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Pros and Cons of Telehealth

Therapists are trained to assist clients during a crisis.  We are trained on how to de-escalate and stabilize the situation. We are trained to remain calm so that our clients trust that we can meet their needs. But what happens when the client and the therapist are experiencing the same crisis at the same time?

In my career, I can’t recall another world event that has impacted me personally and professionally the way this pandemic has.

On the clinical services team at Holt, there were definitely stages that occurred in which we were all trying to find our footing and then taking small steps toward stabilization. Video therapy became the only safe way for us to continue providing services to our clients, and we quickly transitioned to doing therapy through a computer instead of in person. Below is a list of pros and cons that I have developed based on my personal experience during this transition.


  • I was able to get a glimpse of how my clients lived. For kids, one of their favorite things was to show me their pets. Pets provided a huge amount of emotional support and healthy distraction during the pandemic.
  • We could schedule days and times that were never possible before due to school and work. Flexibility was freeing for many clients and therapists.
  • No-shows and cancellations decreased. Because clients did not have their usual schedules and extracurricular activities, they typically looked forward to our sessions!
  • Most were more comfortable in their own homes. They were able to do more processing than normal because they were more relaxed.
  • We had to come up with innovative ways to work with our clients. This was positive for clients because they were able to participate in new activities while therapists gained new resources for working with them.


  • I miss being in the same space as my clients. I rely heavily not just on facial expressions, but full body language. There is an energy we all receive and need when in physical proximity with one another.
  • Working with younger children has been quite the challenge. When working with kids who have difficulty self-regulating, they don’t want to sit still in front of a computer or phone screen!
  • Technological difficulties! We have to rely on a good internet connection and a platform that doesn’t crash. This can also cause frustration when a client is expressing something and they “freeze.” Asking them to repeat themselves breaks the moment of vulnerability and connectedness.
  • It’s easier for younger kids to refuse to participate. They can just walk out of the room or distract themselves with things in the room. This can happen in the therapy office too, but we have ways to get them to engage when in person.
  • We are limited as therapists who practice playfulness with our clients. We can’t get on the floor with them and enjoy being in the same space.

What have I learned?  My main practice will be face-to-face/ in-person therapy.  But I have learned that video sessions can be a great tool in certain circumstances for providing services.

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