what works for you?

During the lockdowns, Zoom counselling became the new normal. And after the lockdowns, it still remains hugely popular, not least because flexible work patterns allow people working from home to carve out an hour in the working day for a weekly therapy session. If you are planning to do online counselling, here are a few points to bear in mind:

1 Bandwidth
Your internet connection needs to be fast and reliable enough to allow an uninterrupted two-way video conversation for about an hour. A 'hybrid' solution is to use a standard phone connection for the conversation, and leave the video running. So if it freezes, the conversation can simply continue uninterrupted.

2 Which provider

I generally work with Zoom or Teams.

3 Sound and vision

If you plan to make your video calls using a smartphone, consider using earbuds/microphone to leave your hands free, or just prop it up in front of you. Part of the appeal of a video call is that we can communicate with more than just our words, bringing in facial expressions, gestures and all the nuances of body language.

4 Eye contact

During an online video call using a laptop or desktop computer, looking directly at someone on the screen means we are looking below the level of the camera (if it is at the top of the screen). So when we think we look someone in the eye what they see is our gaze cast down towards the keyboard. Does this matter? Perhaps. Looking someone in the eye communicates something rather different from casting our eyes down – a ‘downcast’ look. To get around this, try to shift the video image of the person you are talking with towards the top of the screen.

5 The room set-up

You need a private space where you can be sure you won’t be overheard or interrupted, with no distractions. This is crucial. Ideally, use an identical setting every week, which means you won’t need to think any more about the practical stuff, and can simply focus on your counselling session. If you can't find a suitable room, then a phone session may give you more options.

6 Lighting

Bear in mind that during daytime, if you have a window behind you as you face the camera, your face will be in shadow. Similarly, your room lighting may seem to be OK, but your webcam may see it differently. It’s best to test this out first.

7 Framing

Think about how you want to be ‘framed’ by the camera. The most typical format for a Zoom session is ‘head and shoulders’, though in counselling, many people find it more comfortable to sit a little further back from the camera.

8 Alerts, messages, calls

Block out any alerts from popping up on screen during your session – a major distraction.

9 Before and after
It may be a good idea to create a bit of time immediately before your session as a kind of ‘virtual commute’ – as if you were travelling to the appointment, making a space in between the counselling and the rest of the day. Similarly, when the session is over, it could be worthwhile just taking a quiet moment before resuming your day.

If face-to-face counselling is not an option, many people turn to Zoom or Teams. But let’s not underestimate the power of phone call.

When face-to-face counselling is not possible, then most people think of online counselling as the obvious second-best. The idea of conducting counselling on the phone becomes a kind of runner-up, a lowly third-placed option of last resort. But is this really fair?

Video calls are far from perfect. Amazingly, the bandwidth problem still makes itself felt from time to time on most video platforms, causing a certain amount of havoc to any call, let alone a counselling discussion.

By contrast, the phone conversation provides a steady, uninterrupted and focussed means of communication, robust enough not to be prone to outages and screen freeze, and free from the distractions of the ‘almost eye contact’ because we are never looking directly into a camera. But how do we manage, in counselling, without any visuals at all?

An image as a starting point

I think that having a mental picture of who we are talking to is of real benefit, and this goes for both client and therapist. Perhaps the best form of phone counselling is one where the initial contacts are set up via a video call. (Some therapists also say that the best kind of video calls are the ones where the initial contacts are from a face-to-face meeting). So an initial video call can give both parties a kind of first impression: time, if you like, to form those initial gut-reactions about the other person. It’s not scientific of course, and they will no doubt evolve over time, but it is a vital part of what will become the on-going relationship.

Continuing with video calls is always an option. But moving away from video and on to the phone can also bring benefits, provided we are mindful about what we might be missing from the lack of visuals, and try instead to listen a little more attentively. After all, someone living with a visual impairment remains just as capable as a fully-sighted person of ‘reading’ other people in conversation, or being attuned to someone else’s emotional state.

Visual clues are important, but they are only part of the myriad ways we communicate. As we get to know someone, we notice how the quality of their voice will change when charged with stress or emotion, just as we notice variations in the speed and patterns of speech. And then there are the moments with no speech at all: silences during a phone call may seem awkward in a conversation with a family relative, but in a therapeutic conversation can provide space to think and feel, or simply provide the time to let a stray thought bubble up to the surface.

Helplines like Samaritans have developed to a fine art the ability to get people to talk and think about their emotional states during a phone call, and the results of the Samaritans’ approach speaks for itself. Callers, many in extreme emotional distress, contact someone they have never spoken to before (and probably never will again) and in the space of a half hour, or an hour, or perhaps longer, share their darkest and most private thoughts and feelings with this unseen stranger on the other end of the line.

