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By Beverly Ford
Opening up in therapy isn’t easy. An added challenge? Opening up in therapy when your roommates or family members are nearby.
Courtney Campbell, a 19-year-old freshman at Clark University in Worcester, knows this first hand. Since transitioning to remote therapy as a precaution during the COVID-19 pandemic, she has found it difficult to find the private space she took for granted during in-office therapy sessions. “It’s really uncomfortable not to have total privacy at home,” she says.
Now, Campbell either has to reserve private time in her shared dorm room or navigate her family home, surrounded by parents and a younger sister. Even hunkered down in a bedroom behind closed doors, she says, she worries about her sessions being overheard.
Campbell is just one of the many people to start remote therapy, which serves the same purpose as in-person therapy but via the phone or video conferencing, since COVID-19 appeared earlier this year.
“There is a great demand on practitioners right now,” says Danna Mauch, president and CEO of the Massachusetts Association for Mental Health, citing the increased stress and anxiety of the pandemic as part of the reason. And more and more sessions are being conducted remotely. In fact, a national study conducted by researchers at Virginia Commonwealth University found before the pandemic, psychologists reported conducting less than 10% of their clinical work through remote therapy. Now, that number is above 85%.
Research shows that video sessions are as effective as in-person visits, notes Dr. Ken Duckworth, medical director for behavioral health at Blue Cross Blue Shield of Massachusetts. For many people, who live far away from a therapist or can’t fit a commute into their schedule, it’s also a more convenient option. But remote therapy does come with its own challenges. Especially now, with many peoples’ partners or roommates working from home and children doing remote or hybrid school, one of the biggest obstacles is recreating the feeling of privacy and comfort of a therapist’s office at home.
But experts say you don’t need to invest in soundproofing to consider remote therapy. Instead, use these tricks to add privacy to sessions.
1. Find your comfort zone in advance
To get the most out of therapy, you should be able to share your thoughts and feelings without censoring yourself, even subconsciously. That’s why it’s key to scope out a quiet location away from distractions, interruptions, and the rest of your household even before starting your first phone or Zoom therapy session, says Dr. Adam Licurse, a primary care physician and executive director of virtual care at Brigham and Women’s Hospital in Boston.
“If possible, we want people to recreate the environment they have when they come into a practice,” says Licurse. “Go someplace quiet, shut the door, and let the people around you know you are discussing your health.”
Some rooms in your apartment may already have thicker walls than others. Try testing out which space is the most private by playing a podcast or TV show in various rooms while standing outside and hearing how well the sound travels.
For those who share a home with roommates or relatives, try designating a private room that can be reserved—perhaps via a whiteboard schedule on the door of the room—for therapy sessions, important meetings, or general quiet time to get away. After all, you may not be the only one in your house looking for privacy. You can even have a household “do not disturb” sign as a reminder when the room is in use.
2. Design your space to your advantage
It’s beneficial to make yourself feel as comfortable as possible in the space too, says Martha Rettig, who teaches communication design at the Massachusetts College of Art and Design in Boston. Surrounding yourself with plants, photos, favorite books, or calming colors have all been shown to alleviate stress and improve mood, for example.
Prepare your space with everything you’ll need in advance of your therapy appointment so you won’t have to leave to get anything mid-session, and potentially run into housemates. Many therapists’ offices are stocked with water and tissues on hand. Take a cue from them, and make sure these comforts are available in your space too.
A pair of headphones can ensure your therapists can only be heard by you. They can also help you focus on the conversation by drowning out any outside noise, potentially even helping you calm fears of being overheard.
Consider keeping a notebook nearby to jot down ideas and practices you want to remember from your therapy sessions, either during your conversations or immediately after. If you leave your space and re-enter the chaos of everyday life too quickly, you may find yourself forgetting what you discussed with your therapist faster.
3. Make some noise
You can be strategic about when you schedule your session in addition to where. Ask for a time slot when there are more voices elsewhere in your home to drown out your therapy conversation. For example, mid-day when your partner is on work calls and your kids are busy with remote schooling may feel more comfortable than early morning when you’re the only one in the house making a sound.
You can further use sound to your advantage by turning on music or a white noise machine in the room you’re using to muffle your conversations, suggests Dr. Lynn Bufka, senior director of practice transformation and quality at the American Psychological Association. Campbell does this by turning on a fan near her door to buffer the sound of her therapy sessions from family when she’s at home.
If you feel comfortable asking others for alone time, do so. This strategy has worked well for Campbell.
“In the dorms, I try to arrange my therapy around my roommate’s schedule or I will tell her I have a Zoom call or an appointment and I need to be alone,” she says.
The best practice for Campbell has been to be straightforward: “Just communicate with people,” she says. “People can be more accommodating than we expect them to be at times.”
This goes for communicating with your therapist too. Some therapists may offer the flexibility to schedule sessions outside of normal office hours if that’s when you have the most privacy. If a morning or evening slot would work best for you, try asking about this when scheduling your next appointment.
5. Think outside the box
Not all therapy needs to be conducted by video. Doing therapy over the telephone can give you the flexibility you need to find true privacy, especially if you simply are not comfortable having these conversations at home for any reason. With your phone, sessions anywhere outdoors become an option.
For times when she’s unable to coordinate schedules with her roommate, Campbell looks for other private spots on campus. She has found taking walks, sitting in her car, or going to a quiet area outside her dorm can offer the privacy needed for a therapy session.
Beaches, parks, or nature reservations can offer the privacy you crave for outdoor remote sessions. Don’t forget those green spaces outside your front door either. Look for a quiet spot in your neighborhood—a vacant playground or ball field—that may fit your privacy needs. Therapy can be conducted effectively in many different places, and the best place depends on your individual circumstances. Just make sure you have your phone charged up enough before your session.
And remember, it often takes new therapy patients time to feel fully comfortable sharing their private thoughts and feelings, and remote therapy is no different. Give yourself the patience you deserve as you navigate another new element of pandemic life and learn what works best for you.