TeleHealth is used when Face-to-Face is not available. TeleHealth literally comes from “tele” meaning distance, and “health”. Joshua Davidson Therapy offers TeleHealth in the forms of Video and Phone. Medicare rebates and NDIS funding can be used for TeleHealth services.
TeleHealth can be very useful when you are feeling like you might be coming down with a contagious illness, such as a cold, flu or Covid-19. TeleHealth can also be used for people conditions that make coming for a Face-to-Face difficult, such as Anxiety, Depression and ADHD.
There are some useful things you can do to make your TeleHealth experience good.
While our counselling rooms are private and sound dampened, your home, office or park likely isn’t. Try to find a location that is not too loud and that you can get enough privacy to talk freely.
As TeleHealth isn’t in person, we want the best connection you can get. Try to ensure that your device has good reception; either to the mobile network or to the internet (preferably a good wifi connection and internet speed).
Ideally use a computer with a reasonable quality web camera, however a mobile phone will do if needed.
Wearing earphones both helps you hear me well, and separates the microphone from the speakers, which helps us to hear you better.
Make sure that your battery devices are well charged (where relevant). It can be very frustrating to run out of charge part way through the session.
Please dress as you would to go out. This is a formal session, not an informal one.
We will generally check when we call you that this is an appropriate time, just in case something unexpected has come up.
It works better not to speak over each other, thus giving space for the other person to speak is important. Due to the delays inherent in technology, it is important to give a little bit more time between statements for the other person to say something. A pause that works well in Face-to-Face is a fraction of a second, while a pause that works well in TeleHealth is about 2 seconds. This makes it clear that the other person can speak.
Try to avoid having background sounds going on, such as the television, music, industrial noise and so on. Computers and phones seem to pick these up very well and in preference to you.
It is hard to read the expression, body language and voice tone in TeleHealth, which can easily lead to misunderstandings. If you perceive something odd, please explicitly ask for a repeat or clarification before taking to heart a likely bad transmission.
Sometimes there will be multiple people in the room, or multiple people in a call. This can make TeleConferencing quite challenging.
It is important to introduce everyone in the conference discussion and how they relate to the client(s) at the heart of the discussion.
Multiple People in a Room
If there are multiple people in a room, headphones will not be possible. Try to have the microphone pickup as far from the speakers as you can, and still have it loud enough for all people to hear the speakers.
When multiple people are talking it is very hard for the microphone to pick up everything that is said. Try to have only one person speaking at a time, which includes people who are on the other end of the TeleHealth call (not in the room).
Multiple People on Multiple Devices
The more people on different devices the technology has to connect, the harder the technology finds it to keep all communication synchronised. This means that the delay of 2 seconds when you want to allow someone else to say something should be strongly adhered to, perhaps even extended to around 3 seconds.
If needed, a signalling system can be created so that everyone knows who’s turn it is to talk. Generally we facilitate who is talking and what the topic is, but we are open to someone else taking on that role.
Some Further Notes
As stated above, while TeleHealth technology is impressive, there are some technological limits, such as the already mentioned need to add extra time in pauses, and extra consideration to the chances of misunderstandings – arguing over TeleHealth is never a good idea!
Convenience has a Cost
While TeleHealth is very convenient, there are some limitations to it. Part of what we do as therapists is to do ongoing physical assessments to looks for tells, traits and both emotional and cognitive responses. This is much harder to do on a phone call, and still quite hard on a video. There are important clues to what can be at the root of someone’s experience that can best be seen in a Face-to-Face meeting.
We often find that TeleHealth calls progress at about half the speed of Face-to-Face.
TeleHealth is more fatiguing than Face-to-Face. This is generally because of the extra cognitive work load in trying to compensate for the technological limitations whilst also processing some inner aspects of self. Here are a few things to reduce this:
- Be in a quiet location. If you do need to pace, try to do so in quiet areas.
- Wear headphones to get a clearer audio signal
- Put the screen at arms length or more – if you see a therapist Face-to-Face they are generally further away, our brains don’t like people in our personal space even if it is on a screen.
- Remember to slow the discussion down, and keep it to one person talking at a time