The Best Practices for Online Family Therapy
Wednesday, August 14, 2024.
The world of family therapy has gotten a serious upgrade—or maybe a download—thanks to the rise of online communication tools.
Now, instead of gathering in a cozy office, families can hash out their issues in the comfort of their own homes, possibly still in their pajamas.
But making the switch from face-to-face sessions to virtual therapy isn’t just a matter of logging on and hoping for the best.
It takes a bit of finesse (and maybe a sense of humor) to keep things running smoothly.
Let’s dive into the best practices for online family therapy, with a few laughs along the way, and some real-deal social science research to back it all up.
Establishing a Secure and Confidential Environment
First things first—privacy is key. You wouldn’t want someone eavesdropping on your deepest family secrets, whether you’re in an office or on Zoom. In online therapy, making sure you’ve got a secure setup is just as crucial as making sure your teenager doesn’t have their camera aimed at their bedroom ceiling for the whole session.
Best Practice: Use encrypted communication platforms that are specifically designed for teletherapy. Therapists should gently remind clients to find a quiet, private space for their sessions—maybe even the elusive spot in the house where the Wi-Fi actually works. And yes, headphones are a great idea unless you want your therapy session to turn into a family-wide broadcast.
According to DeAngelis (2020), feeling secure in your online therapy platform isn’t just about tech—it’s about trust. When clients know their digital space is locked down tighter than Fort Knox, they’re more likely to open up about what’s really going on.
Building and Maintaining Therapeutic Rapport
Rapport. It’s the secret sauce of therapy—the thing that makes people feel comfortable enough to spill the beans. But let’s be honest, building that connection through a screen, where body language sometimes looks like an old-school stop-motion animation, can be a bit tricky.
Best Practice: Therapists should go the extra mile to engage each family member. Think of it as a virtual handshake (but without the germs). Open-ended questions, reflective listening, and the occasional encouraging nod can go a long way. It also helps to address the elephant in the (virtual) room: that Zoom isn’t quite the same as meeting in person.
Norwood and Atkinson (2020) found that while it might take a little longer to hit it off in online therapy, once you do, the connection can be just as solid as it is in person. So, if it feels a bit awkward at first, don’t worry—you’re not the only one.
Adapting Therapeutic Techniques for the Virtual Space
Some therapy techniques are like that pair of pants you’ve had since college—they just don’t fit anymore when you try to use them online. But that doesn’t mean they’re out of style; they just need a little alteration.
Best Practice: Therapists need to get creative, swapping out physical props for digital tools. Screen sharing, digital whiteboards, and other online resources can be lifesavers when it comes to keeping everyone engaged and on the same page (literally).
Burgoyne and Cohn (2020) emphasize that flexibility is the name of the game in online therapy. When therapists adapt their methods to the virtual world, clients are more likely to stay engaged—and maybe even enjoy the process.
Addressing Technological Challenges
Let’s face it: tech glitches are the modern-day equivalent of showing up late to your therapy session because of traffic. They happen, they’re annoying, and they can throw you off your game. But just like in real life, it’s all about how you handle them.
Best Practice: Always have a backup plan. Whether it’s switching to a phone call or rescheduling, it’s good to have a contingency ready when the inevitable Wi-Fi gremlins strike. A quick tech check before the first session can also help avoid those awkward “Can you hear me now?” moments.
McBeath et al. (2020) found that when therapists handle tech issues with patience and competence, clients are more likely to stick with online therapy. So, don’t sweat the small stuff—just keep calm and reboot.
Managing Group Dynamics in a Virtual Space
Family therapy is all about navigating group dynamics—kind of like herding cats, but with more talking. In a virtual setting, managing these dynamics can be even more challenging when you can’t pick up on every non-verbal cue.
Best Practice: Set some ground rules early on, like taking turns speaking or using the “raise hand” feature (yes, it’s there for a reason). If things get heated, therapists can use breakout rooms or the chat function to give everyone a little space to cool off.
Glueckauf et al. (2018) found that laying down the law early—by which we mean setting communication guidelines—can make online sessions smoother and more productive. Think of it as the virtual version of a talking stick, but with fewer splinters.
Fostering Engagement and Participation
Keeping everyone engaged in an online therapy session can be a bit like trying to keep a group of toddlers interested in a lecture on tax law. Distractions abound, and it’s all too easy for participants to mentally check out.
Best Practice: Spice things up with interactive elements like polls, quizzes, or shared documents. Regular check-ins with each participant can also help keep everyone on track and make sure no one’s sneaking off to check Instagram.
Madigan et al. (2020) suggest that interactive and multimedia elements can be game-changers for online therapy engagement. When clients are actively involved, they’re more likely to stay focused and make meaningful progress.
Cultural Sensitivity and Inclusivity
Cultural sensitivity is important in any therapy setting, but online therapy adds a layer of complexity. Without the full range of non-verbal cues, it’s even more important to be mindful of how cultural differences might impact communication and comfort.
Best Practice: Therapists should take the time to understand the cultural backgrounds of their clients and tailor their approach accordingly. This might mean using culturally relevant examples or being extra mindful of language differences and digital literacy levels.
Sue and Sue (2016) remind us that cultural competence isn’t just a buzzword—it’s essential for building trust and rapport in therapy. And in an online setting, it’s even more critical to get it right.
Final thoughts
Online family therapy offers a unique opportunity to support families who might otherwise have limited access to therapy.
Consider following these best practices—establishing a secure environment, building rapport, adapting techniques, managing technology, navigating group dynamics, fostering engagement, and being culturally sensitive—therapists can ensure that their online sessions are just as effective (and maybe even more convenient) than in-person therapy. So, while the medium may have changed, the mission remains the same: helping families connect, communicate, and thrive.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Burgoyne, N., & Cohn, A. S. (2020). Lessons from the Transition to Relational Teletherapy During COVID-19. Family Process, 59(3), 974-988. https://doi.org/10.1111/famp.12589
DeAngelis, T. (2020). Teletherapy transforms how psychologists work. American Psychological Association. https://www.apa.org/monitor/2020/07/cover-teletherapy
Glueckauf, R. L., Maheu, M. M., Drude, K. P., Wells, B. A., Wang, Y., & Gustafson, D. J. (2018). Survey of psychologists’ telebehavioral health practices: Technology use, ethical issues, and training needs. Professional Psychology: Research and Practice, 49(3), 205-219. https://doi.org/10.1037/pro0000188
Madigan, S., Racine, N., Cooke, J. E., Korczak, D. J., Eirich, R., & Tough, S. (2020). Maternal Adverse Childhood Experience and Infant Health: Examining the Roles of Maternal Mental Health and Negative Parenting Practices. Developmental Psychology, 56(4), 688–700. https://doi.org/10.1037/dev0000894
McBeath, A. G., du Plessis, C., & Bager-Charleson, S. (2020). The challenges and experiences of psychotherapists working remotely during the coronavirus pandemic. Counselling and Psychotherapy Research, 20(3), 394-405. https://doi.org/10.1002/capr.12326
Norwood, C., & Atkinson, S. (2020). Online versus in-person therapy: A mixed-methods investigation. Journal of Marital and Family Therapy, 46(3), 465-482. https://doi.org/10.1111/jmft.12405
Sue, D. W., & Sue, D. (2016). Counseling the Culturally Diverse: Theory and Practice (7th ed.). Wiley.
