Don't Let Covid Steal Your Clinical Creativity
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Artist credit: John Cameron
Welp, here we are my friends and colleagues, several months into this unprecedented time. And, for the record, is anyone besides moi tired of the word “unprecedented?” I’m sensing a lot of you are nodding in agreement, so how about we substitute the word “fluster cluck” instead?
We therapists are on the virtual front lines of this world crisis, hour upon hour, day after day, week after week, supporting our clients’ mental health and wellbeing. We show up each day doing our best not to let our own cheese fall off our proverbial crackers. It’s not easy, that’s for damn sure!
And, for those of you who are juggling the rigors of parenting, or caring for an elderly family member, or nursing a loved one back to health (been there), or sheltering in solo, all the while keeping your practice afloat, I send you light, prayers, and BIG respect my fellow healer.
A theme that has been surfacing recently in my business coaching calls are colleague clients sharing that they are losing their creative mojo and feeling Zoom fatigue, or what I not so lovingly refer to as Zoom Gloom. I get it friends, believe me, I get it. Though I am a Certified Telehealth Therapist who has been supporting my therapy clients via Telehealth for 12 years, and exclusively providing Telehealth sessions for the last 4 years, I am also feeling weary and a bit worn around the edges.
Eventually this chapter of our lives will be in our rearview mirrors, but until then, it looks like providing Telehealth sessions is going to be the best standard of care and safety we can extend to our clients. While this may feel sobering for many of us, I refuse to allow ‘rona to steal my therapeutic creativity and joy.
This month I decided to dig deep and shake off the “blahs” get my rear in gear and move back into my “a-ha’s!” I was determined to find my clinical core, and discover ways of infusing creativity and enjoyment in my online sessions once again. I thought I’d take some time to outline a few tips that you may find helpful and inspiring as well.
Walk Talk Therapy
I’ve been providing W/T therapy for clients for the last 15 years, long before it was part of our accepted clinical work. In fact, when I first started W/T I received quite a bit of push back from our community, some finger wagging, and some tsk tsk-ing from the peanut gallery. And…I kept walking and talking with clients.
These days meeting clients for walk talk therapy is difficult given the safety recommendations of physically distancing and wearing masks while in public (sidebar: I see you doing your part to flatten this virus, thank you!). One way my W/T clients and I have been getting around this is to meet on our respective treadmills.
Say what Mari??
You heard me.
Now, I realize not everyone has a treadmill, and frankly, mine is an ancient dinosaur, but if you happen to have a treadmill, and your client does as well, or even a stationary bike, it has been a lot of fun for my clients to do their W/T sessions with us on our own treadmills in the comfort of our homes. Yes, it can be done safely and ethically via Telehealth.
A couple of important reminders:
Be sure that you are dressed appropriately, just as you would show up for an in person walk talk session. Ratty shorts, revealing tank tops, or messy buns are fine for solo workouts, but this is your client’s time so let’s show up as professionals.
Though walk talk certainly has health benefits for the therapist, this is not your work out time, this is not a spin class, it is the client’s session time. Speed walking at a breathless pace on your treadmill is not the goal. The idea is to support clients clinically while incorporating movement, and that may mean that you walk slowly. Remember: The client always sets the pace.
Have a walk talk therapy consent form that your client signs that outlines safety, consent, your scope, medical issues and so forth. If you need a form and prefer not to reinvent the wheel, you can download my form here.
Movement Therapy
If you work somatically with clients like I do, moving slowly and gently to music as a centering and grounding practice during Telehealth sessions is something my clients request and enjoy. Simple arm circles, swaying side-to-side, reaching toward the ceiling, and even doing jazz hands (with ensuing laughter) is a wonderful way of infusing movement, fun, and releasing anxiety and trauma from the body. I have a client who enjoys ending each session with a chair dance to a song selected from the client’s playlist.
For clients dealing with acute complex trauma, this can be quite grounding. I’ve found that clients sometimes prefer to be barefoot and or on a yoga mat, in that case, I am happy to slip my shoes off and sit on my yoga mat during session as a way of attuning to their process.