So let’s not underestimate what can be exchanged in a phone call, and, more specifically, the potential power of telephone counselling. For many people, it can provide a vital 50-minutes of sanctuary in a difficult week.

MORE ABOUT THE THERAPY >

Combining counselling with an invigorating walk is becoming increasingly popular. It is very different from traditional counselling in a therapy room, but can be extremely effective.

Outdoor counselling is exactly that: a set of counselling sessions that take place outside in the open air, and most often during the course of a good walk. It is proving popular - not just among those who live on the doorstep of beautiful rural countryside, but also for city dwellers, making the most of local parks and riverside walks. In my own neighbourhood, we are lucky to have three parks on our doorstep: Clapham Common, Wandsworth Common, and Battersea Park - all of which are venues for outdoor sessions.

When we think about outdoor counselling, it prompts an immediate comparison with ‘indoor counselling’. Which is better? Well, it’s almost impossible to say if one is better or worse. But they are each very different from each other.

While some people find the therapy room a bit constricting at first sight - a small room usually, with just the two chairs and very little else to look at - it is built like this for a reason. It helps to keep the focus is on the communications (verbal and otherwise) between counsellor and client, while the closed room provides a safe and private space for a confidential discussion. It is an unchanging background that becomes a neutral backdrop - one that is quickly ignored, but which serves its purpose, containing what goes on within its four walls.

Outdoor counselling is distinctly different, and is perhaps a more laid-back format for talking therapy, which may help explain its popularity, especially among those who find the close focus of the therapy room daunting or perhaps difficult to sustain. Walking side-by-side, shoulder-to-shoulder, the privacy of the conversation is maintained - with the occasional pause, perhaps, for passers-by. And as the walk progresses, the surroundings change: so what we see around us may feed into the conversation, sometimes triggering unexpected thoughts, feelings, and memories. The lack of the ‘neutral backdrop’ - so essential to the indoor version of counselling - can lead instead to unlooked-for discoveries. Not to mention some healthy, beneficial exercise.

My in-person therapy takes place in purpose-designed therapy rooms in Clapham and Battersea, close to tube, train and bus routes.

Counselling in person is a very different experience to phone, Zoom or outdoor counselling. You will find there is just that little bit of extra focus to in-person counselling, and it can sometimes create a kind of 'high definition' impact: something which might allow you to take a conversation, or a thought or feeling, into a new direction. The longer the counselling goes on, the more the two people get to know each other and learn to ‘read’ each others’ gestures and expressions. That’s not to say that this is not possible with Zoom or outdoor counselling, for example, but with in-person (in a room) the whole effect feels just that little more concentrated.

I work from three locations, all in the same neighbourhood: 76A Battersea Rise and 6 Northcote Road, both in Battersea, SW11; and Lion Yard, in Clapham, SW4.

Some clients start with in-person counselling and move to Zoom later for logistical reasons. Similarly, Zoom clients occasionally shift to in-person or outdoor sessions. So it's flexible.

Are you a morning person? If so, sessions can start as early as 7am. 

“Counselling at 7am. You’re joking. Don’t you just fall asleep?” This is what many people think when they hear about counselling sessions starting at – gulp – seven in the morning. But those who do this will be able to tell you of some immediate benefits.

The most obvious, of course, is that 7am counselling does not take a big chunk out of your afternoon, make you late getting into work, or cause you to have to pack up work early to get to see your therapist on time. Many of us prefer not to share the fact we are in counselling with our work colleagues. And the act of having to leave early, or get in late, can sometimes make us feel that we are somehow letting down other people in a team. (This guilt may be totally misplaced, and counselling can actually help deal with this kind of thinking).

But as well as making minimal impact on your working day, early morning counselling (and it could be online counselling) makes use of a time when you may be at your most alert. Unless you live right next door to the therapy room, it is likely you will have made a journey, perhaps simply a walk, to get to counselling, which will have worked off the early morning grogginess or ‘sleep inertia’. Your mind will be in its normal state of cognitive functioning, but still free of the inevitable tiredness that has yet to accumulate as the day goes on.

Some people find that pre-work counselling provides a small island of calm before the working day begins. Even if the counselling work itself can be intense, it exists in a quiet space where the pace and intensity is set by you. Instead of engaging in a mad rush from the time the alarm goes off – jumping into the shower, grabbing a coffee, running for the bus – taking a counselling session in the morning is a kind of antidote to all that. Yes, you will get up an hour earlier. But think of it as a gift to yourself. 

And the counselling ‘vibe’ can stay with you as you make the journey to work, perhaps mulling over some of the things that came up during your 50-minute session. What may have felt at times like an intolerable commute can even become a testing ground for your own mindfulness, or a backdrop to your musings about a part of your life that might be very far away from the noise and crowds that surround you.

MORE ABOUT THERAPY >