Remote Therapy Is Bad for Therapists: Why You Want Your Therapist at the Office
November 30, 2023
Remote therapy is easy, but working entirely remotely is bad for therapists
As COVID has become less of a concern, many therapists still only provide remote therapy. Understandably so—working remotely saves money on office costs and cuts out the commute for therapists and patients alike. It also helps that therapy is one of the easier jobs to do remotely. Unlike most medicine, therapy doesn’t require special equipment and it’s supposedly “just talk.”
Another reason for the influx of remote therapy is that workplace culture is, in many ways, broken. For years, employers took workplace culture for granted, mishandled return-to-work policies, and offered absurd perks rather than examine the real issues of equity, decision-making, diversity and disability, flexibility for workers who are parents or students, and harassment and discrimination. Undervalued employees have strained to work under these tough circumstances, making working from their kitchen table that much more appealing.
Yet, many employees are now finding something lacking without an office environment. Therapy is no different. In fact, working entirely remotely is bad for therapists (as is private practice). For the best therapy, patients should want their therapist to be in the office of a supportive and collaborative group practice.
We bring our whole selves to therapy, including our physicality
There is an assumption that therapy is only talk (and even if it was only talk, there is evidence from neuroscientists that our brains don’t process video chat the same way as in-person conversations). However, therapy is an embodied experience. Therapy trades on transference—some of the most meaningful parts of therapy are worked through the relationship with the therapist. This can include the impact of being in someone’s space or noticing aging, annoying habits, movement, smells, and sounds.
We bring our stature, our breath, and how we move in and out of space into the therapy room. These can all be raw data. For instance, on a basic level, symptoms like anxiety, fear, and depression show up in our bodies. We jump at the sound of the buzzer. We slouch when talking about our mother. The panic is so bad that our knees are shaking.
Not all of these are impossible to communicate through a screen, but it’s much harder. And even then, a lot of importance gets left out. We talk in therapy about the idea of the “whole self.” This evokes the idea of integration, meaning the ability to be with all of ourselves, even the parts that are painful and unpleasant. It also relates to showing up with and having all of ourselves revealed. Our bodies, in particular, are inseparable from ourselves.
A therapist does their best work in an office with an infrastructure of collective support
Even if you have to log in to therapy remotely, patients still benefit from a therapist being in an in-person workplace built with an infrastructure of collective support. Therapy is fairly easy to do well enough: Show up, be supportive, and offer advice. For some people, that’s enough. But lasting change and grappling with nuances of personality and lifelong suffering takes much more work.
At best, a therapist in private practice might have an hour per week of individual or group supervision (and most don’t—this is only required for the first few years of practice) and (hopefully) an hour or two a week of their own therapy. This leaves therapists isolated to grapple with huge clinical challenges, ethical quandaries, and personal struggles that can make the already hard work of therapy that much harder, risking burnout.
In contrast, therapists in a supportive group practice office can create an environment that makes room for both struggle and balance. Colleagues are able to notice what an individual therapist isn’t recognizing alone. They can pull their colleague aside and say, “Hey, you seemed angry after your 10 am,” or, “How are you doing since your breakup last month? I wonder if it’s hard to work with couples who are struggling with whether or not to stay together when you’re going through it?” Even something as simple as sharing lunch, coffee, and good cheer can make better therapists. Rather than a mere hour of supervision a week, therapists have the best resources at hand to show up with good energy and exactly what they need to do the work.