Here are a couple of music selections that my clients have enjoyed:
Video One: Crystal Singing Bowls
Video Two: Peace and Vitality
Mindfulness Based Sessions
Like many of you, I have several post graduate certifications on top of my LMFT license. Among them is my MBATT certification or Certified Mindfulness Based Addiction and Trauma Therapist. I am also a senior faculty member with The Mindfulness Academy for Addiction and Trauma Training. I have been weaving mindfulness work into my clinical sessions for over a decade with beautiful results.
There seems to be a dusty old myth that has been passed around that mindfulness worked cannot be done via Telehealth. I am here to tell you that nothing is further from the truth. Yes, there is psycho education involved in preparing the client, and it is important to have training, however, mindfulness work can be facilitated beautifully via Telehealth sessions.
A few activities that my Telehealth clients love are:
•Guided Imagery
•Breath Exercises
•Body Scan
•Peaceful Centering Work
• Addiction Trigger Work
• Betrayal Trauma Work
If you are interested in obtaining your MBATT Certification, the information is provided on The Mindfulness Academy’s website here. Because of Covid-19 TMAATT has moved their training online which is rather brilliant, and hey, let’s face it, online training saves money!
EMDR Therapy
Like many of you who are trained in EMDR, I’ve been hearing for years that EMDR could not be facilitated via Telehealth. Enter the Corona Virus and !BAM! we’ve certainly seen a swift change of heart within EMDRIA and our EMDR communities since COVID arrived. Perhaps this is one small silver lining from this challenging time.
EMDR is a beautiful modality to use with Telehealth clients. Resourcing can be done as well as reprocessing. I prefer butterfly tap myself, but I also have clients who prefer eye movement BLS. For those clients who prefer visual BLS, a good tip is to use a yellow highlighter or a pen with something bright on the end so that they can track the object more easily.
A website that provides EMDR bilateral stimulation resources is called “remoteEMDR”; as shared on their website, the EMDR trained therapist is able to:
Perform BLS synchronously on both your and your client's computer.
Monitor and have full control over the BLS on your client's computer.
Vary the visual and auditory aspects of the BLS - its color, speed, type and more.
There are also resources on Youtube as well. The days of poo-pooing online EMDR sessions are officially over. With proper training this can be executed beautifully. Let’s toss up some virtual confetti!
Note: I am not affiliated with remoteEMDR.
Phone Sessions
Finally, if you are noticing eye strain or over all brain drain from Zoom calls or other visual platforms, I feel you. You may want to consider switching it up a bit and doing a phone session now and then with your clients. Many of my clients prefer this option, and it gives the therapist a chance to support clients without staring at a screen for hours on end.
You might alternate weeks, so one week Zoom and one week phone, etc. Discuss this option with your clients and have them give it a try. While phone sessions may not be ideal for specific clients depending upon their presenting issues or the way they process material, you may find that some of your clients greatly prefer phone over Zoom.
Moving Forward
Colleagues, I hope this information and my creative suggestions have added some wind under your weary clinical wings. As we forge ahead through the upcoming months, please know that I am standing in solid support. For each of you doing your best, wearing your masks, sheltering in, honoring physical distancing and safety considerations, I salute you and I stand with you 100%.
We will get through this, let’s encourage and support one another my fellow healers. If you have tips or suggestions from your own online work, you are welcome to post below.
If you need support with your therapy practice, you can learn what other colleagues have to say about my coaching support here. If you are in need of group forms or clinical therapy forms to support your practice, those are located here.
Finally, if you’d like to join us for the next Mindfulness Based Addiction and Trauma Therapist Certification training, you can learn more and sign up for the interest list here.
Wishing you and those you love safety, peace and health in the months ahead…
Kindly and in support,
Mari A. Lee, LMFT, CSAT-S, CPTT-S, MBATT-S, EMDR II, Gottman II