Communication Barriers Therapists Face in a Remote World

Teletherapy has provided ample opportunities for essential mental health support as therapy continues to expand—however, the move to virtual created challenges for therapists with communication barriers. We must tackle these roadblocks to maintain the trust that makes therapy effective. Here are some common barriers and suggestions for how you can tackle them.

 Difficulty in Forming Initial Trust

Building trust in therapy usually begins by creating a welcoming setting, having eye contact, and setting the tone of comfort. These areas are more challenging to facilitate in a virtual setting. In addition, when clients book a Georgia therapist, hearing a therapist talk about their work and watching some of their subtle in-person reassurance and interpersonal warmth may develop trust around salient edges. 

New clients often feel uncertain about sharing with someone they have only seen on a screen. Therapeutic trust usually occurs or is best facilitated face-to-face, where the opportunity to follow through is much greater than via only verbal communication.

One solution to this reality is to create a transparent and personable online profile that can enhance client trust. Having a listing of credentials and therapeutic modalities, as well as providing tiny video clips of yourself, goes some distance in building a responsive trust. Teletherapy platforms that maintain a quantified statistical listing of qualified professionals and provide personalized, reliable background data about the therapist at the onset can work to enhance the client’s comfort and transparency from the outset.

Loss of Nonverbal Signals

Therapists can get an expansive view of nonverbal signals (posture, gestures, microexpressions) during in-person clinical sessions, and comprehensively understand a client’s emotional state. Video calls restrict the clinician’s capacity to utilize all of their senses, reducing the information observed to only the face and voice. Poor lighting or camera position can obscure signals even further. Without whole body language, clinicians may miss signals indicating discomfort or other shifts in emotional state. 

To mitigate this loss of dimensionality, clinicians should narrate their observations, ask clients to characterize their physical sensations, and employ open-ended questions to nudge the discussion in the required directions. Improvements to the quality of cameras and lighting to establish a connection in remote therapy can go a long way to enhancing the quality of that connection, like having clear videos with good video placement at eye level.

Technology Disruption

Technology errors such as audio issues, lag, or disconnections can interrupt the therapy flow. These errors bring frustration and undermine the therapeutic hour in that they interrupt what may come out to be a vulnerable or emotionally laden moment. Clients may not only feel disappointed by the therapy session but also feel rejected or disconnected, even if this was not the therapist’s intent, after being interrupted or leaving the session without prior notice. 

Therapists and clients should have a plan established during the first session to determine what actions can be taken when there is a disconnection and if they would switch to a phone as a backup or alternative contact option. By conducting regularly scheduled tech checks, using data to ensure a stable and safe web connection, and having alternative options for contacting the therapist, therapy is preserved. It technically assists in establishing professionalism and preparedness.

Decreased Privacy on the Client’s Side

Clients in therapy from home often do not have a truly private space. Whether it’s children in the house, a roommate nearby, or the fact that there is limited physical space, the client often feels uncertain as to what they can share. 

They may feel they are not able to express themselves fully, may guard whatever it is they are sharing out of privacy concerns, or have to cancel sessions. We need to normalize these challenges for the client, be creative, and problem-solve with the client. 

We suggest scheduling sessions at different times, using earbuds (increased privacy), and sitting in a car with the engine off, for example. We suggest that clients engage in typed or written activities when sharing verbally if it feels unsafe. Acknowledging the client’s environment and boundaries helps to maintain the therapeutic alliance under less-than-ideal conditions.

Misunderstanding in Text

Many therapists and clients have additional written conversations, like the sessions, in email communication, text check-ins, and chat therapy apps. Text can be very efficient; it is also the most misunderstood type of communication because tone, body language, and immediate follow-up for clarification are not present. The intended supportive message may even sound cold, or the intended boundaries may sound too blunt. 

To manage and reduce misunderstanding, therapists always want to use structured language that portrays intention and avoids all ambiguous phrases. We all love to use emojis, and when attempting to convey warmth, consider tone indicators or emojis. 

Be sure to seek clarification and feedback on responses to written communication from clients. Setting standard communication norms is essential to avoid misunderstanding and to ensure clients’ emotional safety in balance.

Endnote

Moving to remote therapy is more than just having the technology skills. Therapy is complex; therapists must be purposeful, flexible, and imaginative communicators.

If therapists can think about how to circumvent these seven barriers, trust, empathy, and relational connection can be maintained in an ever-growing digitally dominated space. Teletherapy will likely exist and develop, with thoughtful modifications and platforms to support use.