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Zoom Therapy: Tele-Therapy During COVID-19

Tele-therapy; image licensed from Adobe Stock

Zoom Therapy, otherwise known as Tele-Therapy or Tele-Health has become a common practice for many therapists during the COVID-19 pandemic.

Recently, I attended a Zoom Happy Hour with my therapist colleagues, and we got to talking about Tele-therapy.

At the start of the Pandemic, I was happy to show my clients my home office space, and they gladly showed me theirs. I met their dogs, cats, children, and even some family members. These interactions were all relevant for the therapy that was going on with my clients.

Since then, during the 11 months of Zoom therapy, I have counseled people from their beds, cars, closets and empty bathtubs.

Of course, they are seeking private spaces, so they needed to get creative. My colleague told me I was completely unprofessional. I couldn't disagree more.

Therapy is all about transparency.

Zoom tele-therapy like is much like doing In-Vivo therapy, similar to the olden days of in-home family therapy in which the client is in the environment that stresses them.

Zoom Etiquette

Yes, if you are about to go into a business meeting then by all means you might want to follow the social norms, see below.

For a therapy experience, get comfy and have your tissues ready. It is helpful for me as the therapist to see the client's life; warts and all.

I do request that people have adequate light for me to see them. Reading facial expression is important. This is different from in-person therapy. In a therapy office, we tend to use soft lighting, so things aren't as harsh.

Perceived "Norms" of Zooming

Reviewing several sites that outline "best practices" on Zoom calls, here are some highlights of what Zoom experts recommend:

In “normal” times, when we get dressed, we look at the proportions of the whole body and how they balance one another. However, when our visual impression is restricted to a small box on screen, it is harder to make an impact.
What you wear around your face is key, as the focus during these calls will be on your top half. Therefore, color is vital and wearing flattering colors important for you to look healthy on screen. This is your cue to offer a Color Analysis session – especially if you can do this virtually!
Earrings can bring a focus to your face. This is especially important if you have short hair. However, avoid big, excessively dangly earrings as they will become a distraction. I would also avoid lots of bracelets as these can be noisy if you move your hands around when you are talking...
And finally, tick the “Touch up my appearance” button in the video settings within Zoom. I'm not sure if it makes any difference but I'll take all the help I can get! (

For a therapy session, anything goes. No makeup is necessary, no need for jewelry and if you aren't interested in seeing yourself — feel free to use the “Hide Myself” feature that Zoom provides.

Should you stage your background?

One common question in the age of Zoom meetings is whether you should be using a virtual background.

Some industry experts swear by it, citing virtual backgrounds may help keep the conversation focused rather than introducing unnecessary distractions, such as clutter.

Stage your video area: Keep in mind that people aren’t just seeing you, they’re also seeing whatever the camera is pointed at behind you. Maybe arrange it so that your camera isn’t facing towards a pile of unfolded laundry? (

How do you make a virtual meeting interesting?

Virtual tele-therapy is always interesting.

One client had an emergency meeting at another location and it ran late, so he logged in while driving home with me. He is a single dad, and it was really a rich session.

When he arrived home his dog hadn't been fed or let out and had an accident. All on a Zoom meeting with me, he had to let the dog out and clean up the mess.

Additionally, his teen-aged daughter had broken something on the floor and hadn't clean it up. And he needed to feed the dog.

At that point, I understood the complexity and busyness of his life. We spent the rest of the session talking about his stress and ways to manage it.

Given that I was there watching, it was rich indeed.

How do you connect with someone on a deeper level?

Clarify nicknames and preferred names: We can then take ownership for referring to people as they wish, not in whatever way is most convenient or memorable for us. (

Of course, therapy Zoom meetings are generally deep and emotional given the nature of the topic. That said, I recently learned someone's preferred pronouns. I hadn't asked previously and saw it on the screen. It provided fodder for a good discussion.

How do I make connections better with people?

Grab your cup of coffee or tea, scoot over to the screen and just be you. Virtual meetings don't have to be different from in-person meetings.

Sometimes it seems that because people are in their own environment that they are more relaxed, more open and can go deeper than in the office.

It might be easier to make a personal connection this way. In the business world, video meetings might be more formal, but meeting with your therapist is different.

So, I am not sure what my colleague says to his clients that they have to be formal.

It makes all the sense in the world to me to have my clients meet where it is private, safe and comfortable for them... even if it is a bathtub. I don't have any questions about it!

Tele-therapy; image licensed from Adobe Stock

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1 Comment

Nathan Adrian
Nathan Adrian
Jul 22, 2022

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