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Gain the tools you need to create a solid foundation of connection and alliance, and be as effective virtually as you are in the session room.
Working virtually with our clients is an amazing opportunity. It allows us to reach outside our physical location and expand our client repertoire. It also creates career flexibility where it previously didn’t exist. It wasn’t long ago that a computer was a single, cold, impersonal object. It’s become such a powerful tool for therapists, to connect with clients and help them heal. As seeing clients virtually becomes common, it’s vital that we prioritize and maintain the therapeutic alliance, understanding how it shifts as we work through a screen.
There are two key aspects to consider. The first is how you appear on screen. The second is how the client experiences you—how they’re able to feel your compassion and humanity beyond the screen.
Presentation matters
How we appear transmits a specific energy.
Not being centered in the screen or being poorly lit can make it hard for the client to feel your presence. Being too low down at the bottom of the screen can make you look like a child to the subconscious of the viewer. Having too much light washing you out can disturb the viewer and instill a lack of confidence or trust.
The key is to make sure your camera is positioned so there’s equal distance all around the frame of your face.
There should be the same amount of space between the top of your head and the top of your screen as there is from the bottom of your face to the bottom of your screen. The same applies for the sides of your face. This helps support a visual reference of balance, stability, and presence.
Additionally, direct daylight filtered by a soft white curtain is best. White paper lamps or ring lights also do an amazing job of allowing you to be seen clearly without harsh effects or appearing too washed out.
The layout of the space behind you is important as well. Test your video before a session, and take a look at what the client can see. The sense of a safe and secure environment is essential, especially when clients have been affected by trauma
A well-organized office or neutral background is best. Scattered supplies or debris can be disturbing or convey a lack of order and organization. The goal is to convey the same envergy visually as you would holistically, in person, in the session room.
Comfort matters—for yourself and your client
Do you have a comfortable chair that support you and you can lean back into? Use one that helps you feel relaxed and focused.
My personal tip: Since our counseling chairs don’t usually match the height of an office desk, sit in your favorite chair and adjust your computer in front of you on an ironing board. They’re easily adjusted so the camera gets into the perfect spot!
Offer direction to your clients as well. Just as we suggest ways to be comfortable in our office space, we can do so virtually. Invite your client to take a moment to make sure their seating is comfortable, and ensure they’re in a private, safe space for their session.
If necessary, help them set up their screen so you can see their upper body as well as their face. You need to see the upper body in order to read their body language. Taking a few moments to set up their space sends the message that your time and your work together are important.
Physical comfort helps them relax, and sets them up to be present and thoughtful, which ultimately creates a meaningful connection and alliance with you.
Presence matters
In the session room, most therapists make a lot of eye contact, unless there are cultural reasons for not doing so. Do your best to look straight at the client, which means looking directly through the camera.
When you look straight into the camera lens, it appears to them as though they were in the room with you. If this feels too unnatural, keep your focus toward the upper middle of the screen.
Tablets and phones aren’t set up for eye-to-eye contact, and overall they’re not ideal for virtual sessions.
In portrait mode, we appear on a narrow screen. In landscape mode, the camera sits at the side of the device and makes you appear to be looking away from the person on the other end. A camera in the top middle of a computer screen is the best fit for a virtual therapy session.
The heart of our work relies on the power of connection, and that connection starts with you. Take time before each appointment to center yourself and shift from your previous session or your personal tasks. Ground yourself and connect internally to your strengths and skills.
Your client can feel it if you’re fully aware and in the moment. Consider short grounding exercises or building a posture that supports loving awareness. “Head over heart over pelvis” is a Yoga instruction that I find useful. You may be surprised by how much stronger and easier it is to connect through the computer when you’ve taken the time to check in internally.
A strong therapeutic alliance is our most significant tool, and we need to adjust how we’re establishing it as our work shifts to online. It’s about how we look, our presence, and our energy.
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