their episode is sending them.
An example of this might be for them to sing a song, touch something soft or textured, eat something really cold or sour, or looking at the cars passing by their window.
A gratitude journal is a writing exercise specifically designed to connect clients to the things they are “grateful” for. This therapy activity is good for clients dealing with anxiety, depression, hopelessness, or are struggling to connect to and identify the good in their life.
Having the client write down in a journal what they are thankful for is a great way to connect them to joy during a time where that might be hard for them.
Design the Perfect Day:
For clients who battle overwhelming thoughts or can’t seem to slow down their minds enough to take a deep breath, the “perfect day” exercise might be the right fit. This therapy activity is great for both in-person and virtual settings.
The idea of designing the “perfect day” is to intentionally focus a client’s mind on one specific thing rather than a million different things at once. Have them explain what their perfect day would look like in extreme detail. The more detail they use from their imagination, the more likely their mind is to focus on just that one thing.
The goal of positive inception is to identify and explore the positive characteristics/attributes of a situation. It hinges on the idea that by starting any new situation with a positive outlook or focusing on the strengths of a situation, you set it up for a better chance at success. When you start anything new with an overwhelming amount of negativity, then it will be harder for it to turn out well. This sounds a lot like choosing optimism, but it is much more intentional.
A great example of this is to have the client introduce themselves in their best light. Many therapeutic relationships are initiated by the client listing off all the things that feel are wrong with them. Instead, providers should have the client tell a story about themselves where they were proud of themselves or brings out good feelings about themselves.
The idea is that this will set the tone for the future of the therapeutic relationship, encouraging positive rapport, positive narratives, and a better concept of themselves as they explore potentially difficult topics.
Therapy activities come in all shapes and sizes. Some work better for in-person, some work better for telehealth visits, and some work great for both. As therapists continue to utilize telehealth to deliver care it is always important to consider what is best for that unique patient, their living situation, and their goals for therapy.
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