Many of the triggers for clients’ anxieties are in the outside world. For someone with social anxiety issues, even getting on a bus and having to buy a ticket from the driver can be too much. When we went into lockdown, all of these triggers were removed from their lives. The result was that clients with social anxiety issues were actually quite happy. Bizarrely this made counselling someone with these issues more difficult. Being uncomfortable drives change but these clients weren’t uncomfortable any more. Even if we did develop coping strategies, there was no opportunity for the client to try them out and provide feedback on the experience in the next session.
When using Zoom we have no control over the environment at the client’s end. My most unusual session had a backdrop of a car on an hydraulic ramp going up and down. On a more serious note, there have been a few instances of parents interfering. We had to suspend counselling one of my clients because a parent insisted on sitting off camera and whispering prompts to the client.
Including assessments, I have now seen about 75 clients remotely. Despite a few challenges, overall it has worked remarkably well and there have been some definite advantages. For example, I have been able to seamlessly complete a course of counselling even though the client relocated to a far away university after session 3. Many YPs are more comfortable communicating via zoom than they are face to face. For some clients, joining a counselling session from the comfort and familiarity of their home has been helpful for them. There are solutions to the issues around confidentiality, one client used to attend our zoom sessions on her phone from her mother’s car parked in the driveway. Another joined from her camper van parked in the company car park.
The thing I miss the most is not being able to use artwork in therapy. I can get a client to draw something but the process as to how they draw it I find far more revealing than the end result. Via Zoom I cannot see the order they draw the items in the artwork, nor can I see the energy and time taken for different parts. Even the effort deciding what colours to use is hidden.
My personal opinion is that we will never go back to 100% face to face counselling. The advantages of comfort, convenience and accessibility for the client plus the greater capacity and lower cost for YPI are too significant to ignore, but for some clients face to face will be the only viable option.
COVID-19 will permanently change how we deliver our counselling service.