Author Archives: ccook

Computer Keyboard

New Ways of Arriving: Counselling in an Online Context

Telehealth counselling, remote counselling, video sessions – before this year, I had never wanted to specialize in electronic therapy formats.

There’s a scene in the film Star Trek: First Contact, where the medical officer Dr. Beverly Crusher says, “I swore I would never use one of these,” and then activates a holographic doctor to help when an infestation of robot-zombies, called the Borg, are determined to infect the ship.

I was not as extreme as Dr. Crusher – I never swore off electronic counselling formats – but almost. Now, I can’t imagine my private practice without them. These formats allow me to connect with clients who might not otherwise be able to access counselling services. They enable clients to explore session content in their own homes, where they also might put the insights and tools they gain in session into practice.

But I’ve been reflecting on the journey to the counselling office. The actual physical act of going there. I miss it. I wonder if my clients miss it, too?

Each workday, I would walk over to my office, climb three flights of stairs, unlock the front door, turn on the lamps and radio in the waiting room, and settle into my office chair for sessions. At the end of each workday, I would do the same thing in reverse, a coming-and-going ritual that I took for granted until it was gone.

Before and after each in-person session, my clients would also move through a ritual. Some might walk to the office, or ride their bike, or take the bus, but arriving and leaving a counselling session was a journey rather than a single act – not just turning on a laptop, picking up the phone, or waking up a tablet.

On my journey to the counselling office, I would settle my mind on my work for the day, or let myself focus on the world I was moving through, centring and focusing. Of course, I’m romanticizing – sometimes, I was utterly distracted or running late, and the trip was hectic. On my journey from the counselling office, I would partially process the day’s work through movement. Again, I’m romanticizing, but the point is, some days, going to and from the office supported my work. And now that support is missing.

For clients, the trip to a specific space where they engage in counselling may also promote focus, and clients may very well process the content of their session partially on their journey home. What is more, the movement to and from the counselling office provided a physical representation of a border, a boundary between therapy work and the rest of our lives that permitted us to leave the work in the counselling space between appointments. I believe such a border is essential.

So I’ve been trying to move at the start and the end of my counselling days. And I’ve been encouraging my clients to do the same. We may not be making the journey to and from the therapy room, but we can still create movement-based rituals that mark arriving at and leaving the electronic therapy hour. I walk around the block; I go for a run; I dance to my favourite song on repeat.

The holographic doctor that Beverly Crusher activates in First Contact proves indispensable, giving her and her patients enough time to escape the robo-plague. Electronic therapy is how I’ve conducted the majority of my counselling sessions this year, and has become crucial to my private practice.

But the need remains for movement – rituals of coming and going from the therapy room. These rituals extend counselling beyond the therapy hour, providing a liminal space to process, and, if need be, to partition the work until we can return to it.

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Chris Cook is a second-year counselling psychology Ph.D. student at the University of British Columbia. A therapist and a playwright, Chris runs a private practice in Vancouver, BC and – now – online, and loves Star Trek.

 

“Computer Keyboard” by Ian Britton is licensed under CC BY-NC 2.0