We are here to help as demand for mental healthcare in the UK increases during the COVID-19 outbreak.Find out more.

Delivering Remote Therapy Effectively Blog Series - Part Four

As Ieso's Chief Clinical Officer and chair of the BABCP IT Special Interest Group, Sarah Bateup provides advice and guidance to clinicians on how to adapt working practices and deliver therapy effectively during the current coronavirus outbreak. In this regular blog series, Sarah will cover many topics including:

  • The best preparation for seeing patients using digital therapy methods during COVID-19
  • Housekeeping and consent when moving to digital therapy methods
  • How to deal with patient contact in-between therapy delivery
  • The common phenomena when moving to non-face to face therapy delivery
  • …and much more.

As we navigate through the coming weeks and month and adjust to this changing world, we will provide guidance on digital therapy delivery, and what to think about and look out for during this challenging time.

Part four: The common phenomena when moving to non-face to face therapy delivery

When therapists begin to use delivery methods other than face to face, we tend to see a commonly observed phenomenon. Whether the method used is telephone, video conferencing or text-based communication, we find therapists struggle with pacing in the session.

All therapists are trained to deliver face to face therapy, and there is very little in the academic curriculum for CBT therapists that supports delivering therapy via alternative methods. Therefore, if you're finding delivering CBT using a different method challenging, then please don't feel disheartened. My experience is that only 10% of therapists will find the transition to digital delivery relatively easy, but for most of us, we will struggle in one way or another.

Therapists generally struggle with the pacing in the session because we're thinking about the structure of the session. As it feels a little different when we're online, we then speed up and race through processes. Rather than taking our time and ensuring we do a short assessment with a clear formulation and a considered differential diagnosis, and thinking if we've used the right measures or not. We tend to think about the protocols we're going to deliver when delivering them, and then race through the change mechanisms with the patient rather than socialising it with them first. By taking the time to use guided discovery, you can really ensure that the patient understands the change mechanism that you're working on together, and the rationale for that change mechanism.

The key message here is to slow down when using digital methods. Take your time. Go back to basics. Use more guided discovery, rather than leaning towards being didactic. That's not to say that being didactic is problematic, because clearly the psycho-education and providing instruction or teaching is very necessary from time to time. But often clinicians use other methods and tend to become more didactic. By taking a more guided, more Socratic approach, both you and your patient will reap the rewards and benefits just by taking time.

If you have some suggestions of things that you'd like Sarah to cover specifically, please email us at info@iesohealth.com.

Please take the time to read our other blogs by clicking the links below:

In an emergency
Call 111 - if you urgently need medical help or advice but it is not a life threatening situation
Call 999 - if you or anyone else is in immediate danger or harm
Call the Samaritans 24 hours a day on 116 123