I live in Seattle, ground zero for the Coronavirus in the United States. Today, I had my first request from a client who wanted to have online therapy to avoid the virus. I said, of course and will do her session on Secure Video, a HIPPA-compliant platform for video meetings. I had no hesitation because I use this platform nearly every working day to do group and individual consultation throughout the U.S., Canada, and some European countries. I’ve also used it with clients, mostly people who left Seattle in the midst of psychotherapy.

My experience of “tele-healthcare” is that it’s a lot like regular therapy sessions. We meet, we greet, the clients speak their minds, and we get down to the task at hand. If it’s trauma therapy, we usually do EMDR and/or ego state therapy. EMDR is almost exactly what it’s like in person. We set up the target, with cognitions, affect, and sensations, and apply bilateral.  Eye movements work, if I wave my hand where the camera on the top of my laptop screen can see it. The only difference is that when my hand goes left, their eyes go right. As far as I can tell, it works exactly as it does if we were in person.  The ego state work is similar, “Go inside and tell me the age that goes with that feeling/behavior/idea of the world.” The client closes their eyes for a moment, and says, “That’s my 6-year-old.” “Bring that kid out here and let her know that it’s 2020 and she’s safe now. Tell her X, Y, and Z.”  It’s the same work.

The clients and both say that it’s not the same, and we’d prefer to be in the same room.  We also both say that we still feel connected, and the work works, and it’s better than not doing it. Since, as Maureen Kitchur and then the local CIMBS trainers taught me to sit close to people to enhance the attachment experience, I miss it. However, if I sit close to my computer, and so does my client, we fill the screens and connect.

I’ve been sick for the last two weeks, not CV, but a really bad cold that’s also going around. (So say two doctors.) I’ve done several online sessions, since I didn’t want to infect my clients, but still had the brains to work. Every client said they missed the office, and close proximity, and were surprised at how connected they felt and the work they did, despite the distance.


Some insurance companies don’t pay for “telehealth”. You or your clients need to figure out how to deal with that.

You and your clients both need to have computers with sound and video. All laptops have them. Some PCs don’t, and need separate attached mics and cameras to work.

If your or their internet is bad, the session will be full of freezes and garbled words. Because I do so many consult meetings online, I’ve got the best and strongest internet that I could buy. (Also really good for streaming Netflix!)

I know some local psychotherapists who have moved all their sessions online until the pandemic calms down. They are all older and have underlying medical issues that would be horribly exacerbated by CV.

Good luck to you all, and stay well!